SB 137 Implementation The Latest from Sacramento
|
|
- Rachel Elliott
- 6 years ago
- Views:
Transcription
1 SB 137 Implementation The Latest from Sacramento April 13, 2017 Mary Watanabe Deputy Director, Health Policy and Stakeholder Relations Havi Jogani Attorney, Office of Plan Licensing
2 California Provider Directory Requirements Senate Bill 137 added California Health & Safety Code section (repealed section ) Uniform Provider Directory Standards Released: 12/30/2016; Compliance Date: 1/1/ pds.pdf For Medi-Cal Plans: 42 C.F.R (h)
3 Timeline Date Description July 1, 2016 Compliance date for SB 137 December 30, 2016 January 1, 2018 TBD January 1, 2021 Uniform Provider Directory Standards Released Compliance date for Uniform Provider Directory Standards Compliance date for SB 1135 (Timely Access to Care) Two revisions of provider directory standards and development of regulations Final regulations promulgated
4 Major Provisions Provider directories must be available online, updated weekly Directory inaccuracies can be reported for investigation by telephone, , and hyperlink Annual provider notification verification process Online interfaces for providers to easily verify or submit changes to provider directory information
5 Required Provider Information Provider s name Practice location(s) Contact information Type of practitioner National Provider Identifier number California license number and type of license Area of specialty, including board certification Provider s office address, if available Provider group affiliations Non-English languages spoken Panel Status (whether provider is accepting new patients) Network tier, if applicable
6 SB 137 Provider Requirements Providers must report to plans within 5 business days any change in panel status (whether a provider is accepting new patients) If a provider who is not accepting new patients is contacted by an enrollee or potential enrollee seeking to become a new patient, the provider shall: 1. Direct the enrollee or potential enrollee to the plan for additional assistance in finding a provider; and 2. Direct the enrollee to the DMHC to report any inaccuracy with the plan s provider directory. Providers must verify or submit changes to provider directory information using the process required by plans
7 Uniform Provider Directory Standards Directories must list a provider s licensed name (preferred names may be included) For full-service commercial health plans, all products must include product type and metal level, as applicable Parameters for display of panel status and provider s office address Directories must display the date of the most recent update
8 DMHC s Oversight of SB 137 Compliance Initial compliance filing Annual compliance filings Incorporating SB 137 compliance into DMHC s routine health plan survey process Monitor complaints to DMHC Help Center Enforcement action when necessary and appropriate
9 SB 137 Next Steps Monitor plan compliance with initial standards Continue to meet and engage with all stakeholders regarding proposed revisions to the uniform standards Issue further regulatory guidance on provider directories as necessary Overlap with other Legislation implementation
10 Related Activities SB 1135, Timely Access to Care Timely Access Compliance Reports Annual Network Review AB 72, Prohibition on Surprise Balance Billing Undertakings Related to Provider Directories
11 Questions Mary Watanabe Deputy Director Health Policy and Stakeholder Relations (916) Havi Jogani Attorney Office of Plan Licensing (916)
8. Provider Rights and Responsibilities
8. Provider Rights and As a Provider, you are responsible for understanding and complying with terms of your Agreement and this section. If you have any questions regarding your rights and responsibilities
More informationpresenter David Melendez Senior Project Manager, Language Assistance Program Blue Shield of California
1 presenter David Melendez Senior Project Manager, Language Assistance Program Blue Shield of California 2 Blue Shield s new Blue Shield s new Language Assistance Program Beginning January 1, 2009 Language
More informationMedi-cal Manual Update Section 12 Provider Network Operations (pg ) SECTION 12: PROVIDER NETWORK OPERATIONS
SECTION 12: PROVIDER NETWORK OPERATIONS The Provider Network Operations Department is dedicated to educating, training, and ensuring all participating providers have a resource to voice any concern they
More informationCredentialing Standards
