MedicaidPrior AuthHigh impact
Complete Hospital Admission Notification & Authorization Request Submissions
L.A. Care Health Plan·CA·Prior Authorization
Effective date
Apr 28, 2026
We identified it
Jun 20, 2026
Summary
L.A. Care Health Plan now requires hospitals to submit complete clinical documentation (H&P, ED notes, progress notes, lab results, etc.) along with the admission face sheet for all inpatient authorization requests. Face sheets alone will no longer be processed, and incomplete submissions will cause delays or denials.
Action Required
Immediately: Hospital billing teams must update admission notification workflow to include ALL required clinical documentation with face sheet submissions. Use consolidated fax submissions to (213) 438-5063. Ensure H&P, ED notes, progress notes, admission orders, and relevant lab/imaging results are included in every packet. Incomplete submissions will not be processed for medical necessity review.