Health Plan of San Joaquin provider Alerts

MCAS Measure: AMR – Asthma Medication Ratio

Date: September 16, 2020 To: Health Plan of San Joaquin (HPSJ) Primary Care Providers {PCP} and OBGYN From: Health Plan of San Joaquin Subject: MCAS Measure: AMR – Asthma Medication Ratio Business: Medi-Cal AMR – Asthma Medication Ratio This measure looks at members who are 5–64 years of age who were identified as having persistent [...]

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Update: Cost Avoidance and Post Pay Recoveries – DHCS Intervention

Date: September 4, 2020 To: Health Plan of San Joaquin (HPSJ) All Practitioners and Facilities From: Health Plan of San Joaquin Subject: Update: Cost Avoidance and Post Pay Recoveries – DHCS Intervention Business: Medi-Cal Managed Care The California State Law requires Medi-Cal and Managed Care Plans (MCP’s) to be the payer of last resort for [...]

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**Reminder**DHCS Encounter Requirement – NDC Required

Date: September 4, 2020 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: Health Plan of San Joaquin Subject: **Reminder**DHCS Encounter Requirement – NDC Required Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ) sent out a provider alert on August 5, 2019 informing providers of the new DHCS requirement for [...]

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MANDATORY – Fraud, Waste, and Abuse (FWA) Training for HPSJ Providers

Date: September 4, 2020 To: Health Plan of San Joaquin From: Health Plan of San Joaquin (HPSJ) Providers Subject: MANDATORY – Fraud, Waste, and Abuse (FWA) Training for HPSJ Providers Business: Medi-Cal Health Plan of San Joaquin (HPSJ), is a licensed health care services plan regulated by the Department of Managed Health Care (DMHC) and [...]

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ANNUAL CULTURAL COMPETENCY TRAINING 2020- Mandated

Date: September 3, 2020 To: Health Plan of San Joaquin (HPSJ) Providers From: HPSJ Provider Services Department Subject: ANNUAL CULTURAL COMPETENCY TRAINING 2020- Mandated Business: Medi-Cal Health Plan of San Joaquin is launching our annual required Cultural Competency Training and Attestation collection from 09/01/2020-11/02/2020. Training Based on Title 22, California Code of Regulations (CCR) Sections, [...]

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Clinical Review: 2020 Standards of Care for Treatment of Type 2 Diabetes

Learning Objectives: Review recommendations provided in the American Diabetes Association (ADA) Standards of Medical Care – 2020 addressing the pharmacologic approach to glycemic control for patients with type 2 diabetes Describe patient factors to consider when prescribing antihyperglycemic agents Understand the boxed warnings for antihyperglycemic agents Download the full documente here: Key Points: Diabetes is […]

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Requirements – Office Closure/Re-Opening Notifications

Date: September 1, 2020 To: HPSJ Providers, Practices (PCPs & Specialists), Hospitals & Ancillary Facilities From: Health Plan of San Joaquin Subject: Requirements – Office Closure/Re-Opening Notifications Business: Medi-Cal We are intensely aware of the difficult position medical offices are enduring, as each takes steps to keep their teams and patients safe. Each day HPSJ [...]

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COVID-19: Overpayments on Testing Codes

Date: August 31, 2020 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: Health Plan of San Joaquin Subject: COVID-19: Overpayments on Testing Codes Business: Medi-Cal In response to the Novel Coronavirus (COVID-19), the Centers for Medicare & Medicaid Services (CMS) established the following HCPCS codes for COVID-19 diagnostic testing services: U0003: [...]

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Pharmacy Update: Oncology Medicine

Date: August 31, 2020 To: Health Plan of San Joaquin (HPSJ) Physicians, Providers, and Pharmacies From: Health Plan of San Joaquin Subject: Pharmacy Update: Oncology Medicine Business: Medi-Cal Effective 11/2/2020, all oncology medications will require prior authorizations. Please note that the following list of the medications is not all inclusive. Download the Oncology Medicine PDF [...]

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MCAS Measure AMM – Antidepressant Medication Management

Date: August 27, 202 0 To: HPSJ Primary Care Providers {PCP} and Behavioral Health Care Providers From: HPSJ Quality Management Department Subject: MCAS Measure AMM – Antidepressant Medication Management Business: Medi-Cal The HPSJ Quality Team looks at adults ages 18+ who have a diagnosis of major depression and have been subsequently prescribed antidepressants. When documenting [...]

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