MedicaidDocumentationHigh impact
25-1114 Hospice Documentation Deadlines Enforced Starting January 8, 2026
Health Net·CA · Palliative Care·Prior Authorization
Effective date
Jan 8, 2026
We identified it
Jun 20, 2026
Summary
Health Net will strictly enforce hospice documentation deadlines starting January 8, 2026, requiring all required documentation to be submitted within 5 calendar days of hospice election. Services will not be reimbursed for any dates prior to receipt of completed documentation, and coverage is now limited to in-network hospice providers unless medically necessary services are unavailable.
Action Required
Before January 8, 2026: Billing team must implement strict 5-calendar-day documentation submission timeline for all hospice elections. Update workflow to ensure all required certifications are submitted immediately upon hospice election. Verify all hospice providers are in-network before services begin. Access and utilize Health Net's Hospice Services Documentation Guide in Provider Library. For outpatient hospice: send documentation via encrypted email to Hospice CTI forms. For inpatient hospice: obtain prior authorization and attach all documentation. Failure to meet 5-day deadline will result in non-reimbursement from admission date until documentation is complete.