Provider Alerts

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Date:	January 7, 2021
To:	Health Plan of San Joaquin (HPSJ) Providers and Pharmacists
From:	Health Plan of San Joaquin
Subject:	DHCS Guidance – COVID-19 Vaccines & Vaccination Administration
Business:	Medi-Cal

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The California Department of Health Care Services (DHCS) has now issued guidance for all Medi-Cal managed care health care plans regarding both COVID-19 vaccine coverage and vaccination administration. As a valued member of the Health Plan of San Joaquin (HPSJ) Provider Network, we want you to be aware of this important information. Essentials to know from the attached All Plan Letter (APL 20-022) include the following –

• Medi-Cal members will incur no costs for COVID-19 vaccines or the administration of these vaccines.
• This is a carve-out Medi-Cal benefit – DHCS will carve out the COVID-19 vaccines and associated administrative fees from the Medi-Cal managed care delivery system; DHCS will reimburse providers under Medi-Cal fee-for-service (FFS) for medical, pharmacy and outpatient claims. Claims will NOT come through HPSJ.
• For the initial phases of vaccination distribution, the federal government is paying for the vaccines and there will be no provider reimbursement – however, providers will be able to bill Medi-Cal FFS for COVID-19 vaccine administration fees.
• As supplies of vaccines become increasingly available in California:
  • All providers serving Medi-Cal patients are encouraged to stay current with developments by bookmarking the State’s Medi-Cal COVID-19 site
  • https://files.medi-cal.ca.gov/pubsdoco/COVID19_response.aspx
• DHCS currently is seeking federal approval for reimbursement rates, as
  described in the attached (APL 20-022), including for Federally Qualified Health
  Centers, Rural Health Centers and Tribal 638 clinics.
• Pharmacies, retail clinics, providers and any other sites of care must sign an agreement with the U.S. government to receive free supplies of the COVID-19 vaccines. Details for how to enroll in the CALIFORNIA COVID-19 VACCINATION PROGRAM are included in the attached APL 20-022.

ATTACHED: All Plan Letter (APL 20-022) – 5 pages