June 30, 2022 / by Health Plan / Alerts
Date: June 30, 2022 To: Health Plan of San Joaquin (HPSJ) Physicians and Providers From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Medical Benefit Updates Business: Medi-Cal Managed Care Effective September 5, 2022, the Pharmacy and Therapeutics Committee has approved the following changes to the medical benefit: Code J2357 - INJECTION, OMALIZUMAB [...]
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Health Plan of San Joaquin provider Alerts
Proposition 56 Value-Based Payment Programing Has Ended
July 6, 2022 / by Health Plan / Alerts
Date: July 5, 2022 To: HPSJ Primary Care Providers (PCP) and Contracted Facilities From: Health Plan of San Joaquin (HPSJ) Subject: Proposition 56 Value-Based Payment Programing Has Ended Business: Medi-Cal Managed Care The Value-Based Payment (VBP) Program has ended effective June 30, 2022. The VBP Program was directed to Managed Care Plans (MCPs) to make [...]Read more
Revised DHCS Facility Site Review and Medical Record Review Tools and Standards
July 1, 2022 / by Health Plan / Alerts
Date: July 1, 2022 To: Health Plan of San Joaquin (HPSJ) PCP’s and FQHCs From: HPSJ Quality Management Department Type: Informational/Regulatory Subject: Revised DHCS Facility Site Review and Medical Record Review Tools and Standards Business: Medi-Cal Managed Care Beginning July 1, 2022, the Department of Health Care Services (DHCS) will be implementing the use of [...]Read more
2022 Mandatory Annual Trainings Final Reminder
July 1, 2022 / by Health Plan / Alerts
Date: June 30, 2022 To: Health Plan of San Joaquin (HPSJ) Practitioners, Providers & Facilities From: Health Plan of San Joaquin Subject: 2022 Mandatory Annual Trainings Final Reminder Business: Medi-Cal ACTION REQUIRED Please complete ALL THREE trainings by June 30, 2022 Annual training is mandated by California’s Department of Health Care Services (DHCS) and the [...]Read more
Medical Benefit Updates
June 30, 2022 / by Health Plan / Alerts
Date: June 30, 2022 To: Health Plan of San Joaquin (HPSJ) Physicians and Providers From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Medical Benefit Updates Business: Medi-Cal Managed Care Effective September 5, 2022, the Pharmacy and Therapeutics Committee has approved the following changes to the medical benefit: Code J2357 - INJECTION, OMALIZUMAB [...]Read more
Reminder: Phase 2: ECM and Community Supports – San Joaquin and Stanislaus Counties
June 30, 2022 / by Health Plan / Alerts
Date: June 30, 2022 To: HPSJ Primary Care Providers, Specialists, Hospitals and Facilities From: Health Plan of San Joaquin Subject: Reminder: Phase 2: ECM and Community Supports – San Joaquin and Stanislaus Counties Business: Medi-Cal Enhanced Care Management and Community Supports Starting in January of 2022, new benefits and services called Enhanced Care Management (ECM) [...]Read more
2022 Mandatory Annual Training – Reminder Table
June 29, 2022 / by Health Plan / Alerts
Date: June 17, 2022 To: Health Plan of San Joaquin Practitioners, Contracted Providers, Facilities, and Behavioral Health Providers From: Health Plan of San Joaquin Subject: 2022 Mandatory Annual Training – Reminder Table Business: Medi-Cal Type of Training Requirement Due Date Health Insurance Portability and Accountability Act (HIPAA) HIPAA is a federal law that required […]
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DHCS APL 21-014 Requirements – Clarification of Requirements
June 17, 2022 / by Health Plan / Alerts
Date: June 16, 2022 To: Health Plan of San Joaquin Practitioners, Contracted Providers, Facilities, and Behavioral Health Providers From: Health Plan of San Joaquin Subject: DHCS APL 21-014 Requirements – Clarification of Requirements Business: Medi-Cal Health Plan of San Joaquin (HPSJ) received All Plan Letter (APL) 21-014 from the Department of Health Care Services (DHCS) [...]Read more
REMINDER – Confidentiality of Medical Information
June 17, 2022 / by Health Plan / Alerts
Date: June 16, 2022 To: Health Plan of San Joaquin Practitioners, Contracted Providers and Facilities From: Health Plan of San Joaquin Subject: REMINDER – Confidentiality of Medical Information Business: Medi-Cal OPL 22-010 (Office of Planning Licensing); guidance regarding Assembly Bill (AB) 1184 – confidentiality of medical information, from the Department of Managed Health Care (DMHC) [...]Read more
Provider Dispute Resolution Submission Reminder
June 15, 2022 / by Health Plan / Alerts
Date: June 15, 2022 To: Health Plan of San Joaquin (HPSJ) All Providers & Facilities From: Health Plan of San Joaquin Subject: Provider Dispute Resolution Submission Reminder Business: Medi-Cal Managed Care It has been identified that the incorrect dispute type continues to be selected when submitting a Provider Dispute Resolution (PDR) through the DRE portal. [...]Read more
Prior Authorization Requests Related to Cancer Treatment
June 1, 2022 / by Health Plan / Alerts
Date: May 31, 2022 To: Health Plan of San Joaquin Facilities and Oncologists From: Health Plan of San Joaquin Subject: Prior Authorization Requests Related to Cancer Treatment Business: Medi-Cal For submissions of Prior Authorization Requests Related to Cancer Treatment, the following components must also be provided for review. If any required pieces of information are [...]Read more