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22-535 What News Is Online for June 2022

Date: 07/08/22

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

This information applies to Medi-Cal in Fresno, Kings and Madera counties.

Go to the Provider Library for the latest information that can help you do business with us

The table below outlines communications that have been posted in the Provider Library in June 2022. It includes the posting date, material number and title, type of communication, applicable audience and counties, and a summary of the communication.

Date, Number and Title

Type of notice

Audience

Medi-Cal counties

Summary

June 14. 2022

22-467m, Members Get More Coverage for Medical Supplies under Medi-Cal RX

News & Announcements

Physicians

PPGs

Hospitals

Ancillary providers

Fresno

Kings

Madera

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

22-496m, Cancer Patients Can Now Get Better Access to Biomarker Testing

Regulatory

Physicians

PPGs

Hospitals

Ancillary providers

Fresno

Kings

Madera

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

22-511m, Use the New Invoice Claim Form to Reduce Errors and Improve Accuracy

 

Contractual

Physicians

PPGs

Hospitals

Ancillary providers

Fresno

Kings

Madera

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.

Additional information

If you have additional questions regarding the information contained in this update, contact CalViva Health at 888-893-1569.



Last Updated: 07/08/2022