24-061 See What News Is Online for December 2023
Date: 01/10/24
Use the steps outlined in this update to access the latest provider communications
As a reminder, California Health & Wellness Plan members in Amador, Calaveras, Inyo, Mono, and Tuolumne counties transitioned to Health Net Community Solutions, Inc., (Health Net) on January 1, 2024.
For communications posted in December 2023, refer to the tables below that outline communications posted online, including the posting date, material number and title, type of notice, applicable audience, and a summary of the communication.
Table 1: December 2023 Provider Communications Posted on the California Health & Wellness Plan Website
Date, number and title | Type of notice | Audience1 | Summary |
|---|---|---|---|
December 18, 2023 23-1435m (PDF), Medical Policies – November 2023 | Contractual | Physicians IPAs Hospitals Ancillary providers
| 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/CHWPMedPolicies. 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 21, 2023 23-1462m, Minors Ages 16 or Older Can Consent to Narcotic Replacement Therapy | Regulatory | Physicians IPAs Hospitals Ancillary providers
| 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 26, 2023 23-1491m, Stay in Compliance With Drug Utilization Review Requirements That Target Opioids | Regulatory | Physicians IPAs Hospitals Ancillary providers
| 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, |
December 28, 2023 23-1512m, Stay Informed for 2024: Updates for Electronic Signatures and Expiration Dates, Medical Information Definitions, and Data Exchange of Health Information | Regulatory | Physicians IPAs Hospitals Ancillary providers ECM providers CS providers | 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. |
Table 2: December 2023 Provider Communications Posted in the Provider Library
Date, number and title | Type of notice | Audience1 | Summary |
|---|---|---|---|
December 20, 2023 23-1478m, Get Assistance on How to Serve the Children and Youth Population of Focus | News & Announcements | Physicians PPGs Hospitals ECM providers CS providers
| 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 23-1469m, Keep with Behavior Access Standards Performance Targets to Align with Plan Goals | Regulatory | Physicians PPGs Hospitals Ancillary providers ECM providers CS providers
| Beginning in reporting year (RY) 2024, Health Net 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. |
1 IPAs – independent practice associations; ECM – Enhanced Care Management; CS – Community Supports
Access the Provider Library for communications on and after January 1, 2024
Provider communications distributed and/or posted online on or after January 1, 2024, can be accessed in the Provider Library. To find these communications, navigate to the Medi-Cal section and select Updates and Letters.
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary providers, Community Supports (CS) Providers, and Enhanced Care Management (ECM) Providers.
For Medi-Cal, this information applies to Amador, Calaveras, Inyo, Mono, and Tuolumne counties.