CommercialAdministrativeMedium impact
CA HMO providers arranging for medically necessary network exception requests
Cigna·CA·Network
Effective date
Apr 1, 2024
We identified it
Jun 19, 2026
Summary
California HMO providers must arrange medically necessary out-of-network care within state time frames and geographic standards. Providers should fax network exception request forms to Cigna Healthcare at 800.558.3710 only when the services are Cigna's financial responsibility according to their contracted division of financial responsibility (DOFR).
Action Required
Immediately: California HMO providers must establish process to determine financial responsibility per contracted DOFR before arranging out-of-network care. Fax network exception request forms to Cigna Healthcare at 800.558.3710 only when services are Cigna's financial responsibility. Ensure all medically necessary out-of-network care is arranged within California state time frames and geographic standards regardless of financial responsibility.