23-250 State of Emergency: Severe Winter Storms Impacting Multiple Counties

Date: 03/03/23

Support for impacted Health Net members

On March 1, 2023, Governor Gavin Newsom declared a state of emergency in Amador, Kern, Los Angeles, Madera, Mariposa, Mono, Nevada, San Bernardino, San Luis Obispo, Santa Barbara, Sierra, Sonoma, and Tulare counties due to recent severe winter storms. These storms that began in late February brought damaging winds and significant rain, including snowfall in areas not accustomed to snow. They continue to cause damage and closures to highways and roads, power outages, and forced evacuations stranding residents and motorists.

Health Net* is providing assistance to members affected by the severe winter storms. We want 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, precertification and referrals

Health Net is taking steps to ensure that participating providers in areas affected by the severe winter storms are able to continue providing care for members’ medical needs.

Participating providers may call the Provider Services Center below for guidance on:

• Shortening time limits for health care service plans to approve prior authorization, precertification, or referrals, and extending the time that prior authorizations, precertification, and referrals for treatment remain valid.
• Approving 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 severe winter storms will be extended. Providers may contact the Provider Services Center below for additional guidance on claims extension time frames.

Prescription information

Health Net will approve any essential prescription medications (with current copayments and deductibles) for any member in an area impacted by the severe winter storms whose medication was lost or could not be obtained due to storm conditions. Health Net will also suspend prescription refill limitations and allow an impacted enrollee to refill their prescriptions at an out-of-network pharmacy. 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 Health Net’s Emergency Response Line at 800-400-8987, 8 a.m. to 6 p.m. Pacific time, for questions or assistance.

Member insurance cards and health care information

Members whose insurance cards have been lost or left behind due to the state of emergency and members who have health care questions during the state of emergency can contact Health Net’s Emergency Response Line at 800-400-8987, 8 a.m. to 6 p.m. Pacific time, for questions or assistance.

Coping assistance

Members who lost their homes or have been evacuated due to the severe winter storms may contact MHN, Health Net’s behavioral health subsidiary, for referrals to mental health counselors, local resources or telephonic consultations to help them cope with stress, grief, loss or other trauma resulting from the severe winter storms. Affected members may contact MHN 24 hours a day, seven days a week at 800-227-1060.

Additional information

Depending on how the severe winter storms and their impacts progress, Health Net may make additional changes to its policies as needed to ensure members have access to necessary health care services.

If you have questions regarding the information contained in this update, contact the Provider Services Center listed below.

Line of business	Phone number	Email address
IFP Ambetter PPO	844-463-8188	provider_services@healthnet.com
IFP Ambetter HMO	888-926-2164	provider_services@healthnet.com
Health Net Employer Group HMO, POS, HSP, PPO, & EPO	800-641-7761	provider_services@healthnet.com
Medicare (Individual & Employer Group)	800-929-9224	provider_services@healthnet.com
Medi-Cal	800-675-6110	N/A

 

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 Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.