21-437 State of Emergency: Extreme Heat Event in the State of California
Date: 06/21/21
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, and Ancillary providers.
Support for Cal MediConnect Plan members impacted by extreme heat in excess of 100 degrees
On June 16, 2021, Governor Gavin Newsom declared a state of emergency in California due to a significant heat wave, bringing widespread near-record temperatures well in excess of 100 degrees. Health Net is providing assistance to Cal MediConnect Plan (Medicare-Medicaid Plan) members affected by this extreme heat event.
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 areas affected by the extreme heat event are able to continue providing care for members’ medical needs.
Participating providers may call the Provider Services Center using the contact information in the right-hand column of this page 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 heat event will be extended. Providers may contact the Provider Services Center using the contact information in the right-hand column of this page 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 was impacted by the extreme heat event. 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, affected members can contact Health Net’s Emergency Response line at 800-400-8987, 8:00 a.m. to 6:00 p.m. Pacific time (PT), for questions or assistance.
Coping assistance
Health Net members who were impacted due to the extreme heat event 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 the extreme heat event. For the duration of the extreme heat event and its immediate aftermath, affected members may contact MHN 24 hours a day, seven days a week at 800-227-1060.
Additional information
Depending on how the extreme heat event progresses, 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 | Phone number | Email address |
|---|---|---|
Cal MediConnect – Los Angeles County | 855-464-3571 | |
Cal MediConnect – San Diego County | 855-464-3572 |