Health Net News Now

Health Net News

Health Net's Care Management Team Recognized by Department of Health Care Services

Get Thoroughly Prepared for California IFP 2027 Open Enrollment

Electronic Prior Authorization Changes Begin January 1, 2027

Beginning January 1, 2027, key provisions of the Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization Final Rule (CMS-0057-F) will require certain health plans to support electronic prior authorization through standardized technology. The goal is to improve information sharing between providers and health plans while reducing administrative burden and improving transparency.

Under the new requirements, healthcare providers will be able to electronically determine whether prior authorization is required, review documentation requirements, submit authorization requests directly through electronic health record (EHR) systems, and receive approvals, denials, or requests for additional information electronically. The rule does not eliminate prior authorization requirements or medical necessity reviews. Instead, it modernizes how information is exchanged between providers and health plans.

Health Net is actively preparing for these changes; however, it is important to understand that implementation may vary by carrier, product, and provider system. While CMS requirements apply to certain Medicare Advantage, Medicaid, CHIP, and federally facilitated Marketplace plans, carriers may differ in how and when they adopt similar capabilities for other products.

As the 2027 deadline approaches, electronic prior authorization is expected to make the authorization process more efficient and transparent, helping providers and health plans exchange information more quickly while maintaining existing coverage and medical necessity standards.

In the Community

Health Net Invests $4 Million to Expand Affordable Housingin Modesto

Health Net has awarded a $4 million grant to Self-Help Enterprises to support the development of Morris Village, a new affordable housing community in Modesto. The project will create 45 affordable homes for individuals and families facing housing instability in Stanislaus County.

The investment will help close the project's funding gap and enable construction to begin in late 2026, with completion expected in 2028. Future residents will also have access to community resources and support services designed to promote long-term stability and well-being.

"Safe, stable housing can make a lasting difference in a person's health and well-being," said Dorothy Seleski, President of Medi-Cal at Health Net. "Our $4 million investment in Morris Village reflects our commitment to addressing the root causes of poor health outcomes in the communities we serve. When people with serious health needs have a stable place to call home, they are better able to manage their conditions, stay connected to care, and build a more secure future. We're proud to partner with Self-Help Enterprises to help bring this community to life in Modesto."

Health Net's grant will help Self-Help Enterprises close the project's remaining funding gap so it can begin construction. The 44 affordable homes will support residents earning below the median income for the area.

"Affordable housing is one of the most urgent needs facing families across Stanislaus County, and Morris Village represents exactly the kind of investment our community deserves," said Stanislaus County Supervisor Mani Grewal. "Health Net's $4 million commitment, combined with the expertise and dedication of Self-Help Enterprises, will help Modesto residents build healthier lives, stronger neighborhoods, and a more resilient community. I am proud to support this project and grateful to Health Net and Self-Help Enterprises for their support."

Since 2020, Health Net has committed $93 million to housing and homelessness initiatives across California, reflecting its ongoing commitment to addressing social factors that impact health and improving outcomes for vulnerable communities.

For more information visit our Health Net Newsroom.

Wellness

September highlights several national health observances that can help encourage prevention, early detection and healthier lifestyles.

Healthy Aging Month

A reminder of the importance of staying active and maintaining healthy habits as we age. Explore healthy aging resources from the Office of Disease Prevention and Health Promotion.

National Childhood Obesity Awareness Month

Healthy eating and physical activity can help children build lifelong healthy habits. The CDC offers tips for parents and caregivers.

National Recovery Month

Sponsored by SAMHSA, National Recovery Month raises awareness of mental health and substance use recovery and the resources available to support individuals and families. Learn more.

National Sickle Cell Awareness Month

This observance helps increase understanding of sickle cell disease, available treatments and the importance of newborn screening. Explore resources.

HIV/AIDS Awareness Days – Sept. 18 & 27

September also includes National HIV/AIDS and Aging Awareness Day and National Gay Men's HIV/AIDS Awareness Day, both emphasizing HIV education, testing, prevention and treatment. Visit CDC HIV resources.

These observances offer opportunities to remind clients and employees about preventive care, screenings and health resources available throughout the year.

For more information, visit Health Net's Your Wellness page.

Just For Fun

September's Tastiest Celebrations: A Month of Fun Food Holidays

We tend to think of September as "Back to School Month," but it is also features fun daily food observances ranging from classic comfort foods to quirky snacks. (From The Nibble.)

Feel free to save or print the calendar below and keep it handy on your fridge so you don't miss any of September's delicious celebrations.

Bon appétit !