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20-721 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.

Support for Cal MediConnect Plan 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 Valley Fire burning in San Diego County. Health Net is providing assistance to Cal MediConnect Plan (Medicare-Medicaid Plan) members affected by the extreme heat and weather conditions, in particular to members impacted by fires in San Diego County.

We want 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 is taking steps to ensure that participating providers in impacted areas are able to continue providing care for members’ medical needs.

Health Net participating providers may call the Provider Services Center using the contact information provided below for guidance on:

  • Easing of time limitations for prior authorizations and 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 using the contact information provided below for additional guidance on claims extension time frames.

Prescription information

Health Net will approve any essential prescription medications (with current copayments and deductibles) for any member whose medication access has been impacted by the state of emergency. Providers should inform their Health Net 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, Health Net members can contact Health Net’s Emergency Response line at 1-800-400-8987, 8 a.m. to 6 p.m. Pacific time (PT), for questions or assistance.

Coping assistance

Health Net members impacted by this state of emergency may contact MHN, Health Net’s behavioral health subsidiary, for referrals to mental 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 Health Net members may contact MHN 24 hours a day, seven days a week at 1-800-227-1060.

Additional information

Depending on how the extreme weather conditions and resulting fires progress, Health Net may make additional changes to its policies as needed to ensure members have access to necessary health care services.

If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by county within 60 days at:

Line of Business

Telephone Number

Email Address

Cal MediConnect – Los Angeles County

1-855-464-3571

provider_services@healthnet.com

Cal MediConnect – San Diego County

1-855-464-3572

 



Last Updated: 09/10/2020