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22-277 See What News Is Online for March 2022

Date: 04/07/22

This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, and Ancillary providers.

For Medi-Cal, this information applies to Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.

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The table below outlines communications posted in the Provider Library in March 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 posted

Number and title

Type of notice

Audience

Lines of business1

Summary

March 4, 2022

22-003m, Population Health Management Programs for Providers and Members

News & Announcements

  • Physicians
  • PPGs

 

  • IFP (HMO, EPO, PPO) Employer Group (HMO/POS/HSP, PPO, EPO) Medi-Cal (all counties)
  • Molina

Informs providers about a resource flyer available to them that lists the different member and provider programs we offer. It includes a brief program description and contact information.

March 4, 2022

22-005m, Population Health Management Programs for Providers and Members

News & Announcements

  • Physicians
  • PPGs

 

  • Medicare Advantage HMO/PPO

 

Informs providers about a resource flyer available to them that lists the different member and provider programs we offer. It includes a brief program description and contact information.

March 10, 2022

22-206m, Improve Care for Members Who Need Skilled Nursing Services with Help from Rockport

News & Announcements

  • Physicians
  • PPGs
  • Hospitals
  • IFP (HMO, EPO, PPO)
  • Employer Group (HMO/POS/HSP, PPO, EPO)
  • Medicare Advantage HMO/PPO
  • Cal MediConnect
  • Medi-Cal (all counties)

This provider update was developed to notify providers of Health Net’s partnership with Rockport and the new episodic payment model.

March 21, 2022

22-259m, Medicare Billing Changes for 2022

Regulatory

  • Physicians
  • PPGs
  • Medicare Advantage HMO/PPO

Notifies providers about changes made by the Centers for Medicare & Medicaid Services for vaccine reimbursements, place of service (POS) codes for telehealth, notice of admission change, and skilled nursing facility interim billing. The changes went into effect on January 1, 2022 with POS code changes for telehealth effective April 4, 2022.

March 22, 2022

22-192m, Easily Update Your Demographics Online

Regulatory

  • Physicians
  • PPGs
  • Hospitals
  • Ancillary providers
  • IFP (HMO, EPO, PPO)
  • Employer Group (HMO/POS/HSP, PPO, EPO)
  • Medicare Advantage HMO/PPO
  • Cal MediConnect
  • Medi-Cal (all counties)
  • Molina

This twice-per-year notice to providers advises them of how to update their demographic information in the online provider directory, and provides instructions for them to get their information added back if it is not in the directory.

March 22, 2022

22-193m, Easily Update Your Demographics Online

Regulatory

  • Physicians
  • PPGs
  • Hospitals
  • Ancillary providers
  • Medicare Advantage HMO/PPO

This twice-per-year notice to providers advises them of how to update their demographic information in the online provider directory, and provides instructions for them to get their information added back if it is not in the directory.

 

March 28, 2022

22-264m, Apply New Processes for Prescription Prior Authorization and Step Therapy, and Ensure PrEP Coverage

Regulatory

  • PPGs
  • IFP (HMO, EPO, PPO)
  • Employer Group (HMO/POS/HSP, PPO, EPO)

California Assembly Bill 347 requires new prescription prior authorization step therapy processes; California Bulletin 2021-10 describes required coverage for HIV pre-exposure prophylaxis (PrEP).

March 28, 2022

22-216m, Expect More Patients from Medi-Cal’s Older Adult Expansion

Regulatory

  • PPGs
  • Medi-Cal (all counties)
  • Molina

California Assembly Bill 133 expands full-scope Medi-Cal coverage to adults ages 50 or older, regardless of immigration status.

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 within 60 days, by phone or through the provider website as listed in the right-hand column.



Last Updated: 04/06/2022