Special Needs Plan Model of Care
- Participating Physician Groups (PPG)
Health Net of California, Inc. (Health Net) provides a coordinated Special Needs Plan (SNP) for members with certain chronic diseases (C-SNP). Providers must attest the member has diabetes, congestive heart failure or cardiovascular disorders (cardiac arrhythmias, coronary artery disease, peripheral vascular disease, chronic venous thromboembolic disorders) to enroll. The Jade C-SNP (PDF) is offered in Los Angeles, Kern, Orange and San Diego counties.
Health Net also provides a coordinated SNP for members who are dually eligible for Medicare and Medi-Cal/Medicaid (D-SNP). The Amber D-SNP (PDF) is in the following counties: Los Angeles, Orange, San Diego, San Francisco, Alameda, Santa Cruz, Tulare, Kern, Fresno, Kings, Tuolumne, Sacramento, Riverside, Imperial and San Bernardino.
SNP Model of Care Annual Training
The Centers for Medicare & Medicaid Services requires that SNP providers and appropriate staff (those involved in any aspect of the provision of SNP services) complete SNP Model of Care (MOC) Annual Training each year by December 31. SNP providers do not have to submit evidence of training; however, providers are subject to an audit by CMS and Health Net to demonstrate that the training was provided to appropriate staff. Attestation to the SNP MOC training is included in the annual compliance attestation document required by Provider Network Management.