April 12, 2024 / by HPSJ / Alerts
Date: April 10, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Physicians, Providers, and Facilities Type: Formulary Subject: Medical Benefit Update Business: Medi-Cal Managed Care Effective June 13, 2024, the Pharmacy and Therapeutics Committee has approved the following changes to the medical benefit. Code 91304 - SARSCOV2 [...]
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Health Plan of San Joaquin provider Alerts
Health Plan Grant Opportunities
May 8, 2024 / by HPSJ / Alerts
Date: May 08, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) Providers Type: Informational Subject: Health Plan Grant Opportunities Business: Medi-Cal Managed Care Health Plan is proud to announce its investment of $100 million in a three-year Community Reinvestment Program. The following grant opportunities are included: Health Information [...]Read more
Eye Injections Reference Sheet for Ophthalmologists
May 1, 2024 / by Araceli Gallo / Alerts
Date: May 1, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) Ophthalmologists Type: Informational/Educational Subject: Eye Injections Reference Sheet for Ophthalmologists Business: Medi-Cal Managed Care The Pharmacy and Therapeutics (P&T) Committee previously provided medical benefit updates in the Provider Alert issued in April of 2024. As a result, [...]Read more
Reminder: Department of Healthcare Services Skilled Nursing Facilities Workforce and Quality Improvement Program
May 1, 2024 / by Araceli Gallo / Alerts
Date: May 1, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) Skilled Nursing Facilities Type: Regulatory Subject: Reminder: Department of Healthcare Services Skilled Nursing Facilities Workforce and Quality Improvement Program Business: Medi-Cal Managed Care This is a reminder that the Department of Healthcare Services (DHCS) Skilled Nursing [...]Read more
DMHC APL 23-025 and Assembly Bill (AB) 254 – Confidentiality of Medical Information Act: Reproductive or Sexual Health Application Information
May 1, 2024 / by Araceli Gallo / Alerts
Date: May 1, 2024 From: Health Plan of San Joaquin/Mountain Valley Health Plan ("Health Plan") To: Health Plan Providers Type: Regulatory Subject: DMHC APL 23-025 and Assembly Bill (AB) 254 - Confidentiality of Medical Information Act: Reproductive or Sexual Health Application Information Business: Medi-Cal Managed Care On February 7, 2024, the Department of Managed Health [...]Read more
Elective Admission Process Change
May 1, 2024 / by Araceli Gallo / Alerts
Date: May 1, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) Providers and Facilities Type: Informational Subject: Elective Admission Process Change Business: Medi-Cal Managed Care Effective February 20, 2024, the elective admission precertification process for Health Plan has changed. The previous process of a provider submitting an authorization [...]Read more
Reminder: Mandatory Annual Trainings – Complete by 06/30/2024
April 24, 2024 / by Araceli Gallo / Alerts
Date: April 24, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) Providers and Practitioners Type: Regulatory Subject: Reminder: Mandatory Annual Trainings - Complete by 06/30/2024 Business: Medi-Cal Managed Care ACTION REQUIRED This is a reminder that the due date is approaching for Health Plan’s mandatory trainings for [...]Read more
Implementation of Transitional Care Services (TCS) Phone Line
April 18, 2024 / by Cris Bauer / Alerts
Date: April 17, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Practitioners and Facilities Type: Informational Subject: Implementation of Transitional Care Services (TCS) Phone Line Business: Medi-Cal Managed Care Health Plan would like to inform providers that our Transitional Care Services (TCS) phone line is now available [...]Read more
The Department of Healthcare Services Skilled Nursing Facilities Workforce and Quality Improvement Program
April 18, 2024 / by Cris Bauer / Alerts
Date: April 17, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Skilled Nursing Facilities Type: Regulatory Subject: The Department of Healthcare Services Skilled Nursing Facilities Workforce and Quality Improvement Program Business: Medi-Cal Managed Care The Department of Healthcare Services (DHCS) Skilled Nursing Facilities (SNF) Workforce and Quality [...]Read more
Annual Timely Access Report – Measurement Year 2022
April 17, 2024 / by Araceli Gallo / Alerts
Date: April 17, 2024 From: Health Plan To: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Providers Type: Informational Subject: Annual Timely Access Report – Measurement Year 2022 Business: Medi-Cal Managed Care The Department of Managed Health Care (DMHC) published the Annual Timely Access Report results for Measurement Year (MY) 2022. The report summarizes provider appointment availability [...]Read more
Medical Benefit Update
April 12, 2024 / by HPSJ / Alerts
Date: April 10, 2024 From: Health Plan To: All Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Physicians, Providers, and Facilities Type: Formulary Subject: Medical Benefit Update Business: Medi-Cal Managed Care Effective June 13, 2024, the Pharmacy and Therapeutics Committee has approved the following changes to the medical benefit. Code 91304 - SARSCOV2 [...]Read more