October 14, 2026 / by Health Plan / Alerts, Medi-Cal Provider Alerts
Date: October 13, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Therapeutics Committee To: Health Plan Practitioners, Facilities, and Hospitals Type: Informational Subject: Medical Benefit Updates Business: Medi-Cal Managed Care Effective December 21, 2026, the Pharmacy and Therapeutics Committee has approved the following changes to the medical benefit. CODE J8502- INJECTION, [...]
Read more
Free Virtual UCSF Training Opportunity – Introduction to Diagnosing and Treating Depression in Children and Youth on Friday, 11/13/26 from 12-1PM (PST)
October 30, 2026 / by Health Plan / Alerts, Medi-Cal Provider Alerts
Date: October 29, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: All Health Plan Providers, Practitioners and Behavioral Health Providers Type: Educational Subject: Free Virtual UCSF Training Opportunity – Introduction to Diagnosing and Treating Depression in Children and Youth on Friday, 11/13/26 from 12-1PM (PST) Business: Medi-Cal Managed Care Key [...]Read more
Federal Reimbursement Limitation on Gender-Affirming Care Services for Youth
October 29, 2026 / by Health Plan / Alerts, Medi-Cal Provider Alerts
Date: October 28, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Providers and Practitioners Type: Regulatory Subject: Federal Reimbursement Limitation on Gender-Affirming Care Services for Youth Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) issued All Plan Letter (APL) 26- 018 Federal Reimbursement Limitation on [...]Read more
Quality Measures for Encounter Data (QMED)
October 22, 2026 / by Health Plan / Alerts, Medi-Cal Provider Alerts
Date: October 22, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan All Providers Type: Informational Subject: Quality Measures for Encounter Data (QMED) Business: Medi-Cal Managed Care Health Plan provided training on the updates to the Quality Measures for Encounter Data (QMED) 2.0 during a Look & Learn webinar [...]Read more
The Department of Healthcare Services Skilled Nursing Facilities Workforce & Quality Improvement Program – File Reconciliation Calendar Year 2025
October 22, 2026 / by Health Plan / Alerts, Medi-Cal Provider Alerts
Date: October 21, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Skilled Nursing Facilities Type: Regulatory Subject: The Department of Healthcare Services Skilled Nursing Facilities Workforce & Quality Improvement Program – File Reconciliation Calendar Year 2025 Business: Medi-Cal Managed Care Health Plan is providing an update on the [...]Read more
Provider Training Due 12/31/26: Excellent Health Outcomes for All (EHOA)
October 22, 2026 / by Health Plan / Alerts, D-SNP Provider Alerts, Medi-Cal Provider Alerts
Date: October 21, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan All Providers Type: Regulatory Subject: Provider Training Due 12/31/26: Excellent Health Outcomes for All (EHOA) Business: Medi-Cal Managed Care/Medicare Advantage D-SNP Providers and member-facing provider staff that have not yet completed Health Plan's Excellent Health Outcomes for [...]Read more
After-Hours Survey is Here
October 20, 2026 / by Health Plan / Alerts, Medi-Cal Provider Alerts
Date: October 14, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Primary Care Providers Type: Regulatory Subject: After-Hours Survey is Here Business: Medi-Cal Managed Care The Department of Health Care Services (DHCS) and the Department of Managed Health Care (DMHC) require that providers have 24 hours, 7 days [...]Read more
Medical Benefit Updates – Medi-Cal
October 14, 2026 / by Health Plan / Alerts, Medi-Cal Provider Alerts
Date: October 13, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Therapeutics Committee To: Health Plan Practitioners, Facilities, and Hospitals Type: Informational Subject: Medical Benefit Updates Business: Medi-Cal Managed Care Effective December 21, 2026, the Pharmacy and Therapeutics Committee has approved the following changes to the medical benefit. CODE J8502- INJECTION, [...]Read more
Ground Emergency Medical Transportation (GEMT) Supplemental Payments
October 8, 2026 / by Health Plan / Alerts, Medi-Cal Provider Alerts
Date: October 07, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) To: Health Plan Ground Emergency Medical Transportation (GEMT) Type: Informational Subject: Ground Emergency Medical Transportation (GEMT) Supplemental Payments Business: Medi-Cal Managed Care Effective October 1,2026, any claims submitted by a non-contracted ground emergency medical transportation (GEMT) providers that are eligible [...]Read more
Improving Encounter Submission
October 2, 2026 / by Health Plan / Alerts, Medi-Cal Provider Alerts
Date: October 02, 2026 From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) Therapeutics Committee To: Health Plan Primary Care Providers - Capitated PCP's Type: Procedural Update Subject: Improving Encounter Submission Business: Medi-Cal Managed Care Health Plan introduced new Primary Care Provider (PCP) capitation payment rates in December 2024 based on utilization experience [...]Read more
FDA Drug Recall Alert – 0.9% Sodium Chloride Injection, USP
October 1, 2026 / by Health Plan / Alerts, D-SNP Provider Alerts, Medi-Cal Provider Alerts
Date: October 01, 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 Drug Recall Alert – 0.9% Sodium Chloride Injection, USP Business: Medi-Cal Managed Care/Medicare Advantage D-SNP On September 21, 2026, the Food and Drug Administration (FDA) released a recall announcement [...]Read more