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24-310 Provider Communications Posted Online and Operations Manual Updates for March 2024

Date: 04/05/24

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 in the Provider Library in March 2024.

If you have additional questions regarding the information contained in this update, contact Community Health Plan of Imperial Valley at 833-236-4141.              

Communications posted online in March 2024

Date, Number and title

Type of notice

Audience1

Summary

3/12/24

24-204m, Protect Abortion Care: Physician Assistants Allowed to Provide Reproductive Health Care

Regulatory

Physicians

PPGs

Hospitals

Ancillary providers

ECM providers

CS providers

Behavioral Health providers

Informs providers about Senate Bill 385, Physician Assistant Practice Act: abortion by aspiration: training, which was updated to align abortion training to physician assistants and clears pathways for physician assistants to meet requirements to perform aspiration abortions. The bill also protects health care providers from facing penalties for performing abortion care services.

3/12/24

24-198m (PDF), Update Your Demographic Information Without Logging In

News & Announcements

Physicians

PPGs

Hospitals

Ancillary providers

ECM providers

CS providers

Behavioral Health providers

Reminder: Use the simple instructions in this flyer to update your demographic information online and see what else the Plan does to collect contact information so members can find you in our provider directories.  

3/29/24

24-274m (PDF), Medical Policies – February 2024

Regulatory

Physicians

PPGs

Behavioral Health providers

Notifies providers about changes to medical policies for February 2024. 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.

3/29/24

24-284m, Medication Trend Updates and Formulary Changes – Second Quarter 2024

Contractual 

Physicians

PPGs

 

Find out about recent pharmacy trend updates and formulary changes for the second quarter of 2024. This includes a safety alert from the Food and Drug Administration about a rare but serious drug reaction to select antiseizure medicines.

1   ECM – Enhanced Care Management; CS – Community Supports

Medi-Cal Provider Operations Manual changes (for physicians, PPGs, hospitals, and ancillary providers) in March 2024

Effective Date

Document name, path (if applicable) and URL

Audience

Summary

3/5/24

Hospital and Inpatient Facility Discharge Planning

(under Utilization Management)

PPGs

Hospitals

Ancillary

Updated to inform providers on the requirements of the seven-day post discharge follow up and provide details about the Transitional Care Services program.

3/26/24

Responsibility for Inpatient Concurrent Review and Transfer for Transplant Evaluation

(under Benefits > Transplants)

Physicians

PPGs

Hospitals

Ancillary

Updated to clarify for delegated entities that members who are inpatient and are transferred to another facility for a transplant evaluation does not change delegated entities’ utilization management and risk responsibility.

Behavioral Health Provider Operations Manual changes in March 2024

Effective Date

Section

Topic

Summary

3/1/24

Utilization Management - Higher Levels of Care

Procedures > Concurrent Review

Added language to reflect specific requirements that discharge summaries be submitted within 24 hours of discharge.

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.



Last Updated: 04/04/2024