Credentialing Standards Presenters: Mei Ling Christopher Veronica Harris Royal Agenda Definitions vs. 2017 Regulatory Updates Understanding the Standards SB 137 Provider Directories Reminders Questions
More informationHealth Care Legislation Affecting Low-Income Consumers as of October 17, Medi-Cal
Sacramento Office Mike Herald Director of Policy Advocacy Jessica Bartholow Jen Flory Jith Meganathan Anya Lawler Linda T. Nguy The last day for each house to pass bills was September 15, which was the
More informationDelegation Oversight 2016 Audit Tool Credentialing and Recredentialing
Att CRE - 216 Delegation Oversight 216 Audit Tool Review Date: A B C D E F 1 2 C3 R3 4 5 N/A N/A 6 7 8 9 N/A N/A AUDIT RESULTS CREDENTIALING ASSESSMENT ELEMENT COMPLIANCE SCORE CARD Medi-Cal Elements Medi-Cal
More informationCalifornia Children s Services Program Redesign:
California Children s Services Program Redesign: Vision, Goals and Groundwork for the Stakeholder Process September 26, 2014 Agenda 9:30-9:35 Welcome and Introductions Dylan Roby, UCLA 9:35-9:45 Opening
More informationUnderstanding Balance Billing. A Primer for L.A. Care Contracted Providers
Understanding Balance Billing A Primer for L.A. Care Contracted Providers Purpose for this Training 1. With new managed care programs (i.e. Cal MediConnect, Covered California, PASC- SEIU), members and
More informationState advocacy roadmap: Medicaid access monitoring review plans
State advocacy roadmap: Medicaid access monitoring review plans Background Federal Medicaid law requires states to ensure Medicaid beneficiaries are able to access the healthcare providers they need through
More informationSB 75 Full Scope Medi-Cal for Children. SF Health Network - Community Behavioral Health Services June 21, 2016 Maria Jimenez Barteaux, CBHS Billing
SB 75 Full Scope Medi-Cal for Children SF Health Network - Community Behavioral Health Services June 21, 2016 Maria Jimenez Barteaux, CBHS Billing Senate Bill 75 Welfare & Institutions Code, Section 14007.8
More informationProvider Relations Training
Cal MediConnect Provider Relations Training Presented by Victor Gonzalez and George Scolari Provider Relations Training Agenda Overview of Cal MediConnect Eligibility & Exclusions Enrollment & Disenrollment
More informationCoordinating Care for Dual Eligibles: California s Demonstration Project
Coordinating Care for Dual Eligibles: California s Demonstration Project Sarah Arnquist, Harbage Consulting Alameda County Board of Supervisors Health Committee January 30, 2012 Presentation Outline Misaligned
More informationASSEMBLY BILL No. 214
AMENDED IN SENATE AUGUST, 00 AMENDED IN SENATE AUGUST, 00 AMENDED IN SENATE AUGUST, 00 AMENDED IN SENATE JULY, 00 AMENDED IN SENATE JUNE, 00 AMENDED IN SENATE JUNE, 00 AMENDED IN SENATE AUGUST 0, 00 california
More informationProvider Handbook Supplement for CalOptima
Magellan Healthcare, Inc. * Provider Handbook Supplement for CalOptima *In California, Magellan does business as Human Affairs International of California, Inc. and/or Magellan Health Services of California,
More information18. PROVIDER NETWORK. A. Primary Care Physician (PCP) 1. Affiliation Numbers APPLIES TO: A. This policy applies to all IEHP Medi-Cal Providers.
A. Primary Care Physician (PCP) 1. Affiliation Numbers APPLIES TO: A. This policy applies to all IEHP Medi-Cal Providers. POLICY: A. PCPs may have a maximum of two (2) unique IEHP Provider Affiliation
More informationState of California Health and Human Services Agency Department of Health Care Services
State of California Health and Human Services Agency Department of Health Care Services JENNIFER KENT DIRECTOR EDMUND G. BROWN JR. GOVERNOR SynerMed Corrective Action Plan Problem Presented: Recently,
More informationJuly 13, RE: Comments on Whole Child Model Documents. Dear CCS Redesign Team:
Children's Regional Integrated Service System Hemophilia Council of California July 13, 2016 California Children s Services Redesign Team California State Department of Health Care Services 1501 Capitol
More informationSANTA RITA CARE CENTER Notice of Information Practices
SANTA RITA CARE CENTER Notice of Information Practices THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT
More informationKern Medical Center Health Plan
Managed By UCLA Spring Convening on HCCI Kern Medical Center Health Plan Vision An integrated healthcare network Neighborhood access to primary care Enhanced access to specialty and diagnostic care Coordination
More informationIPA. IPA: Reviewed by: UM program. and makes utilization 2 N/A. Review) The IPA s UM. includes the. description. the program. 1.
