21-027 Stay Up-To-Date With Alternative Sites for Infusion Care
Date: 02/26/21
This information applies to Physicians, and Participating Physician Groups (PPGs).
For Medi-Cal, this information applies to Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.
Improve patient experience, enhance patient safety, and encourage medication adherence
Members treated with any of the infusion products listed in the table on page 2 can transition infusions from the hospital to the home, an ambulatory infusion suite (AIS) or a nearby doctor’s office.
Alternate site of infusion care is part of a member's standard benefits.
Health Net has partnered with Coram® CVS Specialty™ Infusion Services as the preferred provider for these infusions.
Coram provides
- Experience. More than 35 years of experience in specialized infusion care and demonstrated expertise in the delivery and administration of complex specialty infused medications. The only national home infusion provider accredited by The Joint Commission.
- Safety. Clinicians are certified and specialize in delivery of chronic and complex drug therapy and careful patient monitoring. Experienced nurses stay for the entire infusion duration making sure patients receive high-level care.
- Convenience. In-home and AIS-based infusions are scheduled directly with patients, enabling flexibility, independence and enhanced quality of life. Clinical support is available to patients 24 hours a day, seven days a week.
- Lower costs. Infusions may be provided at a lower cost to patients promoting compliance to therapy and ultimately improve outcomes and reduce health costs.
Products eligible for alternative site of infusion care
Disorder | Product | Disorder | Product |
|
|---|---|---|---|---|
Alpha-1 Antitrypsin Deficiency | Aralast™ NP, Glassia®, Zemaira® | Lysosomal Storage disorders | Aldurazyme®, Cerezyme®, Elaprase®, Elelyso®, Fabrazyme®, Kanuma® Lumizyme®, Naglazyme®, Vimizim®, Vpriv® | |
Amyloidosis | Onpattro® | Movement disorders | Radicava® |
|
Asthma | Cinqair®, Fasenra®, Nucala®, Xolair® | Multiple Sclerosis | Lemtrada®, Ocrevus®, Tysabri® |
|
Autoimmune Disorders | Actemra®, AvsolaTM, Entyvio®, Inflectra®, Orencia®, Remicade®*, Renflexis®, Simponi Aria® | Ocular Disorders | Tepezza® | |
Hereditary Angioedema | Cinryze® | Paroxysmal Nocturnal Hemoglobinuria | Soliris®, Ultomiris® | |
Immune Deficiencies and Related disorders
| Asceniv®, Bivigam®, Carimune®, Cuvitru®, Flebogamma®, Gammagard® Liquid, Gammagard® S/D, Gammaked™, Gammaplex®, Gamunex®-C, Hizentra®, Hyqvia®, Octagam®, Panzyga®, Privigen®, Xembify® | |||
Rare Disorders | Crysvita® | |||
Sickle Cell Disease | Adakveo® | |||
Systemic Lupus Erythematosus | Benlysta® |
*Health Net prefers these biosimilar products over Remicade®: Inflectra® (infliximab-dyyb), Renflexis® (infliximab-abda)
Additional information
For patient referrals or additional information, contact Peter Tran, Pharm.D, at (714) 934-3362, Monday through Friday, from 9 a.m. to 4 p.m., and reference the Site of Care Optimization of Therapeutic Infusion (SCOTI) Program.
If you have questions regarding the information contained in this update, contact the applicable Health Net Provider Services Center within 60 days at:
Line of Business | Telephone Number | Provider Portal | Email Address |
|---|---|---|---|
EnhancedCare PPO (IFP) | 1-844-463-8188 | ||
EnhancedCare PPO (SBG) | 1-844-463-8188 | provider_services@healthnet.com | |
Health Net Employer Group HMO, POS, HSP, PPO, & EPO | 1-800-641-7761 | provider_services@healthnet.com | |
IFP (CommunityCare HMO, PPO, PureCare HSP, PureCare One EPO) | 1-888-926-2164 | provider_services@healthnet.com | |
Medicare (individual) | 1-800-929-9224 | provider_services@healthnet.com | |
Medicare (employer group) | 1-800-929-9224 | provider_services@healthnet.com | |
Medi-Cal | 1-800-675-6110 | N/A |