23-1299 See What News Is Online for October 2023
Date: 11/08/23
Go to the Provider Library for the latest information that can help you do business with us
The table below outlines communications posted in the Provider Library in October 2023. 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 | Audience1 | Lines of business2 | Summary |
|---|---|---|---|---|
October 20, 2023 23-1192m, Upcoming Change: Wellcare By Health Net Offers an Easier Way to Access Utility Assistance and More in 2024 | News & Announcements | Physicians PPGs Hospitals Ancillary providers | Medicare (Wellcare By Health Net) HMO, PPO
| Effective January 1, 2024, the Plan will no longer offer Special Supplemental Benefits for Chronically Ill (SSBCI). However, members with SSBCI in 2023 will automatically gain value-based insurance design programs in 2024. |
October 24, 2023 23-1211m, Annual Medical Records Collection Begins | News & Announcements | Physicians PPGs | IFP (HMO/PPO) Medi-Cal Medicare (Wellcare By Health Net) HMO, PPO | Datafied is contracted to retrieve medical records from randomly selected physicians and PPGs starting January 1, 2024 through May 3, 2024. The data is being collected based on the HEDIS® Measurement Year 2023 medical record collection project used to evaluate quality of care. |
October 30, 2023 23-1241m, Medical Policies – September 2023 | Contractual | Physicians PPGs Hospitals Ancillary providers
| IFP (HMO/PPO) Medi-Cal Medicare (Wellcare By Health Net) HMO, PPO
| This notifies providers about 1) two new medical policies; 2) changes to existing policies; 3) and retired policies for September 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. |
October 30, 2023 23-1264m, Updated | News & Announcements | Physicians PPGs Hospitals Ancillary providers ECM providers CS providers
| Medi-Cal Molina
| Updated Medi-Cal provider materials are available on online at bit.ly/provider-welcome. These can help you and your staff become familiar with the Medi-Cal line of business and supplement the Medi-Cal Provider Operations Manual. |
October 31, 2023 23-1248m (PDF), Virtually Earn No-Cost Continued Medical Education | News & Announcements | Physicians PPGs Hospitals Ancillary providers | IFP (HMO/PPO) Medi-Cal Molina |
These flyers inform providers that they can virtually earn no-cost continuing medical education (CME) credit through sessions that focus on gaining expertise in the management of certain complex illness and conditions, specifically focusing on Medication Assisted Treatment and patients that experience health disparities secondary to stigma (i.e., Key Populations). |
October 31, 2023 23-1249m (PDF), Virtually Earn No-Cost Continued Medical Education | News & Announcements | Physicians PPGs Hospitals Ancillary providers | Medicare (Wellcare By Health Net) HMO, PPO |
1 ECM – Enhanced Care Management; CS – Community Supports
2 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, by phone or through the provider portal.
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary providers, Community Supports (CS) Providers, and Enhanced Care Management (ECM) Providers.