IPA Delegation Oversight Annual Audit Tool 2011 IPA: Reviewed by: Review Date: NCQA UM 1: Utilization Management Structure The IPA clearly defines its structures and processes within its utilization management
More informationHealth Care Legislation Affecting Low-Income Consumers as of July 6, Medi-Cal
AB 74 Chiu Housing. This bill would create the Housing for a Healthy California Program to provide rental assistance to Medi-Cal members who are homeless. Spot bill for Medi-Cal in case of ACA repeal.
More informationREQUEST FOR PROPOSALS TO UPDATE THE DISTRICT S HAZARD MITIGATION PLAN
REQUEST FOR PROPOSALS TO UPDATE THE DISTRICT S HAZARD MITIGATION PLAN Release Date: March 29, 2018 Deadline for Submission: (Corrected) Wednesday, April 11, 2018 at 2:00 PM Santa Fe Irrigation District
More informationBlue Shield/Care1st and Centene/Health Net Undertakings IHA Stakeholder Meeting
Blue Shield/Care1st and Centene/Health Net Undertakings IHA Stakeholder Meeting Presented by: Shelley Rouillard Director September 19, 2017 HealthHelp.ca.gov 1 Overview DMHC s activities on provider directories
More informationNEW BRIGHTON CARE CENTER
NEW BRIGHTON CARE CENTER 805 6 th Ave NW, New Brighton, MN 55112 NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS
More informationWe are writing this letter to emphasize to you the critical importance of addressing the following issues raised in the sunset oversight hearing:
Sharon Levine, M.D., President 2005 Evergreen Street, Suite 1200 Sacramento, CA 95815 Dear Dr. Levine: As the respective Chairs of the Senate Business, Professions and Economic Development, and the Assembly
More informationCriminal Justice Division
Office of the Governor Criminal Justice Division Funding Announcement: General Victim Assistance Program December 1, 2017 Opportunity Snapshot Below is a high-level overview. Full information is in the
More informationPurpose: To establish guidelines for the clinical practice of Non-Physician Medical Practitioners (NPMP).
Purpose: To establish guidelines for the clinical practice of Non-Physician Medical Practitioners (NPMP). Policy: The Central California Alliance for Health (the Alliance) requires all NPMPs to meet the
More informationDisability Rights California
Disability Rights California California s protection and advocacy system BAY AREA REGIONAL OFFICE 1330 Broadway, Suite 500 Oakland, CA 94612 Tel: (510) 267-1200 TTY: (800) 719-5798 Toll Free: (800) 776-5746
More informationSANTA BARBARA COUNTY DEPARTMENT OF Behavioral Wellness A System of Care and Recovery
SANTA BARBARA COUNTY DEPARTMENT OF Behavioral Wellness A System of Care and Recovery P age 11 of 5 Department Policy and Procedure Section Sub-section Policy Policy# Quality Care Management General Contracted
More informationCredentialing Standards Presenters: Mei Ling Christopher Veronica Harris Royal
Credentialing Standards Presenters: Mei Ling Christopher Veronica Harris Royal Agenda Introductions Definitions vs. 2016 Regulatory Updates Survey Process Reminders Questions and Answers 222 Introduction
More informationAnthem Blue Cross Provider Operations and Technology
Termination of Provider Enrollee Notification Initial Policy Approval Date: 12/17/2001 Policy Review/Revision Approval Date(s): 06/17/2002, 6/16/2003, 3/29/2004, 06/19/2007 Filed DMHC, 1/17/2014 Products:
More informationA. This policy applies to all IEHP DualChoice Cal MediConnect Plan (Medicare Medicaid Plan) Providers.
