25-120 Provider Communications Posted Online and Operations Manual Updates for January 2025
Date: 02/06/25
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The tables below outline provider communications posted online and operations manual changes made in January 2025.
- 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 for January 2025.
Read the latest issue of the winter Provider Pulse newsletter
Check out the winter issue for details on how we are working to support you, your patients and your community. Topics in this issue include:
- CalViva Health Receives Outstanding Foundation Award
- Health Net’s Leadership in Health Equity is Recognized Again
- Health Net Gains Improved Outcomes and Collaboration Through Engagement
- Health Net Grant for UC Davis Stem Cell Program to Improve Access to CAR T-Cell Therapy
Download the current and past issues in the Provider Library. Then, select Medi-Cal > Provider Pulse Newsletter.
Communications posted online in January 2025
Date, Number and title | Type of notice | Audience | Medi-Cal counties | Summary |
|---|---|---|---|---|
1/9/25 25-025m, Medication Trend Updates and Formulary Changes – 1st Quarter 2025 | Contractual | Physicians PPGs
| Fresno Kings Madera | Find out about drug list and formulary changes and medication safety issues for the 1st quarter of 2025. Includes information about the voluntary withdrawal of Oxbryta from the market for the treatment of sickle cell disease due to safety concerns. |
1/14/25 25-044m, Self-Register Now to Access the State-Sponsored EVV System | News & Announcements | Physicians PPGs Ancillary providers Behavioral Health providers | Fresno Kings Madera | Register and use the state sponsored electronic visit verification (EVV) system to track in-home service visits required by the Department of Health Care Services. Learn which provider types must use EVV and services excluded from EVV requirements. |
1/27/25 25-081m, Medical Policies – December 2024 | Contractual | Physicians PPGs Behavioral Health providers | Fresno Kings Madera | Review changes to medical policies for procedures and services for December 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. |
Medi-Cal Provider Operations Manual changes (for physicians, PPGs, hospitals, and ancillary providers) in January 2025
Effective Date | Document name, path (if applicable) and URL | Audience | Summary |
|---|---|---|---|
1/1/25 |
(under Benefits)
| Physicians PPGs Hospitals Ancillary | Updated information about doula services for Medi-Cal. |
1/1/25 | Member Rights and Responsibilities
| Physicians PPGs Hospitals Ancillary | Updated to reflect information included in member Evidence of Coverage (EOC) for 2025. |
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.