November 5, 2025 / by Health Plan / Alerts
Date: November 05, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Practitioners, Facilities, and Hospitals Type: Informational/Educational Subject: Changes to Medi-Cal Rx - 60-day Countdown Business: Medi-Cal Managed Care Medi-Cal Rx Pharmacy Benefit Changes for all Medi-Cal Members. Effective January 1, 2026, the following changes will be implemented [...]
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Health Plan of San Joaquin provider Alerts
REMINDER: ACTION REQUIRED: Model of Care (MOC) Training – Complete by 11/30/2025
November 13, 2025 / by Health Plan / Alerts
Date: November 11, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan (HMO) Network Providers Type: Regulatory Subject: REMINDER: ACTION REQUIRED: Model of Care (MOC) Training – Complete by 11/30/2025 Business: Medicare Dual Special Needs Plan (D-SNP) This is a reminder that the due date is approaching for the [...]Read more
DHCS APL 25-011: H.R. 1 – Federal Payments to Prohibited Entities
November 13, 2025 / by Health Plan / Alerts
Date: November 11, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers Type: Regulatory Subject: DHCS APL 25-011: H.R. 1 – Federal Payments to Prohibited Entities Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) issued an All Plan Letter (APL) 25-011: H.R. 1 – Federal [...]Read more
After Hours Survey is Here
November 7, 2025 / by Health Plan / Alerts
Date: November 06, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Primary Care Providers Type: Regulatory Subject: After Hours Survey is Here Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) and the Department of Managed Health Care (DMHC) require that providers have 24 hours, 7 [...]Read more
REMINDER: ACTION REQUIRED: Model of Care (MOC) Training – Complete by 11/30/2025
November 5, 2025 / by Health Plan / Alerts
Date: November 05, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan (HMO) Network Providers Type: Regulatory Subject: REMINDER: ACTION REQUIRED: Model of Care (MOC) Training – Complete by 11/30/2025 Business: Medicare Dual Special Needs Plan (D-SNP) This is a reminder that the due date is approaching for the [...]Read more
Changes to Medi-Cal Rx – 60-day Countdown
November 5, 2025 / by Health Plan / Alerts
Date: November 05, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Practitioners, Facilities, and Hospitals Type: Informational/Educational Subject: Changes to Medi-Cal Rx - 60-day Countdown Business: Medi-Cal Managed Care Medi-Cal Rx Pharmacy Benefit Changes for all Medi-Cal Members. Effective January 1, 2026, the following changes will be implemented [...]Read more
The Department of Healthcare Services Skilled Nursing Facilities Workforce & Quality Improvement Program – File Reconciliation Calendar Year 2024
November 3, 2025 / by Health Plan / Alerts
Date: November 03, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Skilled Nursing Facilities Type: Regulatory Subject: The Department of Healthcare Services Skilled Nursing Facilities Workforce & Quality Improvement Program – File Reconciliation Calendar Year 2024 Business: Medi-Cal Managed Care Health Plan is providing an update on the [...]Read more
Medi-Cal Pharmacy (Rx) – DHCS APL 25-013 Medi-Cal Rx Pharmacy Benefits, And Cell and Gene Therapy Coverage
October 29, 2025 / by Health Plan / Alerts
Date: October 29, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Practitioners, Facilities, and Hospitals Type: Informational/Educational Subject: Medi-Cal Pharmacy (Rx) – DHCS APL 25-013 Medi-Cal Rx Pharmacy Benefits, And Cell and Gene Therapy Coverage Business: Medi-Cal Managed Care REMINDER: In accordance with Governor Gavin Newsome’s Executive Order [...]Read more
Provider Satisfaction Survey is Here
October 29, 2025 / by Health Plan / Alerts
Date: October 29, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Contracted Provider Network Type: Regulatory Subject: Provider Satisfaction Survey is Here Business: Medi-Cal Managed Care Health Plan conducts an annual Provider Satisfaction Survey for its contracted providers to capture their rate of satisfaction with our plan. Information [...]Read more
REMINDER: Initial Health Appointments
October 29, 2025 / by Health Plan / Alerts
Date: October 29, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Contracted Providers and Facilities Type: Regulatory Subject: REMINDER: Initial Health Appointments Business: Medi-Cal Managed Care REMINDER: Initial Health Appointments (IHA) Health Plan members must be seen for an Initial Health Appointment (IHA) with their Primary Care Physician [...]Read more
Lead Screening in Children (LSC) HEDIS Measure
October 29, 2025 / by Health Plan / Alerts
Date: October 28, 2025 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan PCP's, FQHC's, Pediatricians, Laboratories Type: Informational/Educational Subject: Lead Screening in Children (LSC) HEDIS Measure Business: Medi-Cal Managed Care Healthcare Effectiveness Data and Information Set (HEDIS) Lead Screening in Children (LSC) The Department of Health Services APL 20-016: [...]Read more