January 27, 2025 / by Health Plan / Alerts
Date: January 23, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Primary Care Providers (PCPs), Practitioners, and Facilities Type: Informational/Educational Subject: DHCS, UCSF Launch Cal-MAP to Enhance Youth Mental Health Business: Medi-Cal Managed Care On 12/27/2024, the Department of Health Care Services (DHCS) in collaboration with the University [...]
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Health Plan of San Joaquin provider Alerts
Proper Use of Modifier 59
January 31, 2025 / by Health Plan / Alerts
Date: January 30, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Physicians and Hospitals Type: Regulatory - Billing Guidelines Subject: Proper Use of Modifier 59 Business: Medi-Cal Managed Care Health Plan has identified through internal claims auditing the overutilization or improper use of MODIFIER 59 along with no [...]Read more
Justice-Involved (JI) Reentry Initiative: Rebranding and Screening Portal Updates
January 31, 2025 / by Health Plan / Alerts
Date: January 30, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers Type: Regulatory Subject: Justice-Involved (JI) Reentry Initiative: Rebranding and Screening Portal Updates Business: Medi-Cal Managed Care In accordance with the Department of Health Care Service (DHCS) publication, the Justice-Involved (JI) Initiative has been rebranded to the [...]Read more
Medi-Cal In-Person Training Event – February 2025
January 31, 2025 / by Health Plan / Alerts
Date: January 30, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers, Facilities and Hospitals Type: Event Subject: Medi-Cal In-Person Training Event – February 2025 Business: Medi-Cal Managed Care Medi-Cal’s Outreach and Education Team and the Department of Health Care Services (DHCS) are hosting an in-person training event [...]Read more
Resources for the Breast and Cervical Cancer Treatment Program
January 27, 2025 / by Health Plan / Alerts
Date: January 23, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers Type: Informational Subject: Resources for the Breast and Cervical Cancer Treatment Program Business: Medi-Cal Managed Care The Breast and Cervical Cancer Treatment Program (BCCTP) Presumptive Eligibility (PE) provides immediate, temporary benefits to eligible low-income California residents [...]Read more
DHCS, UCSF Launch Cal-MAP to Enhance Youth Mental Health
January 27, 2025 / by Health Plan / Alerts
Date: January 23, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Primary Care Providers (PCPs), Practitioners, and Facilities Type: Informational/Educational Subject: DHCS, UCSF Launch Cal-MAP to Enhance Youth Mental Health Business: Medi-Cal Managed Care On 12/27/2024, the Department of Health Care Services (DHCS) in collaboration with the University [...]Read more
Transgender, Gender Diverse or Intersex (TGI) Provider Directory Requirements and National Committee for Quality Assurance (NCQA) Practitioner Race and Ethnicity
January 17, 2025 / by Health Plan / Alerts
Date: January 15, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Primary Care Providers (PCPs), Specialists, Hospitals, and Facilities Type: Informational/Educational Subject: Transgender, Gender Diverse or Intersex (TGI) Provider Directory Requirements and National Committee for Quality Assurance (NCQA) Practitioner Race and Ethnicity Business: Medi-Cal Managed Care The Department [...]Read more
Non-Specialty Mental Health Outreach and Education Plan
January 17, 2025 / by Health Plan / Alerts
Date: January 15, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Primary Care Providers, Practitioners, and Facilities Type: Informational/Educational Subject: Non-Specialty Mental Health Outreach and Education Plan Business: Medi-Cal Managed Care In response to the Department of Health Care Services (DHCS) intent to increase Behavioral Health utilization across [...]Read more
2025 Provider Incentive Program
January 9, 2025 / by Health Plan / Alerts
Date: January 08, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers Type: Informational Subject: 2025 Provider Incentive Program Business: Medi-Cal Managed Care Health Plan is pleased to announce the 2025 Provider Incentive Program. This program rewards our providers for promoting quality care for our members. The incentive [...]Read more
REMINDER – Medi-Cal Pharmacy (Rx) Update – Pediatric Integration
January 9, 2025 / by Health Plan / Alerts
Date: January 08, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Practitioners, Facilities, and Hospitals Type: Informational / Educational Subject: REMINDER - Medi-Cal Pharmacy (Rx) Update – Pediatric Integration Business: Medi-Cal Managed Care EFFECTIVE JANUARY 31, 2025, Medi-Cal Rx will reinstate claim edits and prior authorization (PA) requirements [...]Read more
Billing Guidelines for BHT/ABA Services
January 9, 2025 / by Health Plan / Alerts
Date: January 08, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Behavioral Health Treatment (BHT) / Applied Behavioral Analysis (ABA) Providers Type: Regulatory Subject: Billing Guidelines for BHT/ABA Services Business: Medi-Cal Managed Care Through the Claims Editing System (CES), Health Plan has identified a trend in claims not [...]Read more