August 31, 2020 / by Luis Rivera / Alerts, Pharmacy Announcements
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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Health Plan of San Joaquin provider Alerts
MCAS Measure: AMR – Asthma Medication Ratio
September 16, 2020 / by Luis Rivera / Alerts
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 [...]Read more
Update: Cost Avoidance and Post Pay Recoveries – DHCS Intervention
September 4, 2020 / by Luis Rivera / Alerts, Non-Contracted Provider
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 [...]Read more
**Reminder**DHCS Encounter Requirement – NDC Required
September 4, 2020 / by Luis Rivera / Alerts, Non-Contracted Provider
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 [...]Read more
MANDATORY – Fraud, Waste, and Abuse (FWA) Training for HPSJ Providers
September 4, 2020 / by Luis Rivera / Alerts
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 [...]Read more
ANNUAL CULTURAL COMPETENCY TRAINING 2020- Mandated
September 3, 2020 / by Luis Rivera / Alerts
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, [...]Read more
Clinical Review: 2020 Standards of Care for Treatment of Type 2 Diabetes
September 2, 2020 / by Luis Rivera / Alerts, Pharmacy Announcements
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
September 1, 2020 / by Luis Rivera / Alerts
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 [...]Read more
COVID-19: Overpayments on Testing Codes
August 31, 2020 / by Luis Rivera / Alerts, Non-Contracted Provider
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: [...]Read more
Pharmacy Update: Oncology Medicine
August 31, 2020 / by Luis Rivera / Alerts, Pharmacy Announcements
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 [...]Read more
MCAS Measure AMM – Antidepressant Medication Management
August 27, 2020 / by Luis Rivera / Alerts
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 [...]Read more