COVID-19 Provider Updates

Mitigating health impacts: Secondary Stress due to the COVID-19 pandemic – April 13th 2020

“First and foremost, HPSJ appreciates you – providers, practitioners, and facilities – for your tremendous commitment to take care of patients with the COVID 19 illness and others during this pandemic.” – HPSJ Chief Medical Officer Lakshmi Dhanvanthari, MD

While Californians have come together to practice social distancing to slow spread of COVID19; public anxiety due to the virus –  the economic distress related to lost wages and financial assets, school closures and the necessary physical distancing measures – can result in an increase in physical and emotional stress-related morbidity and mortality. Disasters of this nature are well known to result in short-term and long-term mental health and physical health impacts, including increased cardiovascular, metabolic, immunologic and neuropsychiatric risk.

We all worry about the whole range of negative health outcomes which can include:

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  • Increased rates of heart attack and stroke
  • Increased blood pressure
  • Exacerbations of chronic obstructive pulmonary disease and asthma
  • Increased hemoglobin A1c levels among diabetic patients
  • Immune dysregulation – with increased risk for infection, autoimmune disorders, and poorer oral health
  • Poorer perinatal and birth outcomes, including preterm birth and low birth weight
  • Increased intimate partner violence
  • New or recurring mental and behavioral health conditions including depression, anxiety, suicidality, post-traumatic stress disorder, obsessive-compulsive disorder, and substance use disorder (inclusive of alcohol and drugs)

Providers play an essential role in helping to address where possible and mitigate some of the negative health outcomes identified above with appropriate adaptations to provide disaster-responsive, trauma-informed care to your patients.

To mitigate negative secondary health outcomes –

We are sure you agree it is crucial to provide high quality health care to HPSJ enrollees. HPSJ is confident that you will identify the signs of and assess for stress-related morbidity, and create responsive treatment plans – including supplementing usual care with measures that help regulate the stress response system, such as:

  • Supportive relationships
  • Age-appropriate, healthy nutrition
  • Sufficient, high-quality sleep
  • Mindfulness and meditation
  • Adequate Physical activity
  • Mental health care

HPSJ is eager to work with you and to assist you in providing supportive care for our members. To refer HPSJ members for the following services, please call (209) 942-6340:         

  • Case Management
  • Social Work
  • Behavioral Health

Resources helpful in taking care of your patients

APLs related to trauma-informed care can be found at the following link:

 htt ps://www.dhcs.ca.g ov/formsandpubs/Pages/AllPlanLetters.aspx

For Telehealth: https://www.dhcs.ca.gov/provgovpart/Pages/Telehealth.aspx

DMHC APL 20-13 for Telehealth Services: http://www.dmhc.ca.gov/Portals/0/Docs/OPL/APL%2020-013%20-%20Telehealth%20Services%20(4_7_2020).pdf?ver=2020-04-07-093820-233 

Additional resources on how to mitigate the stress-related health outcomes anticipated with the COVID-19 emergency can be found on www.A CEsAwa re.o rg.

ACEs resources and information for Medi-Cal can be found on the DHCS webpage at

https://www.dhcs.ca.gov/provgovpart/Pages/TraumaCare.aspx.

DHCS COVID-19 guidance on Telehealth – the ACES Aware and other helpful sites are also included here; please review:

Also see the Supplement to APL 19-009, Emergency Telehealth Guidance – COVID-19 Pandemic, which can be found at:

https://www.dhcs.ca.gov/formsandpubs/Pag es/AllPlanLetters.aspx

  • The Substance Abuse and Mental Health Services Administration Concept of Trauma and Guidance for a Trauma-Informed Approach is at:

https://store.samhsa.gov/product/SAMHSA-s-Concept-of -Trauma-and-Guidance-for-a-Trauma-Inf ormed-Approach/SMA14-4884.html

  • The Pediatric ACEs Screening Clinical Workflow is at:

https://www.acesaware.org/wp – content/uploads/2019/12/ACE-Clinical-W orkf lows-Alg orithms-and-ACE-Associated-Health- Conditions.pdf

Another resource: Burke Harris N. The Deepest Well: Healing the Long-Term Effects of Childhood Adversity. Houghton Mifflin Harcourt, 2018

Long Term Care

Get access to long term care resources agencies near you, download the Long Term Care resource guide now!