A. Primary Care Physician (PCP) 1. Affiliation Numbers APPLIES TO: A. This policy applies to all IEHP DualChoice Cal MediConnect Plan (Medicare Medicaid Plan) Providers. POLICY: A. PCPs may have a maximum
More informationSenate Bill No. 586 CHAPTER 625
Senate Bill No. 586 CHAPTER 625 An act to amend Sections 123835 and 123850 of the Health and Safety Code, and to amend Sections 14093.06, 14094.2, and 14094.3 of, and to add Article 2.985 (commencing with
More informationA. Members Rights and Responsibilities
APPLIES TO: A. This policy applies to all IEHP Medi-Cal Members. POLICY: A. For the purpose of this policy, a Delegate is defined as a medical group, IPA or any contracted organization delegated to provide
More informationInternal Grievances and External Review for Service Denials in Medi-Cal Managed Care Plans
Internal Grievances and External Review for Service Denials in Medi-Cal Managed Care Plans Managed Care in California Series Issue No. 4 Prepared By: Abbi Coursolle Introduction Federal and state law and
More informationCustomer Service Center Quick Sort Transfers to Counties/Consortia: Service Standards and Contingencies
Customer Service Center Quick Sort Transfers to Counties/Consortia: Service Standards and Contingencies Juli Baker Chief Technology Officer Covered California Len Finocchio Associate Director California
More informationGENERAL INFORMATION: NURSE PRACTITIONER PRACTICE
BOARD OF REGISTERED NURSING PO Box 944210, Sacramento, CA 94244-2100 P (916) 322-3350 F (916) 574-8637 www.rn.ca.gov Louise R. Bailey, MEd, RN, Executive Officer GENERAL INFORMATION: NURSE PRACTITIONER
More information2018 MEDICARE PROVIDER MANUAL
2018 MEDICARE PROVIDER MANUAL www.care1st.com Care1st Health Plan 601 Potrero Grande Drive Monterey Park, CA 91755 323.889.6638 CARE1ST HEALTH PLAN MEDICARE PROVIDER MANUAL TABLE OFCONTENTS WELCOME 7 INTRODUCTION
More informationMedicaid Managed Specialty Supports and Services Concurrent 1915(b)/(c) Waiver Program FY 17 Attachment P7.9.1
QUALITY ASSESSMENT AND PERFORMANCE IMPROVEMENT PROGRAMS FOR SPECIALTY PRE-PAID INPATIENT HEALTH PLANS FY 2017 The State requires that each specialty Prepaid Inpatient Health Plan (PIHP) have a quality
More information2018 Northern California HMO Provider Manual Kaiser Foundation Health Plan, Inc.
2018 Northern California HMO Provider Manual Kaiser Foundation Health Plan, Inc. Welcome from Kaiser Permanente It is our pleasure to welcome you as a contracted provider (Provider) participating under
More informationTIER I. AB-451 (Arambula) Health facilities: emergency services and care
NAMI CA Legislative Tiered Bills (2017-2018) TIER I AB-451 (Arambula) Health facilities: emergency services and care - NAMI CA has been asked by author for support - (Sponsor) California Chapter, American
More informationChapter II OVERVIEW OF THE MEDICAL BOARD OF CALIFORNIA
Overview of the Medical Board of California 5 Chapter II OVERVIEW OF THE MEDICAL BOARD OF CALIFORNIA A. MBC Generally 2 Created in the Medical Practice Act, the Medical Board of California is a semi-autonomous
More informationTRANSITION OF NURSING HOME POPULATIONS AND BENEFITS TO MEDICAID MANAGED CARE
ANDREW M. CUOMO Governor HOWARD A. ZUCKER, M.D., J.D. Acting Commissioner SALLY DRESLIN, M.S., R.N. Executive Deputy Commissioner TRANSITION OF NURSING HOME POPULATIONS AND BENEFITS TO MEDICAID MANAGED
More informationMEDI-CAL MANAGED CARE OVERVIEW
MEDI-CAL MANAGED CARE OVERVIEW July 2018 Sandy Damiano, PhD Deputy Director DHS Primary Health Eligibility & Enrollment Apply for Medi-Cal year round: County Department of Human Assistance (DHA) Online,
More informationPresented to: The Sacramento Medi-Cal Managed Care Stakeholder s Advisory Committee
The Health Plan/ IPA Relationship: P Partners in i Health H l h Care C Delivery D li Presented to: The Sacramento Medi-Cal Managed Care Stakeholder s Advisory Committee By: Anthem Blue Cross Health Net
