April 13, 2023 / by HPSJ / Alerts
Date: April 13, 2023 To: Health Plan of San Joaquin (HPSJ) Physicians and Providers From: HPSJ Pharmacy and Therapeutics Committee Type: Informational Subject: Medical Benefit Updates Business: Medi-Cal Managed Care Effective June 19, 2023, the Pharmacy and Therapeutics Committee has approved the following changes to the medical benefit. Code J9035 - INJECTION, BEVACIZUMAB (Avastin), 10 [...]
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Health Plan of San Joaquin provider Alerts
Virtual Look and Learn – May 10, 2023, at 12:00 pm
April 25, 2023 / by HPSJ / Alerts
Date: April 24, 2023 To: HPSJ Practitioners, Providers and Facilities From: Health Plan of San Joaquin (HPSJ) Type: Event Subject: Virtual Look and Learn – May 10, 2023, at 12:00 pm Business: Medi-Cal Managed Care Please join us May 10, 2023, from 12:00 pm to 1:30 pm, for a Virtual Provider Look and Learn Session. [...]Read more
DHCS Medi-Cal Renewal Process
April 20, 2023 / by HPSJ / Alerts
Date: April 19, 2023 To: Health Plan of San Joaquin (HPSJ) Primary Care Providers, Specialists, Hospitals and Facilities From: HPSJ Type: Informational Subject: DHCS Medi-Cal Renewal Process Business: Medi-Cal Managed Care In March 2020, the Centers for Medicare & Medicaid Services (CMS) temporarily waived certain Medicaid and Children's Health Insurance Program (CHIP) requirements and conditions [...]Read more
Grievances
April 19, 2023 / by HPSJ / Alerts
Date: April 19, 2023 To: Health Plan of San Joaquin (HPSJ) Transportation Providers From: HPSJ Type: Regulatory Subject: Grievances Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) and the Department of Managed Health Care (DMHC) requires Health Plan of San Joaquin (HPSJ) to monitor and investigate all member complaints regarding their medical [...]Read more
Reminder – APL 22-014 Electronic Visit Verification Implementation Requirements
April 14, 2023 / by HPSJ / Alerts
Date: April 14, 2022 To: Personal Care Services (PCS) and Home Health Care Services (HHCS) Providers From: Health Plan of San Joaquin (HPSJ) Type: Regulatory Subject: Reminder - APL 22-014 Electronic Visit Verification Implementation Requirements Business: Medi-Cal Managed Care The following is a reminder of the Provider Alert sent on October 20, 2022, regarding All [...]Read more
DRE Claims Portal Update
April 14, 2023 / by HPSJ / Alerts
Date: April 13, 2023 To: Health Plan of San Joaquin (HPSJ) Contracted Providers and Facilities From: HPSJ Type: Informational Subject: DRE Claims Portal Update Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ) is pleased to inform you that our DRE Claims Portal has been updated. Effective March 24th, 2023, the portal is now [...]Read more
Medi-Cal Pharmacy (Rx) Update – Reinstatement of PAs for Phase III and IV
April 14, 2023 / by HPSJ / Alerts
Date: April 13, 2023 To: Health Plan of San Joaquin (HPSJ) Practitioners and Facilities From: HPSJ Type: Informational Subject: Medi-Cal Pharmacy (Rx) Update – Reinstatement of PAs for Phase III and IV Business: Medi-Cal Managed Care Outpatient pharmacy benefits were transitioned to Medi-Cal Rx on 1-1-2022. Due to the benefit transitioning, some medications are paid [...]Read more
New Measure – Developmental Screening (DEV) in the First Three Years of Life
April 13, 2023 / by HPSJ / Alerts
Date: April 13, 2023 To: Health Plan of San Joaquin (HPSJ) Contracted Primary Care Providers (PCPs) From: HPSJ Type: Informational Subject: New Measure – Developmental Screening (DEV) in the First Three Years of Life Business: Medi-Cal Managed Care New Measure for Healthcare Effectiveness Data and Information Set (HEDIS) Measurement Year 2023 DEV – Developmental Screening [...]Read more
Medical Benefit Updates
April 13, 2023 / by HPSJ / Alerts
Date: April 13, 2023 To: Health Plan of San Joaquin (HPSJ) Physicians and Providers From: HPSJ Pharmacy and Therapeutics Committee Type: Informational Subject: Medical Benefit Updates Business: Medi-Cal Managed Care Effective June 19, 2023, the Pharmacy and Therapeutics Committee has approved the following changes to the medical benefit. Code J9035 - INJECTION, BEVACIZUMAB (Avastin), 10 [...]Read more
Beacon Health Options Name Change – Now Carelon Behavioral Health
March 27, 2023 / by HPSJ / Alerts
Date: March 27, 2023 To: Health Plan of San Joaquin (HPSJ) Practitioners, Providers and Facilities From: HPSJ Practitioners, Providers and Facilities Type: Informational Subject: Beacon Health Options Name Change – Now Carelon Behavioral Health Business: Medi-Cal Managed Care Beacon Health Options has announced that their name changed to Carelon Behavioral Health effective March 1, 2023. [...]Read more
REMINDER – Updated Physician Certification Form (PCS) – Request for Transportation for Non-Emergency Medical Transportation (NEMT)
March 23, 2023 / by HPSJ / Alerts
Date: March 22, 2023 To: Health Plan of San Joaquin (HPSJ) Practitioners, Provider and Facilities From: HPSJ Practitioners, Providers and Facilities Type: Informational/Regulatory Subject: REMINDER - Updated Physician Certification Form (PCS) - Request for Transportation for Non-Emergency Medical Transportation (NEMT) Business: Medi-Cal Managed Care Non-Emergency Medical Transportation (NEMT) is available for a member with a [...]Read more