22-533 What News Is Online for June 2022
Date: 07/08/22
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, and Ancillary providers.
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The table below outlines communications posted in the Provider Library in June 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 | Audience | Line of Business1 | Summary |
|---|---|---|---|---|
June 10, 2022 22-440m, Submit Request for a Withdrawal or Dismissal Using Member Notification Templates | Regulatory | PPGs
| Medicare Advantage Cal MediConnect | This update advises providers to use the new member notification templates to request that an authorization be withdrawn or dismissed. |
June 14, 2022 22-466m, Members Get More Coverage for Medical Supplies under Medi-Cal RX | News & Announcements | Physicians PPGs Hospitals Ancillary providers | Medi-Cal (all counties) | The Department of Health Care Services has updated the restrictions on therapeutic continuous glucose monitoring devices. Also, effective June 1, 2022, personal, home-use blood pressure monitors and blood pressure cuffs are a covered benefit under Medi-Cal Rx as a pharmacy-billed item. |
June 17, 2022 22-495m, Cancer Patients Can Now Get Better Access to Biomarker Testing | Regulatory | Physicians PPGs Hospitals Ancillary providers | IFP (HMO, EPO, PPO) Employer Group (HMO/POS/HSP, PPO, EPO) Medi-Cal (all counties) Molina | This update notifies providers that, effective July 1, 2022, prior authorization is no longer required for biomarker testing for patients with advanced or metastatic cancer related to specific conditions as described in the communication. Billing diagnosis codes for cancer are also provided for claims submission and reimbursement. |
June 30, 2022 22-512m, Use the New Invoice Claim Form to Reduce Errors and Improve Accuracy
| Contractual | Physicians PPGs Hospitals Ancillary providers | Medi-Cal (all counties) | Providers are encouraged to use the Enhanced Care Management (ECM) and Community Supports Invoice Claim Form for ECM-related and Community Supports services. The invoice form is fillable. Providers can submit an invoice to the Plan with a minimum set of data elements necessary to convert the invoice to an encounter. |
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.