Health Net ordered to extend assisted living coverage in California

California regulators have ordered Health Net to implement a corrective action plan following the insurer's decision to terminate assisted living and home care services for low-income residents. The Department of Health Care Services cited eight deficiencies in how the company handled the transition, including failures to submit transition plans and denying services to members. Regulators stated these violations “jeopardize member safety, disrupt continuity of care, and endanger medically vulnerable members.”

Under the state's mandate, Health Net must extend services for all affected members until the end of the year. This replaces an earlier plan that would have stopped coverage for some as early as October. Advocates estimate approximately 3,500 Medi-Cal patients, many of whom are elderly or living with cognitive issues like dementia, rely on Health Net for these costs.

If the insurer fails to extend benefits and create individualized transition plans, the state may impose fines of $25,000 per member per day. Health Net operates Medi-Cal plans across ten California counties, including Los Angeles, Sacramento, and Fresno.