24-1182 Provider Communications Posted Online and Operations Manual Updates for October 2024
Date: 11/07/24
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The tables below outline provider communications posted online and operations manual changes made in in October 2024.
- Communications posted online: Includes the posting date, material number and title, type of communication, applicable audience, and a summary of the communication.
- Medi-Cal Provider Operations Manual changes (for physicians, participating physician groups (PPGs), hospitals, and ancillary providers): Includes the effective date of the change, document name, path to section where document is located, URLs, audience and a summary of the change.
- Behavioral Health Provider Operations Manual: Includes the effective date of the change, operations manual section, topic and summary of the change.
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- Find Provider Training and Onboarding Resources More Easily on Our Consolidated Site
- Californians’ Health Care in Good Hands Thanks to Community Health Centers
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Communications posted online in October 2024
Date, number and title | Type of notice | Audience | Summary |
|---|---|---|---|
10/11/24 24-1093m, Safeguard Patient Privacy When Sharing Medical Records | News & Announcements | Physicians PPGs Hospitals Ancillary providers ECM providers CS providers Behavioral Health providers | Reminder about protecting patient privacy when sharing medical data. |
10/16/24 24-1108m, Medical Policies – September 2024 | Contractual | Physicians PPGs Behavioral Health providers | Review changes to medical policies for procedures and services for Sept. 2024. Medical policies, available online at Medical Policies, offer guidelines for determining medical necessity for certain procedures, equipment and services. 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. |
10/18/24 24-1018m, Medication Trend Updates and Formulary Changes – 4th Quarter 2024 | Contractual | Physicians PPGs | Information about Medi-Cal drug list changes and medication safety issues for the fourth quarter of 2024. |
Medi-Cal Provider Operations Manual changes (for physicians, PPGs, hospitals, and ancillary providers) in October 2024
Effective Date | Document name, path (if applicable) and URL | Audience | Summary |
|---|---|---|---|
10/3/24 | Member Notification for Specialist Termination (under Provider Oversight > Facility and Physician Additions) | Physicians PPGs Hospitals Ancillary | Updated document to describe updated letter templates that provider groups are required to use to notify members of a specialist’s termination. |
10/23/24 |
(under benefits) | Physicians PPGs Hospitals Ancillary | The Decision Power program is no longer offered and all references in the Medi-Cal Provider Operations Manual were updated to show “health and wellness” or “health and wellness programs, including Sharecare,” where applicable. |
Behavioral Health Provider Operations Manual changes in October 2024
Effective Date | Section | Topic | Summary |
|---|---|---|---|
10/15/24 | Section 3.6 Credentialing: Administrative Guidelines | Types of Termination | Updated section to describe updated letter templates that provider groups are required to use to notify members of a specialist’s termination. |
Provider Services
Line of business | Phone number |
|---|---|
Community Health Plan of Imperial Valley Medi-Cal (including CS and ECM providers) | |
Behavioral Health providers |
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary Providers, Community Supports (CS) Providers, Enhanced Care Management (ECM) Providers, and Behavioral Health Providers.
This information applies to Medi-Cal in Imperial county.