Health Net: Flexibility for Providers Impacted by SoCal Wildfires
In response to the Southern California wildfires, the Department of Managed Health Care (DMHC) issued All Plan Letter (APL) 25-005, directing all health plans to implement temporary operational flexibilities for providers displaced in Los Angeles and Ventura Counties.
The State of Emergency was declared by Governor Gavin Newsom on January 7, 2025, and remains in effect until further notice.
Temporary Flexibilities Now in Effect
- Extension of Prior Authorizations: Existing prior authorizations are automatically extended by 180 calendar days.
- Extended Claims Submission Deadlines: Providers now have 365 days from the date of service to submit claims, applicable to both contracted and non-contracted providers.
- Extended Timeframe to Dispute Overpayments: The timeframe for providers to dispute overpayment determinations has been extended to 180 calendar days.
- Alternative Sites of Care Permitted: Displaced providers may continue to deliver care from mobile clinics or temporary locations for a period of at least six months from the date of the (APL) 25-005 (March 19, 2025).
Wildfire Response Resources
Health Net has maintained a wildfire response webpage, State of Emergency declaration, providing essential information for both members and providers.
In response to (APL) 25-005, the plan has also updated its "Benefits During a Disaster" webpage to include additional provider-specific content. This enhanced site will remain a permanent part of Health Net's emergency response resources and will continue to support providers during future disaster events.
Access the resource pages here:
Upcoming Provider Notification
A formal provider notification summarizing the flexibilities outlined in APL 25-005 is currently being finalized and will be distributed to all contracted providers by April 30, 2025.
Questions?
Your Health Net Account Representative.