21-214 Post-Stabilization Authorization for Emergency Out-of-Network (OON) Hospital Services Suspended

Date: 03/08/21

This information applies to Participating Physician Groups (PPGs).

For Medi-Cal, this information applies to Fresno, Kings, and Madera counties.

Participating physician groups (PPGs) must continue to refer authorization requests for post-stabilization services to Health Net

Due to the COVID-19 pandemic, on March 18, 2020, Health Net paused all OON hospital post-stabilization authorization reviews until further notice. Health Net is responsible for managing these reviews. PPGs should not be reviewing OON hospital post-stabilization authorization requests. PPGs are to refer these back to Health Net for adjudication.

Go to the online COVID-19 alerts page for info about COVID-19 vaccines!

At the online COVID-19 alerts page, you will find information about COVID-19 vaccines. This includes COVID-19 vaccine coverage details, how to enroll to administer the COVID-19 vaccine, and COVID-19 vaccine reporting and coding requirements. Also, access key tips you can use to help talk with and answer questions from your patients about the COVID-19 vaccine, especially those who are hesitant to receive it.

Additional information

If you have questions regarding the information contained in this update, contact CalViva Health at 1-888-893-1569.