24-036 See What News Is Online for December 2023
Date: 01/10/24
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 December 2023. 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 | Audience1 | Counties | Summary |
|---|---|---|---|---|
December 18, 2023 23-1436m (PDF), Medical Policies – November 2023 | Contractual | Physicians PPGs Hospitals Ancillary providers | Fresno Kings Madera | Notifies providers about changes to existing medical policies and a retired policy for November 2023. Medical policies offer guidelines for determining medical necessity for certain procedures, equipment and services, and can be accessed online at bit.ly/HN_med_policies. As a reminder, all services must be medically necessary and member benefits, legal and regulatory mandates take precedence over content of medical policies and must be applied first. |
December 20, 2023 23-1476m, Get Assistance on How to Serve the Children and Youth Population of Focus | News & Announcements | Physicians PPGs Hospitals Ancillary providers ECM providers CS providers | Fresno Kings Madera | Informs providers of DHCS’s Enhanced Care Management (ECM) for Children and Youth Population of Focus (POF) Spotlight (PDF), designed to help contracted and prospective ECM providers serving Children and Youth. |
December 21, 2023 23-1460m, Minors Ages 16 or Older Can Consent to Narcotic Replacement Therapy | Regulatory | Physicians PPGs Hospitals Ancillary providers | Fresno Kings Madera | Informs providers that minors ages 16 or older can consent to narcotic replacement therapy without parent or guardian consent due to Assembly Bill 816. |
December 21, 2023 23-1463m, Keep with Behavior Access Standards Performance Targets to Align with Plan Goals | Regulatory | Physicians PPGs Hospitals Ancillary providers ECM providers CS providers | Fresno Kings Madera | Beginning in reporting year (RY) 2024, the Plan must meet or exceed an 80% Provider Appointment Availability Survey initial performance target for non-physician mental health and substance use disorder providers’ follow-up appointments. |
December 26, 2023 23-1489m, Stay in Compliance With Drug Utilization Review Requirements That Target Opioids | Regulatory | Physicians PPGs Hospitals Ancillary providers | Fresno Kings Madera | Informs providers of their responsibilities for a drug utilization review program, per California Department of Health Care Services All Plan Letter (APL) 23-026, which supersedes a similar APL, 19-012. |
December 28, 2023 23-1513m, Stay Informed for 2024: Updates for Electronic Signatures and Expiration Dates, Medical Information Definitions, and Data Exchange of Health Information | Regulatory | Physicians PPGs Hospitals Ancillary providers ECM providers CS providers | Fresno Kings Madera | Informs providers of updates related to Assembly Bills 1697, 254 and 352, including the use of electronic signatures for medical information release authorizations and expiration dates for authorization requests; medical information definitions, including reproductive and sexual health definitions; and the exchange of health information in real time. |
1 ECM – Enhanced Care Management; CS – Community Supports
Additional information
If you have additional questions regarding the information contained in this update, contact CalViva Health at 888-893-1569.
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.