More informationState of California Health and Human Services Agency Department of Health Care Services
State of California Health and Human Services Agency Department of Health Care Services TOBY DOUGLAS Director EDMUND G. BROWN JR. Governor DATE: JUNE 26, 2014 ALL PLAN LETTER 14-007 TO: ALL MEDI-CAL MANAGED
More informationHEALTHY FAMILIES PROGRAM TRANSITION TO MEDI-CAL
HEALTHY FAMILIES PROGRAM TRANSITION TO MEDI-CAL NETWORK ADEQUACY ASSESSMENT REPORT PHASE 1 November 1, 2012 Submitted by the California Department of Managed Health Care in Fulfillment of the Requirements
More informationSECTION 12: PROVIDER NETWORK OPERATIONS
Updated Section SECTION 12: PROVIDER NETWORK OPERATIONS The Provider Network Operations Department is dedicated to educating, training, and ensuring all participating providers have a resource to voice
More information2017 ACNL Health Policy Committee Issue/Watch Log (IWL)
General Legislative Update/Activity All Committee members Monitor CA State Legislative calendar and activity. Identify potential legislative issues significant to ACNL organizational priorities and goals.
More informationTemplate Language for Memorandum of Understanding between Duals Demonstration Health Plans and County Behavioral Health Department(s)
Template Language for Memorandum of Understanding between Duals Demonstration Health Plans and County Behavioral Health Department(s) Updated Draft February 14, 2013 In the duals demonstration, participating
More informationDEPARTMENT OF THE ARMY U.S. Army Corps of Engineers Washington, DC Engineering and Design CORPS-WIDE CENTERS OF EXPERTISE PROGRAM
CECW-CE Regulation No. 1110-1-8158 DEPARTMENT OF THE ARMY U.S. Army Corps of Engineers Washington, DC 20314-1000 Engineering and Design CORPS-WIDE CENTERS OF EXPERTISE PROGRAM Distribution Restriction
More informationInland Empire Health Plan Quality Management Program Description Date: April, 2017
Inland Empire Health Plan Quality Management Program Description Date: April, 2017 Page 1 of 35 Table of Contents Introduction.....3 Mission and Vision........3 Section 1: QM Program Overview........4
More informationObservation Care Evaluation and Management Codes Policy
Policy Number Observation Care Evaluation and Management Codes Policy 2017R0115A Annual Approval Date 3/8/2017 Approved By Reimbursement Policy Oversight Committee IMPORTANT NOTE ABOUT THIS You are responsible
More informationScripts for the Transition to Medi-Cal
Scripts for the Transition to Medi-Cal Question: Where can we get the latest information on the transition plan? The State Law has changed and requires children enrolled
More informationWelcome! The webinar will begin at 1:30 PM
Welcome! The webinar will begin at 1:30 PM Connect to the audio via your computer or call-in Use the Chat function to ask questions - Questions will be managed through the Chat and will be answered at
More informationSpecific Comments on Proposed Amendments
June 8, 2015 Division of Dockets Management (HFA-305) Food and Drug Administration 5630 Fishers Lane Room 1061 Rockville, MD 20852 RE: Docket No. FDA 2002-N-0323 Proposed Rulemaking: Amendments to Registration
More informationLaurie A. Soman Lucile Packard Children s Hospital CRISS
Laurie A. Soman Lucile Packard Children s Hospital CRISS 1 Birth of CCS Program CCS Program Established in 1927 for Orthopedically Handicapping Conditions CCS Originally Crippled Children s Services Response
More informationCalifornia Provider Handbook Supplement to the Magellan National Provider Handbook*
Magellan Healthcare, Inc. * California Provider Handbook Supplement to the Magellan National Provider Handbook* *In California, Magellan does business as Human Affairs International of California, Inc.
