20-720 State of Emergency: Extreme Weather Conditions and Fires in California
Date: 09/10/20
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, and Ancillary providers.
This information applies to Medi-Cal in Fresno and Madera counties.
Support for CalViva Health members impacted by record-breaking temperatures and resulting fires throughout the state
On September 3, 2020, Governor Gavin Newsom declared a state of emergency throughout the state. On September 6, 2020, Governor Newsom declared a state of emergency due to the Creek Fire burning in Fresno and Madera counties. CalViva Health is providing assistance to members in areas affected by the extreme heat and weather conditions, in particular to members impacted by fires in Fresno and Madera counties.
CalViva Health wants to help ensure that members who have been impacted because they or their usual health care providers have been temporarily displaced, have continued access to health care services and prescriptions during the state of emergency.
Here is what you need to know.
Prior authorization and referrals
Health Net, on behalf of CalViva Health, is taking steps to ensure that participating providers in impacted areas are able to continue providing care for members’ medical needs.
Participating providers may call the Provider Services Center at 1-888-893-1569 for guidance on:
- Easing of time limitations for prior authorizations referrals for services.
- Approval for out-of-network services in the event a contracting provider or facility becomes unavailable.
- Authorization for the replacement of medical equipment or supplies.
Filing claims
The deadline to file claims for providers impacted by the extreme weather conditions and resulting fires will be extended. Providers may contact the Provider Services Center at 1-888-893-1569 for additional guidance on claims extension time frames.
Prescription information
Any essential prescription medications will be approved for any member whose medication access has been impacted by the state of emergency. Providers should inform their CalViva Health patients that to obtain an emergency supply, affected members can return to the pharmacy where the original prescription was filled. If the pharmacy is not open due to the state of emergency, CalViva Health members can contact the CalViva Health Medi-Cal Member Services Department at 1-888-893-1569 for questions or assistance.
Coping assistance
CalViva Health members impacted by this state of emergency may contact CalViva Health for referrals to behavioral health counselors, local resources or telephonic consultations to help them cope with stress, grief, loss or other trauma resulting from this state of emergency. For the duration of the state of emergency and its immediate aftermath, affected CalViva Health members may contact the CalViva Health Medi-Cal Member Services Department at 1-888-893-1569.
Additional information
Depending on how the extreme weather conditions and resulting fires progress, additional changes to policies may be made as needed to ensure members have access to necessary health care services.
If you have questions regarding the information contained in this update, contact CalViva Health at 1-888-893-1569.