22-1058 See What News Is Online for November 2022
Date: 12/09/22
Go to the Provider Library for the latest information that can help you do business with us
The table below outlines communications posted in the Provider Library in November 2022. The table includes the posting date, material number and title, type of notice, applicable audience and counties, and a summary of the communication.
Date, Number and title | Type of notice | Audience1 | Lines of business | Summary |
|---|---|---|---|---|
November 4, 2022 22-927m, 22-928m, 22-929m, Updated Letter Templates for Coverage Suspension for Enrollees Using APTCs | Regulatory | PPGs
| (HMO/POS/HSP, PPO, EPO)
| This attached update advises delegated participating physician groups (PPG) to use the attached updated letter templates (Type 3B–APTC Claims Look-Back letter and Type 4–APTC Authorization Rescind letter) to notify providers of coverage suspension for members receiving federal Advance Premium Tax Credits (APTCs). |
November 17, 2022 22-930m, Screen Patients for ACEs and Get Paid | News & Announcements | Physicians PPGs
| Medi-Cal (all counties)
| This update provides a reminder to providers about the importance of screening patients for Adverse Childhood Experiences (ACEs). |
November 22, 2022 22-1001m, Short-Term Post-Hospitalization Housing Supports Recovery for Members in Need | News & Announcements | Physicians PPGs Hospitals Ancillary providers ECM providers CS providers
| Medi-Cal (all counties) Molina
| This Short-Term Post Hospitalization Housing provider update provides information about eligibility, restrictions, and service requirements. The program provides a place to stay for high medical- or behavioral-health utilization members without a home to continue their recovery immediately after leaving the hospital. |
November 29, 2022 22-995m, How to Use the Day Habilitation Benefit for Medi-Cal Members | News & Announcements | Physicians PPGs Hospitals Ancillary providers ECM providers CS providers
| Medi-Cal (all counties)
| Describes the CalAIM Community Supports day habilitation benefit and criteria for who is eligible. |
November 30, 2022 22-1029m, Housing Options for Members Through Community Transition Services/Nursing Facility Transition Services To a Home | News & Announcements | Physicians PPGs Hospitals Ancillary providers ECM providers CS providers
| Medi-Cal (all counties)
| The update helps Community Supports (CS) providers identify and refer individuals who may need help transitioning from nursing facilities to community settings. The update provides information on eligibility requirements, billing code and roles of CS providers. |
November 30, 2022 22-1017m, Respite Services: Provide Temporary Relief for Primary Caregivers | News & Announcements | CS providers
| Medi-Cal (all counties)
| This update provides a reminder for providers to offer respite services for members’ caregivers so they can receive temporary relief from caring for the member and subsequently avoid burnout.
|
November 30, 2022 22-1040m, Help Members Live Independently with Personal Care and Homemaker Services | News & Announcements | CS Providers
| Medi-Cal (all counties)
| This update provides a reminder for providers to offer Personal Care and Homemaker Services to help members who need assistance with Activities of Daily Living (ADLs) or Instrumental Activities of Daily Living (IADLs). |
1 Medi-Cal (all counties) indicates that the communication applies to Medi-Cal Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.
Additional information
If you have questions regarding the information contained in this update, contact the Health Net* Provider Services Center by email within 60 days, by phone or through the provider website.
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary providers, Community Supports (CS) Providers, and Enhanced Care Management (ECM) Providers.
For Medi-Cal, this information applies to Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.