More informationStandard Operating Procedures
Clinical Monitoring and Site Verification Procedure Overview To define the standard procedures for preparation and documentation of site visits for clinical monitoring and spoke verification for any NETT
More informationKnox-Keene Regulatory Requirements
Knox-Keene Regulatory Requirements The Knox-Keene Act (the Act ) is voluminous and highly detailed. A complete outline of its requirements would fill a book. Nevertheless, there are certain requirements
More informationPage 1 of 6 ADMINISTRATIVE POLICY AND PROCEDURE
Page 1 of 6 SECTION: Contracts SUBJECT: Credentialing DATE OF ORIGIN: 6/1/08 REVIEW DATES: 8/1/15, 2/8/17 EFFECTIVE DATE: 12/1/17 APPROVED BY: EXECUTIVE DIRECTOR I. PURPOSE: To have a written system in
More informationMental Health Board Member Orientation & Training
1 Mental Health Board Member Orientation & Training See Tab 1 Mental Health Timeline 1957 Sources: California Legislative Analyst Office & California Department of Health Care Services to Prior to 1957
More informationState of Reform: What Does Universal Coverage Look Like in California?
State of Reform: What Does Universal Coverage Look Like in California? April 26, 2018 Tam Ma Legal and Policy Director California s Health Care Landscape 93% of Californians have health coverage 39.54
More informationJoint Recommendations to Address Race and Language Disparities In Regional Center Funding of Services for Children
Joint Recommendations to Address Race and Language Disparities In Regional Center Funding of Services for Children Senate Human Services March 14, 2017 1. DDS POS budget and allocation methodology must
More informationEmergency Response Preparedness. Don Rickerhauser Manager, Safety and Security
Emergency Response Preparedness Don Rickerhauser Manager, Safety and Security 1 Why have a plan? Every aviation organization, which includes, operator, service provider, maintenance organization, and airport
More informationStandard NUC Nuclear Plant Interface Coordination
A. Introduction 1. Title: Nuclear Plant Interface Coordination 2. Number: NUC-001-2.1 3. Purpose: This standard requires coordination between Nuclear Plant Generator Operators and Transmission Entities
More informationCalifornia Hospital Association Medication Safety Committee
California Hospital Association Medication Safety Committee An interagency, interdisciplinary committee for safe medication use. Jeannette Hanni, R.Ph., M.P.A., FCSHP Co-Chair, CHA Medication Safety Committee
More information2014 Complete Overview of the URAC Standards
2014 Complete Overview of the URAC Standards Session Code: TU09 Time: 10:00 a.m. 11:30 a.m. Total CE Credits: 1.5 Presented by: Sandra Greenwalt, RN, BSN, MCHA, CCM, CCP, CPHQ URAC Provider Credentialing,
More informationYOUR APPEAL RIGHTS THIS NOTICE DESCRIBES YOUR RIGHTS TO FILE AN APPEAL WITH COMMUNITY HEALTH GROUP. PLEASE REVIEW IT CAREFULLY.
