Obstetrics Authorization Process Update
| Date: | April 29, 2026 |
| From: | Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) |
| To: | Health Plan Acute Care Hospitals |
| Type: | Procedural Update |
| Subject: | Obstetrics Authorization Process Update |
| Business: | Medi-Cal Managed Care |
We are reaching out to inform you of an important update to our authorization requirements for obstetrics (OB) services under the Medi-Cal line of business. Effective May 1st, 2026, Health Plan will no longer require inpatient authorizations for obstetrics services and hospital stays related to delivery.
Please review the following details regarding this change:
- Effective May 1, 2026, inpatient hospital stays related to delivery will no longer require authorization for Medi-Cal members.
- Post-delivery inpatient stays due to complications will require authorization. Please follow standard inpatient authorization request procedures.
- Authorization is still required for all OB-related inpatient admissions not associated with delivery, including high-risk, medically complex, or other non-delivery OB admissions.
- The process for submitting the baby face sheet remains unchanged. Providers must continue to submit the infant’s face sheet so the newborn can be added to our system ensuring timely coverage.
This update is intended to support timely access to obstetric care for our members and reduce administrative workload for our Medi-Cal provider partners.
Thank you for your continued partnership in supporting our Medi-Cal members.
If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan and our services is always available on our website www.hpsj-mvhp.org
