MedicaidPrior AuthHigh impact
Quarter 4 - 2025
Molina Healthcare·CA·Provider Bulletin
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Molina Healthcare of California is implementing new federal requirements for prior authorization turnaround times, reducing standard request processing from current timeframes to 7 calendar days effective January 1, 2026. Providers must ensure complete clinical documentation is submitted with initial requests to avoid delays and comply with the new CMS-0057 Final Rule requirements.
Action Required
By January 1, 2026: Billing team and providers must update prior authorization submission processes to ensure all required clinical documentation is included with initial requests. Review current prior auth workflows and identify documentation gaps. Train staff on complete submission requirements since Molina must now respond within 7 calendar days instead of current timeframes. Incomplete submissions will cause delays in patient care access.