DHCS Equity and Practice Transformation Payments Program

Date: August 2, 2023 To: Health Plan of San Joaquin (HPSJ) Primary Care Provider Organizations From: HPSJ Type: Informational Subject: DHCS Equity and Practice Transformation Payments Program Business: Medi-Cal Managed Care On July 19, 2023 HPSJ hosted a virtual Look and Learn focused on the Department of Health Care Services (DHCS) Equity and Practice Transformation [...]

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Missing Claims Files

Date: July 26, 2023 To: Health Plan of San Joaquin (HPSJ) Contracted Providers & Facilities From: HPSJ Type: Informational Subject: Missing Claims Files Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ) has identified an issue with 837 claim files submitted between June 1, 2023, and July 21, 2023. Please be assured that our [...]

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Long Term Care Web Page on HPSJ Public Site

Date: July 26, 2023 To: Health Plan of San Joaquin (HPSJ) Contracted Providers and Facilities From: HPSJ Type: Informational Subject: Long Term Care Web Page on HPSJ Public Site Business: Medi-Cal Managed Care This Provider Alert serves as a notification that Health Plan of San Joaquin (HPSJ) has created a dedicated Long-Term Care (LTC) web [...]

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REVISED Provider Alert – New Measure – Topical Fluoride Varnish for Children (TFL-CH) and HPSJ’s Topical Fluoride Varnish & Supplementation Benefit Reminder

Date: July 26, 2023 To: Health Plan of San Joaquin (HPSJ) Contracted Primary Care Providers (PCP) From: HPSJ Type: Informational Subject: REVISED Provider Alert - New Measure - Topical Fluoride Varnish for Children (TFL-CH) and HPSJ’s Topical Fluoride Varnish & Supplementation Benefit Reminder Business: Medi-Cal Managed Care The following is a revision to information posted [...]

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Reminder – Collecting Social Determinants of Health (SDOH) Data

Date: July 26, 2023 To: Health Plan of San Joaquin (HPSJ) Contracted Primary Care Physicians From: HPSJ Type: Informational/Educational Subject: Reminder - Collecting Social Determinants of Health (SDOH) Data Business: Medi-Cal Managed Care As part of the Department of Health Services (DHCS) California Advancing and Innovating Medi-Cal (CalAIM) program introduced in 2019, Population Health Management [...]

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Doula Services

Date: July 21, 2023 To: Health Plan of San Joaquin (HPSJ) Primary Care Providers (PCP), Specialists, Hospitals and Facilities From: HPSJ Type: Regulatory/Informational Subject: Doula Services Business: Medi-Cal Managed Care In accordance with All Plan Letter (APL) 22-031, Doula Services are a covered benefit effective January 1, 2023. The following provider alert provides information regarding [...]

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Skilled Nursing Facilities – Long Term Care Carve – In APL 23-004 Changes

Date: July 21, 2023 To: Health Plan of San Joaquin (HPSJ) Contract Providers and Facilities From: HPSJ Type: Regulatory/Informational Subject: Skilled Nursing Facilities - Long Term Care Carve - In APL 23-004 Changes Business: Medi-Cal Managed Care Effective January 1, 2023, Health Plan of San Joaquin (HPSJ) is responsible for the Long-Term Care (LTC) benefit. [...]

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Updated Guidance by the CDC and FDA for Prescribing Opioids – June 2023

Maximize the use of nonopioid therapies when possible and only consider opioids if the benefits of therapy are expected to outweigh the risks. Many nonopioid therapies (including nonpharmacological interventions) are at least as effective as opioids for common types of acute pain. Before starting opioids for pain, establish realistic treatment goals and discuss a plan [...]

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