Provider Updates

Behavioral Health Funding Opportunities for Telehealth - July 1, 2020

Behavioral Health Funding Opportunities for Telehealth

The California Department of Health Care Services (DHCS) has two funding opportunities for organizations to develop, enhance, and/or expand their facility’s telehealth infrastructure to address the needs of people with substance use disorder, mental health disorders, or both. The Center at Sierra Health Foundation will assist DHCS with the administration of these federal grant funds. Click here for more.
Essential for Kids under age 2 - April 9, 2020
Should you see your doctor or take kids to the pediatrician during the pandemic? Report from NBC News medical correspondent Dr. John Torres, April 3, 2020 See the full report video, click here. AAP Recommends Keeping Pediatrician Appointments For Young Children During Coronavirus Pandemic  TODAY (4/3) featured NBC News medical correspondent Dr. John Torres, who provided answers to questions about the coronavirus and routine physician visits. Regarding whether parents should take their child to the pediatrician, TODAY said that "the American Academy of Pediatrics has issued guidance on this question, which Torres said has to do with the child's age." Torres explained, "With kids it's a little more important to get those visits, and what the current recommendation is from a lot of experts is if they're younger than 2, then you want to go ahead and keep those well baby visits. If they're above 2 and it's a well child visit, just ask them 'Can I delay this? Is there a reason...to come right now?' And if you can delay it, delay it." Meanwhile, physicians "and hospitals are turning to telemedicine during the pandemic." Torres remarked, "Virtual visits are a big option, and the American Academy of Pediatrics is actually recommending that most pediatricians switch a lot of these to virtual visits. There's a lot of telemedicine, tele-mental health going out right now, and so see if you can do it that way."  -------------------------------------------------------------------------- The NBC News clip is at https://www.today.com/health/should-i-go-doctor-should-i-take-my-kid-pediatrician-t177530
HPSJ: Open for Business during COVID-19 - March 19, 2020
Health Plan of San Joaquin (HPSJ) is closely following the advisories from the CDC, the California Department of Public Health, each of our local public health departments, and the Department of Health Care Services (DHCS) and the Department of Managed Health Care (DMHC). Our message to you and each valued member of our Provider Network is – We remain open for business. We will be available to every part of our Provider Network throughout this time. As always, you and your staff are welcome to call Customer Service with your questions, at 209.942.6320. You can continue to rely on your partners at Health Plan of San Joaquin. Should there be any changes in our business practices related to the pandemic, we will notify you as soon as possible. To see the practical and timely advice we are giving our members, please go to COVID-19 Page – including the link to CDC. Stay Safe and thank you!

Pharmacy Updates

Health Plan of San Joaquin has notified our Pharmacy Network and our PBM (MC-Rx Powered by ProCare Rx) to authorize early refills for members needing extended medication supplies and 90-day supply of medications for chronic medications. If members need to shelter-in-place, we are authorizing their medications to be filled from both in-network and out-of-network pharmacies as well as to be mailed directly to their home. HPSJ Pharmacy staff are monitoring drug shortages and other access concerns. We will provide updates with any new developments.

We continue to provide pharmacy phone support 24/7 for our members and providers via our provider line at 1-888-936-7526, Option 1, or our PBM (MC-Rx Powered by ProCare Rx) at 1-855-828-1484.

Mental Health Support – 

We want you to be aware that on the COVID-19 (Coronavirus) page we set up for HPSJ members, we offer this advice.

If you are feeling overwhelmed, or worried about family members:

  • Get help from HPSJ Customer Service or your county mental health plan
  • See helpful information from American Red Cross – click here
  • Call Beacon Health Strategies at 1.888.581.7526

In this time of heightened anxiety and need for support, please know that HPSJ social workers and Care Management/Disease Management teams continue to reach out to our members with support during this time of COVID-19/Coronavirus pandemic.

You and your practice may also find useful the following resources at this time, and as you continue your care for your patients.

  • Social Distancing Tips
  • Tips-social-distancing-quarantine-isolation
  • ACES Aware – COVID-19 & Stress (ACES Aware supports health care providers, their teams, and all those on the front lines of administering care and interventions as California addresses stress and anxiety related to COVID-19

https://www.acesaware.org/heal/covid19/

  • American Red Cross – Be Red Cross Ready, Coping with Shelter-in-Place Emergencies

https://www.hpsj.com/wp-content/uploads/2020/03/RedCross.ShelteringInPlace.pdf

Claims Updates

Clarification (March 10, 2020 Alert) – Billing
  • U07.1 is for confirmed cases only and is not available to bill until 04/01/2020.
  • B97.29 should be the diagnosis code providers use for confirmed cases through 03/31/2020.
Any testing or visits, prior to confirming a COVID-19 positive case should be billed with diagnosis codes pertaining to the patient’s symptoms at the time of the visit. You should not bill diagnosis code B97.29 or U07.1 in order to be reimbursed for testing.
ICD-10-CM Coding Updates (March 19, 2020 Alert)
The Centers for Disease Control and Prevention (CDC) has issued reporting guidance for Clinical Modification (ICD-10-CM), effective with the next update (October 1, 2020). Full information regarding the new code and the final title will be available soon; we will provide an update as soon as available.

For now, the ICD-10-CM Official Coding Guideline – Supplement Coding Encounters Related to COVID-19 Coronavirus Outbreak (February 20, 2020) provides you with the coding specifications HPSJ is using. They can be found at: https://www.cdc.gov/nchs/icd/icd10cm.htm

California Medical AssociationFree webinars to help guide physicians about COVID-19 issues.

Posted on March 25th, 2020 and last modified on October 22nd, 2020.

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