MedicaidPrior AuthHigh impact
26-741 Provider Communications Posted Online and Operations Manual Updates for May 2026
Health Net·CA·Prior Authorization
Effective date
May 12, 2026
We identified it
Jun 20, 2026
Summary
Medi-Cal updated prior authorization timelines from seven calendar days to five business days or seven calendar days (whichever is less), effective May 12, 2026. Additional updates include youth trauma screening requirements affecting claims reimbursement and newborn capitation payment procedures.
Action Required
Immediately: Billing team must update prior authorization request timelines for Medi-Cal patients to five business days or seven calendar days (whichever is less). Update workflow procedures and staff training materials to reflect new timeline. For youth trauma screening: Review claims processes for Medi-Cal members under age 21 to ensure compliance with new screening requirements effective April 1, 2026, as non-compliance may affect reimbursement.