July 10, 2026 / by Health Plan / Alerts, D-SNP Provider Alerts
Date: July 08, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Practitioners, Providers, and Facilities Type: Regulatory Subject: Medi-Medi Payments and Balance Billing Business: Medicare Advantage D-SNP As you know, Health Plan launched a Medicare Advantage Dual Special Needs Plan (D-SNP) starting 01/01/2026 known as Health Plan of [...]
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Health Plan of San Joaquin provider Alerts
DHCS APL 26-013: H.R. 1 – Federal Payment to Prohibited Entities – Important Update: End of One–Year Restriction on Federal Payments
July 17, 2026 / by Health Plan / Alerts, Medi-Cal Provider Alerts
Date: July 15, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers Type: Regulatory Subject: DHCS APL 26-013: H.R. 1 – Federal Payment to Prohibited Entities – Important Update: End of One–Year Restriction on Federal Payments Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) issued [...]Read more
Planned JIVA System Maintenance and Social Care Connect Go-Live
July 10, 2026 / by Health Plan / Alerts, D-SNP Provider Alerts, Medi-Cal Provider Alerts
Date: July 09, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan All Providers, Enhanced Care Management & Community Supports Providers, and CBO's Type: Regulatory Subject: Planned JIVA System Maintenance and Social Care Connect Go-Live Business: Medi-Cal Managed Care/Medicare Advantage D-SNP Health Plan will be performing planned system maintenance [...]Read more
Medi-Medi Payments and Balance Billing
July 10, 2026 / by Health Plan / Alerts, D-SNP Provider Alerts
Date: July 08, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Practitioners, Providers, and Facilities Type: Regulatory Subject: Medi-Medi Payments and Balance Billing Business: Medicare Advantage D-SNP As you know, Health Plan launched a Medicare Advantage Dual Special Needs Plan (D-SNP) starting 01/01/2026 known as Health Plan of [...]Read more
Driven to Thrive – Fuel Your Future: Teen Wellness & Empowerment Expo for High School Students
July 10, 2026 / by Health Plan / Alerts, Medi-Cal Provider Alerts
Date: July 08, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan All Practitioners and Behavioral Health Providers Type: Event Subject: Driven to Thrive - Fuel Your Future: Teen Wellness & Empowerment Expo for High School Students Business: Medi-Cal Managed Care Please share and encourage eligible teens and families [...]Read more
Medi-Cal Pharmacy (Rx) – Removal of Basaglar (Insulin Glargine)
June 26, 2026 / by Health Plan / Alerts, Medi-Cal Provider Alerts
Date: June 24, 2026 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) – Removal of Basaglar (Insulin Glargine) Business: Medi-Cal Managed Care Effective August 9, 2026, Medi-Cal Rx will no longer cover Basaglar (Insulin Glargine). This drug will be [...]Read more
REMINDER: Mandatory Annual Trainings – Complete by 06/30/2026
June 26, 2026 / by Health Plan / Alerts, D-SNP Provider Alerts, Medi-Cal Provider Alerts
Date: June 24, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan All Providers Type: Regulatory Subject: REMINDER: Mandatory Annual Trainings – Complete by 06/30/2026 Business: Medi-Cal Managed Care/Medicare Dual Special Needs Program (D-SNP) This is a reminder that the due date is approaching for Health Plan’s mandatory trainings [...]Read more
Medical Benefit Updates – Effective August 31, 2026
June 25, 2026 / by Health Plan / Alerts, D-SNP Provider Alerts, Medi-Cal Provider Alerts
Date: June 24, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Physicians and Providers Type: Formulary Subject: Medical Benefit Updates – Effective August 31, 2026 Business: Medi-Cal Managed Care/Medicare Dual Special Needs Program (D-SNP) Effective August 31, 2026, the Pharmacy and Therapeutics Committee has approved the following changes [...]Read more
FDA Medical Device Recall Alert – Certain Omnipod Pods
June 18, 2026 / by Health Plan / Alerts, D-SNP Provider Alerts, Medi-Cal Provider Alerts
Date: June 10, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Practitioners, Facilities, and Hospitals Type: Informational/Educational Subject: FDA Medical Device Recall Alert – Certain Omnipod Pods Business: Medi-Cal Managed Care/Medicare Dual Special Needs Program (D-SNP) On May 26, 2026, the Food and Drug Administration (FDA) released a [...]Read more
Cell and Gene Therapy Access Model and Coverage
June 18, 2026 / by Health Plan / Alerts, Medi-Cal Provider Alerts
Date: June 17, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Qualified Treatment Centers (QTC's) and Authorized Treatment Centers (ATC's) Type: Regulatory Subject: Cell and Gene Therapy Access Model and Coverage Business: Medi-Cal Managed Care Background on Cell and Gene Therapy Coverage In March of 2025, the Department [...]Read more
Upcoming Payment Fulfillment Transition
June 15, 2026 / by Health Plan / Alerts, D-SNP Provider Alerts, Medi-Cal Provider Alerts
Date: June 10, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers Type: Informational Subject: Upcoming Payment Fulfillment Transition Business: Medi-Cal Managed Care/Medicare Dual Special Needs Program (D-SNP) Health Plan will be transitioning its payment fulfillment services to Optum Financial (Optum). This is anticipated to occur in Q4 [...]Read more