MedicaidPrior AuthHigh impact
26-407 Updates to Prior Authorization Requirements
Health Net·CA·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Health Net California is updating prior authorization requirements for various codes, effective January 1 through June 1, 2026. The changes apply to all provider types including physicians, hospitals, and ancillary providers in specific California counties.
Action Required
By January 1, 2026: Billing team must download the Provider Update PDF from Health Net California's provider library to review specific prior authorization code changes. Update billing system and workflows to reflect new prior authorization requirements for affected codes. Verify patient eligibility in the specified California counties (Amador, Calaveras, Inyo, Los Angeles, Molina, Mono, Sacramento, San Joaquin, Stanislaus, Tulare, and Tuolumne) before submitting claims.