Provider Communications and Operations Manual Updates for December 2023

Date: 12/02/23

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The tables below outline provider communications posted online and operations manual changes made in
November 2023.

• Communications posted online: This includes the posting date, material number and title, type of notice, applicable audience and lines of business, and a summary of the communication.
• Provider operations manual changes: This includes the effective date of the change, document name (and path to section where document is located), audience, affected lines of business and URLs, and a summary of the change.

Communications posted online in November 2023

Date posted	Number and title	Type of notice	Audience1		Lines of business2	Summary
Date	22-XXXm, Title	News & Announcements (or Contractual, Regulatory, Legislative)	Physicians PPGs Hospitals Ancillary providers	ECM providers CS providers	IFP (Ambetter HMO, Ambetter PPO) Employer Group (HMO/POS, PPO) Medicare Advantage HMO/PPO Medi-Cal (all counties) Molina	Summary from monthly summary text email from Writer.

¹ ECM – Enhanced Care Management; CS – Community Supports

² Medi-Cal (all counties) indicates that the communication applies to Medi-Cal Amador, Calaveras, Inyo, Los Angeles, Mono, Sacramento, Tuolumne, San Joaquin, Stanislaus, and Tulare counties.

Provider operations manual changes in November 2023

Effective Date	Document name	Audience	Lines of business	Summary
10/6/23	Monitoring Provider Exclusions	Physicians PPGs Hospitals Ancillary providers	HMO, PPO, EPO, PPO, Medicare Advantage  Medi-Cal	This document has been updated to include the Office of Personnel Management (OPM) under the Federal Employee Health Benefit Plan (FEHBP) as an excluded service provider for various activities.
10/14/23	Injectable Medication HCPCS/DOFR Crosswalk	Physicians PPGs	HMO, Medicare Advantage, Medi-Cal	The Injectable Medications HCPCS/DOFR Crosswalk has been updated for the 2nd and 3rd quarter of 2023.

Additional information

If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by email, by phone or through the provider portal.