Transgender, Gender Diverse or Intersex (TGI) Provider Directory Requirements and National Committee for Quality Assurance (NCQA) Practitioner Race and Ethnicity
| 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 of Health Care Services (DHCS) and the Department of Managed Health Care (DMHC) published All Plan Letter (APL) 24-017 (https://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL%202024/APL24-017.pdf) and APL 24-018 (https://www.dmhc.ca.gov/Portals/0/Docs/OPL/APL24-018-CompliancewithSB923(8_15_24).pdf?ver=TsjeH_OzMF6PAB8yAj1nmQ%3D%3D) which provides guidance to Medi-Cal managed care plans (MCPs) regarding the transgender, gender diverse, intersex (TGI) provider directory changes required by Senate Bill (SB) 923 for the purpose of providing trans-inclusive health care to Medi-Cal members.
Trans-inclusive health care is defined in Health and Safety Code (HSC) section 1367.043(d)(3) as comprehensive health care that is consistent with the standards of care for individuals who identify as TGI, honors an individual’s personal bodily autonomy, does not make assumptions about an individual’s gender, accepts gender fluidity and nontraditional gender presentation, and treats everyone with compassion, understanding, and respect.
In accordance with Section 1367.28, no later than March 1, 2025, Health Plan must include information accessible from the provider directory that identifies which in-network providers have voluntarily affirmed they offer and provide gender-affirming services, as specified in All Plan Letter (APL) 20-018, https://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2020/APL20-018.pdf.
If you would like to affirm that you offer and provide gender-affirming services, please complete the Roster Template found at:
https://www.hpsj.com/forms-documents-2/. This information will be displayed on the Provider Directory in the Health Plan’s public website, https://www.hpsj-mvhp.org.
In addition, the National Committee for Quality Assurance (NCQA) requires health plans to share their in-network providers’ race and ethnicity information with their members, when the information is voluntarily provided. You may voluntarily provide your race and ethnicity by completing the Roster Template found at found at https://www.hpsj.com/forms-documents-2/. This information will be displayed on the Provider Directory in the Health Plan’s public website, https://www.hpsj-mvhp.org
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