YOUR APPEAL RIGHTS THIS NOTICE DESCRIBES YOUR RIGHTS TO FILE AN APPEAL WITH COMMUNITY HEALTH GROUP. PLEASE REVIEW IT CAREFULLY. A grievance is an expression of dissatisfaction that a member communicates
More informationMISSISSIPPI LEGISLATURE REGULAR SESSION 2017 COMMITTEE SUBSTITUTE FOR SENATE BILL NO. 2330
MISSISSIPPI LEGISLATURE REGULAR SESSION 2017 By: Senator(s) Harkins To: Medicaid; Appropriations COMMITTEE SUBSTITUTE FOR SENATE BILL NO. 2330 1 AN ACT ENTITLED THE "MISSISSIPPI WELFARE FRAUD PREVENTION
More informationQuality Management Training 2013 CALENDAR
MONTH DATE CODE TRAINING TIME ROOM January Jan. 8, 2013 G1 Progress Notes and Service Codes 9:00 a.m. - 12:00 p.m. Conf. Rm. 2 Jan. 8, 2013 F1 Problem Resolution/Advance Medical Directives 9:00 a.m. -
More informationLanguage Assistance Program Provider Training
Language Assistance Program Provider Training Created by ICE Education and Training Workgroup 4/14/2009 Role of ICE To establish, coordinate and oversee a multi-disciplinary team of volunteers from health
More informationQuality Management Training 2014 CALENDAR
MONTH DATE CODE TRAINING TIME ROOM January Jan. 7, 2014 G1 Progress Notes and Service Codes 9:00 a.m. - 12:00 p.m. Conf. Rm. 2 Jan. 9, 2014 F1 Problem Resolution/Advance Medical Directives 9:00 a.m. -
More informationNetworkNotes. U.S. Behavioral Health Plan, California (USBHPC) News for Clinicians and Facilities Fall 2009
CALIFORNIA NetworkNotes U.S. Behavioral Health Plan, California (USBHPC) News for Clinicians and Facilities Fall 2009 Update Your Expertise Clearly identifying your areas of expertise facilitates appropriate
More information1.5. Health Plan provides alternative format materials in accordance with ADA Alternative Formats Policy.
Page: 1 of 19 1.0 Policy Statement 1.1. Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Hospitals, The Permanente Medical Group, Inc., and the Southern California Permanente Medical Group are
More informationMember Services Director
Central Coast Alliance for Health September 2006 Duty Statement page 1 Member Services Director 1. Responsible for senior management and strategic planning for the Member Services Department, including
More informationSOUTHERN TIER LIBRARY SYSTEM OUTREACH MINI-GRANT. Apply to: Alfonso Oliveras, Deputy Director
SOUTHERN TIER LIBRARY SYSTEM OUTREACH MINI-GRANT Apply to: Alfonso Oliveras, Deputy Director (oliverasa@stls.org) Program Description The STLS Coordinated Outreach Services Advisory Committee provides
More information#14 AUTHORIZATION FOR MEDI-CAL SPECIAL TY MENTAL HEAL TH SERVICES (OUTPATIENT)
COUNTY OF SANTA BARBARA ALCOHOL, DRUG AND MENTAL HEAL TH SERVICES Section - Policy- QUALITY ASSURANCE #14 AUTHORIZATION FOR MEDI-CAL SPECIAL TY MENTAL HEAL TH SERVICES (OUTPATIENT) Director's /{A A.. \
More informationShow me the Money How Medicaid Can Pay for Language Services. Webinar: May 31, 2007
Show me the Money How Medicaid Can Pay for Language Services Webinar: May 31, 2007 Roadmap Introduction How Medicaid Can Pay for Language Services States with Existing Reimbursement Methods Advocacy Efforts
More informationPractitioners may be recredentialed at any time, but in no circumstance longer than a 36 month period.
