24-212 Provider Communications Posted Online and Operations Manual Updates for February 2024
Date: 03/07/24
Access the Provider Library for the latest operational and Plan updates and changes to better service your patients
The tables below outline provider communications posted online and operations manual changes made in February 2024.
- Communications posted online: Includes the posting date, material number and title, type of communication, applicable audience and counties, 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 and URL for the document; audience; and a summary of the change.
- Behavioral Health Provider Operations Manual: No changes were made to this manual in February 2024.
Communications posted online in February 2024
Date, number and title | Type of notice | Audience1 | Medi-Cal counties | Summary |
|---|---|---|---|---|
2/2/24 24-070m, Medi-Cal Expands Coverage to Adults Ages 26-49 Effective January 1, 2024 | News & Announcements | Physicians PPGs Hospitals Ancillary providers ECM providers CS providers | Fresno Kings Madera | Reminder: Medi-Cal expanded coverage to adults ages 26-49, effective January 1, 2024, no matter their immigration status. Find out more details on care and service coordination for new members and data sharing requirements for the Plan and its delegated PPGs. |
2/9/24 24-129m, Update to the Provider Suspended and Exclusion Lists | Regulatory | Physicians PPGs Hospitals Ancillary providers ECM providers CS providers | Fresno Kings Madera | Find out how to access the Office of Personnel Management under the Federal Employee Health Benefit Plan sanction and debarment list and the Restricted Provider Database list through the provider website. Check the lists regularly to ensure you, or a provider you do business with, is not sanctioned/excluded from doing business with us. |
2/9/24 24-168m, Ask Members to Complete the Health Information Form So They Get Needed Services | News & Announcements | Physicians PPGs Hospitals Ancillary providers ECM providers CS providers | Fresno Kings Madera | Encourage CalViva Health members to complete the Health Information Form within the first 90 days of enrollment. This notice includes how members can access the form and why they should complete it. |
2/14/24 24-009m (PDF), Keep Patients Healthy with Flu Vaccine Recommendations | News & Announcements | Physicians PPGs Hospitals Ancillary providers ECM providers CS providers Behavioral Health providers | Fresno Kings Madera | This flyer includes information about the flu vaccine for the 2023-2024 season and provides helpful tips you can use to encourage your patients to get the vaccine. |
2/20/24 24-140m, All Plan Letter 20-021 (Revised) Has Been Retired for the Discontinued Acute Hospital Care at Home Program | Regulatory | PPGs Hospitals | Fresno Kings Madera | The California Department of Health Care Services has retired All Plan Letter 20-021 (Revised), Acute Hospital Care at Home, as of Jan. 8, 2024. Hospitals can no longer apply for a Centers for Medicare & Medicaid Services waiver for the program or provide at-home care under the program. |
2/21/24 24-147m, Submission Reminder: Avoid Rejected Paper Claims | News & Announcements | Physicians PPGs Hospitals Ancillary providers ECM providers CS providers | Fresno Kings Madera | Reminds providers of guidelines and specifications to avoid rejected paper claim submissions. |
2/20/24 24-171m, Stay Informed About Quality Goals and Activities to Improve Members’ Health | Regulatory | Physicians PPGs Hospitals Ancillary providers ECM providers CS providers Behavioral Health providers | Fresno Kings Madera | This provides a comparison of clinical care and service measures between Reporting Years 2022 and 2023. It includes the progress made and improvements that are still needed to improve member health. |
1 ECM – Enhanced Care Management; CS – Community Supports
Medi-Cal Provider Operations Manual changes (for physicians, PPGs, hospitals, and ancillary providers) in February 2024
Effective Date | Document name, URL and path (if applicable) | Audience | Summary |
|---|---|---|---|
2/7/24 | Injectable Medication HCPCS/DOFR Crosswalk (PDF) | PPGs
| The Injectable Medication HCPCS/DOFR Crosswalk was updated for the 4th Quarter of 2023. |
2/9/24 | Monitoring Provider Exclusions (under Provider Oversight) | Physicians PPGs Hospitals Ancillary | Updated information on accessing the Office of Personnel Management under the Federal Employee Health Benefit Plan (FEHBP) sanction and debarment list and the Restricted Provider Database (RPD). Providers are required to access the lists regularly to ensure they, or a provider they do business with, is not sanctioned/excluded from doing business with us. |
2/21/24 | Lactation Education and Support Services (under Benefits > Maternity) | Physicians PPGs Hospitals Ancillary | Select information regarding banked human milk and therapeutic infant formula, as well as authorization forms for therapeutic formula, breast pump and lactation consultant services, and an Infant Nutrition Guide have been temporarily removed. This information and associated forms and references are currently being updated and will be revised in the operations manual once completed. |
2/22/24 | Member Grievance/Complaint Form - English (CalViva) (PDF) | Physicians PPGs Hospitals Ancillary | CalViva Health Member Grievance/Compliant forms have been updated in the Forms and References section of the Provider Library. These forms are referenced in the Appeals, Grievances and Disputes section of the provider operations manual. |
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 Fresno, Kings and Madera counties.