- Participating Physician Groups (PPG)
- San Diego
Health Net covers screening and treatment services for Hansen's Disease (HD) for Medi-Cal members residing in San Diego County.
Health Net collaborates with the local health department (LHD) Hansen's Disease Control program to:
- Control the spread of HD.
- Promote access to HD treatment.
- Establish coordination of care.
Member identification, reporting to the LHD, diagnosis, and multi-drug therapy are standard for treatment and management of HD.
Health Net's participating primary care physicians (PCPs) must report known or suspected cases of HD to the LHD Hansen's Disease Control program (California Code of Regulations (CCR) Title 17, Section 2500) within seven days. Health Net participating PCPs coordinate and collaborate with the LHD for diagnosis, treatment, compliance, and follow-up of members with HD.
Primary care physicians (PCPs) notify the Health Net Medi-Cal Health Services Department of all suspected or active cases of Hansen's Disease (HD). Health Net care managers coordinate with the HD Control program case managers and PCPs on each case.
The local HD Control program reports to the PCP when the member does not respond to treatment or when the member experiences an adverse reaction to medication.
The local health department (LHD) HD case manager is responsible for providing follow-up information concerning contact investigations, verifying and collecting additional information, and communicating with the member's PCP and the Health Net Medi-Cal Health Services Department.
It is the local health department's (LHD's) responsibility to investigate Hansen's Disease (HD) contacts. Coordination with the LHD is necessary in order to report all confirmed or suspected HD cases, conduct contact investigations, and plan for follow-up care for members known to have or suspected of having HD. Health Net participating primary care physicians (PCPs) must notify the local HD Control program and the Health Net Medi-Cal Health Services Department of an actual or potential contact with a Health Net member diagnosed with HD.
Primary care physicians (PCPs) are responsible for:
- Delivering primary care to the member.
- Submitting the required Hansen's Disease (HD) reporting information to the local HD Control program office within seven days, including:
- Member demographics: name, age, address, home telephone, date of birth, gender, ethnicity, and marital status
- Locating information: employer, work address and telephone number
- Disease information: disease diagnosed, date of onset, symptoms, and if available, laboratory results and medications prescribed
- Documenting in the member's medical record.
- Collaborating with the local HD Control program on the member's treatment plan.
HD members may be identified by the PCP during the normal course of practice or by a specialist during consultation and treatment. On receipt by the local HD Control program office, co-management for treatment is discussed. The reporting provider may also notify the Health Net Medi-Cal Health Services Department if there are care management needs.
Health Net participating primary care physicians (PCPs) refer all members diagnosed with Hansen's Disease (HD) to the local health department (LHD) HD Control program for treatment unless the member has been certified by the LHD's Hansen's Disease Control program's formal certification process. The protocols and procedures of the county HD Control program comply with the guidelines recommended by the National Hansen's Disease Programs (NHDP).
Health Net's public programs administrators, in collaboration with county Hansen's Disease (HD) Control program staff, provide ongoing education and training to participating providers. Information sources and seminars are also available from the National Hansen's Disease Programs in Baton Rouge, Louisiana.
Health Net participates in and promotes educational forums for participating providers sponsored by the local Communicable Disease Control and HD programs.