MedicaidPrior AuthMedium impact
26-592 Medi‑Cal Hospice Prior Authorization Update for Hospice Providers
Health Net·CA · Palliative Care·Prior Authorization
Effective date
Jul 9, 2026
We identified it
Jun 20, 2026
Summary
Starting July 9, 2026, Health Net Medi-Cal managed care will require prior authorization for outpatient hospice services (routine home care, continuous home care, and respite care). Hospice providers must submit prior authorization requests with required documentation to support medical necessity before providing these services.
Action Required
Before July 9, 2026: Hospice providers must update workflows to submit prior authorization requests to Health Net for all outpatient hospice services (routine home care, continuous home care, respite care). Ensure billing team has processes in place to obtain prior auth with required documentation including Certificate of Terminal Illness, Election Notice, written care plan, and applicable transfer/discharge summaries before claim submission. Contact Health Net Provider Services at 800-675-6110 for questions.