22-607 State of Emergency: Oak Fire in Mariposa County
Date: 07/26/22
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary providers, Community Supports (CS) Providers, and Enhanced Care Management (ECM) Providers.
This information applies to Medi-Cal in Fresno, Kings and Madera counties.
Support for CalViva Health members impacted by fire
On July 23, 2022, Governor Gavin Newsom declared a state of emergency in Mariposa County due to the Oak Fire. CalViva Health is providing assistance to members affected by the fire.
CalViva Health wants 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*, on behalf of CalViva Health, is taking steps to ensure that participating providers in areas affected by the Oak Fire are able to continue providing care for members’ medical needs.
Participating providers may call the Provider Services Center at 888‐893‐1569 for guidance on:
- Easing of time limitations for prior authorizations 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 Oak Fire will be extended. Providers may contact the Provider Services Center at 888‐893‐1569 for additional guidance on claims extension time frames.
Prescription information
Any essential prescription medications will be approved for any CalViva Health member in Mariposa County whose medication was lost in the fire or remained behind during an evacuation. Providers should inform their 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 the CalViva Health Medi‐Cal Member Services Department at 888‐893‐1569 for questions or assistance.
Coping assistance
As CalViva Health’s downstream subcontractor and Health Net’s behavioral health subsidiary, MHN administers behavioral health services to CalViva Health members. CalViva Health members who lost their homes or have been evacuated due to the Oak Fire may contact MHN for referrals to behavioral health counselors, local resources or telephonic consultations to help them cope with stress, grief, loss, or other trauma resulting from the fire.
For the duration of the fire and its immediate aftermath, affected CalViva Health members may contact the CalViva Health Medi‐Cal Member Services Department at 888‐893‐1569.
Additional information
Depending on how the fire situation progresses, additional changes to policies may be made as needed to ensure members have access to necessary health care services.
If you have questions regarding the information contained in this update, contact CalViva Health at 888‐893‐1569.