24-927 Provider Communications Posted Online and Operations Manual Updates for August 2024
Date: 09/06/24
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The tables below outline provider communications posted online and operations manual changes made in August 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, URLs, audience and a summary of the change.
- Behavioral Health Provider Operations Manual: No changes were made to this manual in August 2024.
Communications posted online in August 2024
Date, number and title | Type of notice | Audience | Medi-Cal counties | Summary |
8/20/24 24-884m, Medical Policies – July 2024 | Contractual | Physicians PPGs Behavioral Health providers | Fresno Kings Madera | Notice about changes to medical policies for procedures and services for July 2024. Medical policies offer guidelines for determining medical necessity for certain procedures, equipment and services, and can be accessed online at Medical 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. |
Medi-Cal Provider Operations Manual changes (for physicians, PPGs, hospitals, and ancillary providers) in August 2024
Effective Date | Document name, URL and path (if applicable) | Audience | Summary |
8/1/24 | Routine Care Costs for Qualifying Clinical Trials (under Benefits > Clinical Trials)
| Physicians PPGs Hospital Ancillary | Added information regarding prior authorization requests submitted for routine care costs for items and services that are furnished as part of a qualifying clinical trial. These requests are considered urgent and this section includes instructions on how to obtain urgent status when submitting a prior authorization request for the routine care costs. |
8/5/24 | Palliative Care Providers (PDF) (under Forms and References > Palliative Care Providers) | Physicians PPGs Hospital Ancillary | The Contracted Palliative Care Providers list was updated. The list can be accessed under Forms and References, and under Utilization Management > Care Management > Palliative Care Services in the manual. |
8/7/24 | Contacts Health Net Enrollment Services Health Net Facility Site Review Compliance Department | Physicians PPGs Hospital Ancillary | Updates applied to these Contacts documents. |
8/19/24 | PCP-PPG Change form – Spanish (PDF) (under Forms and References) | Physicians PPGs Hospital Ancillary | Spanish version of Request form PCP-PPG Change form updated. The form can be accessed under Forms and References and under Member Rights and Responsibilities > PCP Selection and Assignment in the manual. |
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary Providers, and Behavioral Health Providers.
This information applies to Medi-Cal in Fresno, Kings and Madera counties.