26-001m Site of Care Optimization for Therapeutic Infusions (SCOTI) - 1st Quarter 2026
Date: 01/05/26
Changes that improve patient experience, enhance patient safety and encourage medication adherence
Effective January 1, 2026, Health Net is enhancing infusion care access by partnering with Coram® CVS Specialty™ Infusion Services, offering eligible Commercial (HMO, POS, PPO) and Exchange members more flexibility in where they receive therapeutic infusions. Members can now choose from:
Alternative sites of therapeutic infusion care
- Home
- Medical office settings
- Ambulatory Infusion Suites (AIS) in Ontario and San Diego
These options are part of standard member benefits and designed to improve convenience, safety and affordability.
Coram provides:
- Trusted expertise − Coram brings over 40 years of specialized infusion care and is the only national home infusion provider accredited by the Joint Commission.
- Safe, high-quality care − Certified clinicians and nurses deliver and monitor complex therapies with clinical support, available 24 hours a day, 7 days a week.
- Convenience and flexibility − Infusions can be scheduled around your life, empowering independence and improving quality of life.
- Cost savings and better outcomes – Injections (including infusions) outside the hospital may reduce costs, promote therapy adherence and improve outcomes.
Eligible infusion therapies
A wide range of conditions and medications are eligible for home or alternative site infusion.
Disorder | Product |
|---|---|
Alpha-1 Antitrypsin deficiency | Aralast™ NP, Glassia®, Zemaira® |
Amyloidosis | Amvuttra®, Onpattro® |
Asthma | Cinqair®, Fasenra®, Nucala®, Xolair® |
Autoimmune disorders | Actemra®, AvsolaTM, Entyvio®, Inflectra®, Orencia®, Remicade®1, Renflexis®, Simponi Aria® |
Bone disorders3 | Evenity®, Prolia®, Xgeva® (maintenance dose)2 |
Hereditary angioedema | Berinert®, Kalbitor® |
HIV3 | Cabenuva |
Hormonal and metabolic disorders3 | Eligard®, Fensolvi®, Lupron Depot®, Lupron Depot-PED®, Somatuline® Depot |
Immune deficiencies and related disorders | Asceniv®, Bivigam®, Cuvitru®, Flebogamma®, Gammagard® Liquid, Gammagard® S/D, Gammaked™, Gammaplex®, Gamunex®-C, Hizentra®, Hyqvia®, Octagam®, Panzyga®, Privigen®, Xembify® |
Lysosomal storage disorders | Aldurazyme®, Cerezyme®, Elaprase®, Elelyso®, Elfabrio®, Fabrazyme®, Kanuma®, Lumizyme®, MepseviiTM, Naglazyme®, Nexviazyme®, Pombliti®, Vimizim®, Vpriv®, Xenpozyme® |
Movement disorders | Radicava® |
Multiple sclerosis4 | Briumvi®, Ocrevus® (maintenance dose), Ocrevus ZunovoTM |
Neurological disorders | Leqembi®, Vyvgart Hytrulo® |
Ocular disorders | Tepezza® |
Paroxysmal nocturnal hemoglobinuria | BkemvTM, Epysqli®, Piasky®, Soliris®, Ultomiris® |
Platelet disorders3 | Nplate® |
Rare disorders | Crysvita®, Uplizna® |
Sickle Cell disease | Adakveo® |
Systemic Lupus Erythematosus | Benlysta®, Saphnelo® |
1Health Net prefers these biosimilar products over Remicade: Inflectra (infliximab-dyyb), Renflexis (infliximab-abda).
2First two doses of Xgeva are given in the Ontario and San Diego locations.
3Coram can coordinate with CVS Specialty, Inc to have this injection delivered to the doctor’s office for administration.
4First dose of Ocrevus is infused in the Ontario and San Diego locations. Other multiple sclerosis agents, such as Lemtrada and Tysabri, are also eligible for alternative site of infusion care in the Ontario and San Diego locations.
Coverage and coordination details
Eligibility for the SCOTI program depends on financial responsibility between Health Net and the member’s participating physician group (PPG).
If Health Net is financially responsible:
- Use Coram CVS Specialty Infusion Services.
- Coram will coordinate directly with physicians and other providers, including prior authorization and scheduling.
If the PPG is financially responsible:
- PPGs are not required to use Coram.
- Physicians and other providers should arrange home infusion through the PPG’s contracted home health vendor.
PPGs should refer to the Health Net Injectable Medication HCPCS/DOFR Crosswalk to confirm DOFR categorization of medications and financial responsibility.
Referrals and contact information
To refer patients to alternative sites of care (including home infusion), contact Coram:
- Phone: 866-899-1661
- Fax: 866-843-3221
Be sure to reference the SCOTI program if contacting Coram for referrals.
For additional information, contact the Health Net Pharmacy Team Mailbox and reference the SCOTI Program.
Need help? Contact us
If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by email, by phone or through the Health Net provider portal. Behavioral health providers can call 844-966-0298.
Provider Services
Line of business | Phone number | |
|---|---|---|
Ambetter from Health Net IFP Ambetter PPO | ||
Ambetter HMO | ||
Health Net Employer Group HMO, POS, & PPO |
This information applies to Physicians and Participating Physician Groups (PPGs).