January 24, 2024 / by Health Plan / Alerts
Date: January 10, 2024 To: Health Plan Practitioners and Facilities Type: Regulatory Subject: Retrospective Review Process Business: Medi-Cal Managed Care Effective January 1, 2024, DHCS requires all Managed Care Plans to have a retrospective review process that allows providers to submit requests for care provided without prior authorization. Health Plan has established the protocol below [...]
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NAMI San Joaquin County Provider Education Program
February 5, 2024 / by Health Plan / Alerts
Date: February 05, 2024 To: Health Plan Provider Network Type: Informal/Event Subject: NAMI San Joaquin County Provider Education Program Business: Medi-Cal Managed Care The National Alliance on Mental Illness (NAMI) San Joaquin County is hosting a Provider Education Program that begins on February 5, 2024. This five-session course offers a comprehensive view of the experiences [...]Read more
Dured Alternatives to Diphenhydramine for Older Adults
February 5, 2024 / by Health Plan / Pharmacy Announcements
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Retrospective Review Process
January 24, 2024 / by Health Plan / Alerts
Date: January 10, 2024 To: Health Plan Practitioners and Facilities Type: Regulatory Subject: Retrospective Review Process Business: Medi-Cal Managed Care Effective January 1, 2024, DHCS requires all Managed Care Plans to have a retrospective review process that allows providers to submit requests for care provided without prior authorization. Health Plan has established the protocol below [...]Read more
Health Plan of San Joaquin/Mountain Valley Health Plan appoints Betty Clark as new Chief Legal and General Counsel
January 18, 2024 / by Health Plan / Press Releases
(French Camp, CA) – Health Plan of San Joaquin/Mountain Valley Health Plan announced that Betty Clark joined the organization as Chief Legal and General Counsel. With extensive healthcare legal experience, Clark has previously worked as an attorney for the Department of Managed Health Care (DMHC) and as in-house counsel for San Francisco Health Plan and [...]Read more
Health Plan of San Joaquin/Mountain Valley Health Plan appoints Liz Le as new Chief Operations Officer
January 18, 2024 / by Health Plan / Press Releases
(French Camp, CA) – Health Plan of San Joaquin/Mountain Valley Health Plan (HPSJ/MVHP) announced that Liz Le joined the organization as Chief Operations Officer (COO). Le brings a wealth of experience as an accomplished and forward-thinking health care leader. Her extensive background includes operations and progressive management, which encompasses program implementation and development; provider network [...]Read more
HEDIS Preseason Reminder for Measurement Year 2023 – Reporting Year 2024
December 29, 2023 / by Health Plan / Alerts
Date: December 29, 2023 To: Contracted Providers and Facilities Type: Regulatory Subject: HEDIS Preseason Reminder for Measurement Year 2023 – Reporting Year 2024 Business: Medi-Cal Managed Care REMINDER Healthcare Effectiveness Data and Information Set (HEDIS) Medical Record Review (MRR) season is coming. Lists will be faxed out in early February 2024. IMPORTANT: Please note, Health [...]Read more
Continuity of Care (CoC)
December 29, 2023 / by Health Plan / Alerts
Date: December 29, 2023 To: Health Plan Network and Non-Contracted Providers Type: Regulatory Subject: Continuity of Care (CoC) Business: Medi-Cal Managed Care In accordance with All Plan Letter (APL) 23-018 Medi-Cal Managed Care Plan Transition Policy Guide, HPSJ and Medi-Cal Managed Care Plans (MCP) will be required to engage in specific continuity of care and [...]Read more
Update – Electronic Visit Verification (EVV)
December 28, 2023 / by Health Plan / Alerts
Date: December 28, 2023 To: Health Plan Personal Care Services (PCS) and Home Health Care Services (HHCS) Providers Type: Regulatory Subject: Update – Electronic Visit Verification (EVV) Business: Medi-Cal Managed Care This alert is to inform you of the following Electronic Visit Verification (EVV) changes effective January 1, 2024. What is EVV? EVV is a [...]Read more
Healthcare Effectiveness Data Information Set (HEDIS) Regarding Chlamydia Screening in Women (CHL) Reminder
December 15, 2023 / by Health Plan / Alerts
Date: December 15, 2023 To: Health Plan of San Joaquin (HPSJ) Contracted Primary Care Providers & OB/GYN Offices Type: Informational Subject: Healthcare Effectiveness Data Information Set (HEDIS) Regarding Chlamydia Screening in Women (CHL) Reminder Business: Medi-Cal Managed Care Healthcare Effectiveness Data Information Set (HEDIS) for Measurement Year 2023 The following is reminder regarding Chlamydia Screening [...]Read more
Mandatory Signatories to the California Health and Human Services Agency Data Exchange Framework
December 14, 2023 / by Health Plan / Alerts
Date: December 14, 2023 To: Health Plan of San Joaquin (HPSJ) All Network Providers Type: Regulatory Subject: Mandatory Signatories to the California Health and Human Services Agency Data Exchange Framework Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) issued All Plan Letter (APL) 23-013 regarding Mandatory Signatories to the California Health and [...]Read more