Medi-Cal Pharmacy (Rx) – Removal of Basaglar (Insulin Glargine)

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

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

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

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

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

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

FDA Medical Device Recall Alert – Certain Omnipod Pods

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

Primary Care Provider (PCP) Assignment Logic

Date: June 10, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan All Capitated Providers Type: Informational/Educational Subject: Primary Care Provider (PCP) Assignment Logic Business: Medi-Cal Managed Care HPSJ/MVHP completed our review of the changes impacting PCP capitation and have made all necessary adjustments to the monthly payments. The [...]

Read more

Department of Health Care Services (DHCS), All Plan Letter (APL) 23- 029- Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans and Third-Party Entities

Date: June 10, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers and Practitioners Type: Regulatory Subject: Department of Health Care Services (DHCS), All Plan Letter (APL) 23- 029- Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans and Third-Party Entities Business: Medi-Cal Managed Care On August 11, [...]

Read more

Skilled Nursing Facility Workforce & Quality Incentive Program (SNF WQIP) Sunset

Date: June 03, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Skilled Nursing Facilities Type: Regulatory Subject: Skilled Nursing Facility Workforce & Quality Incentive Program (SNF WQIP) Sunset Business: Medi-Cal Managed Care Health Plan is providing an update on the Department of Healthcare Services (DHCS) Skilled Nursing Facilities [...]

Read more

1 2 3 11
top
X