SUBJECT: PRIMARY CARE AND SPECIALTY PHYSICIAN RECREDENTIALING SECTION: CREDENTIALING POLICY NUMBER: CR-02 EFFECTIVE DATE: 1/01 Applies to all products administered by the Plan except when changed by contract
More informationManaged Health Network
Managed Health Network Practitioner Manual 2017 Practitioner Manual 2017 Practitioner Manual Table of Contents SECTION 1 OVERVIEW OF SERVICES... 4 1.1 EMPLOYEE ASSISTANCE PROGRAMS (EAP)... 4 1.2 MHN BEHAVIORAL
More informationMEDI-CAL MANAGED CARE OVERVIEW
MEDI-CAL MANAGED CARE OVERVIEW September 2016 Sandy Damiano, PhD Deputy Director DHHS Primary Health Eligibility & Enrollment Open year round Based on income and family size Simplified procedures Income
More informationFinding Progress on Timely Access Issues
Finding Progress on Timely Access Issues Bill Barcellona SVP for Government Affairs, CAPG L. Gordon Moore, MD Senior Medical Director, 3M Health Data Science Group Dan Southard Deputy Director, Office
More informationMember Handbook. IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan) IEHP (4347) TTY. For The Benefit Year
Member Handbook IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan) For The Benefit Year 1-877-273-IEHP (4347) 1-800-718-4347 TTY 2016 IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid
More informationGOALS. I. Monitoring the quality of health care for safety, effectiveness and efficiency and seek opportunities for improvement
MUTUAL OF OMAHA INSURANCE COMPANY UNITED OF OMAHA LIFE INSURANCE COMPANY PPO & MANAGED INDEMNITY MEDICAL & DENTAL PLANS EXCLUSIVE HEALTHCARE, INC. 2005 QUALITY IMPROVEMENT PROGRAM The Quality Improvement
More informationExecutive Director s Report
Executive Director s Report Peter V. Lee Executive Director California Health Benefit Exchange Board Meeting December 18, 2012 Covered California Board Calendar 2013 Month / Date January 17 February 21
More informationContents Fall History and Administration of Public Benefit Programs... 1/3
Contents Fall 2017 History and Administration of Public Benefit Programs... 1/3 Reforming Reform... 1/11 It s Not Welfare Anymore... 1/11 Strategies to Support Work and Reduce Poverty... 1/13 Ten Years
More informationCoordinated Care Initiative DRAFT Assessment and Care Coordination Standards November 20, 2012
Coordinated Care Initiative DRAFT Assessment and Care Coordination Standards November 20, 2012 Table of Contents CARE COORDINATION GENERAL REQUIREMENTS...4 RISK STRATIFICATION AND HEALTH ASSESSMENT PROCESS...6
More informationOther languages and formats
Dear member, We re glad you re part of our health plan! It s important to us that you have the most up-to-date information about your benefits. We re sending you the following notices with this letter:
More informationDepartment of Health Care Services
State of California Department of Health Care Services Streamlining the Cal MediConnect Voluntary Enrollment Experience April 2016 This is one of three documents released by the Department of Health Care
More informationCredentialing Application and Process
Credentialing Application and Process What is Credentialing? Credentialing is the process of obtaining, verifying and assessing the qualifications of a healthcare practitioner to provide patient care services
More informationChapter VIII EXPERT REVIEWER PROGRAM
Expert Reviewer Program 103 Chapter VIII EXPERT REVIEWER PROGRAM A. Overview of Function and Updated Data In a quality of care disciplinary matter against a physician, expert opinion testimony is required
More informationL.A. Care Presents: New Provider Training, Onboarding, and Oversight & Monitoring
L.A. Care Presents: New Provider Training, Onboarding, and Oversight & Monitoring Presented by: Alma Mejorado, Senior Manager Leslie Padilla, Senior Account Specialist New Provider Training, Onboarding,
More informationNATIONAL CONSORTIUM OF TELEHEALTH RESOURCE CENTERS
NATIONAL CONSORTIUM OF TELE RESOURCE S For the California Telehealth Resource Center Conference May 17, 2018 877-707-7172 cchpca.org Mario Mei Guttierez Wa Kwong, JD DISCLAIMERS Any information provided
More informationRegulatory Compliance Policy No. COMP-RCC 4.60 Title:
I. SCOPE: Regulatory Compliance Policy No. COMP-RCC 4.60 Page: 1 of 6 This policy applies to (1) Tenet Healthcare Corporation and its wholly-owned subsidiaries and affiliates (each, an Affiliate ); (2)
More informationREQUEST FOR PROPOSALS: AUDIT SERVICES. Issue Date: February 13 th, Due Date: March 22 nd, 2017
REQUEST FOR PROPOSALS: AUDIT SERVICES Issue Date: February 13 th, 2017 Due Date: March 22 nd, 2017 In order to be considered, proposals must be signed and returned via email to rtan@wested.org by noon
More informationI. Coordinating Quality Strategies Across Managed Care Plans
Jennifer Kent Director California Department of Health Care Services 1501 Capitol Avenue Sacramento, CA 95814 SUBJECT: California Department of Health Care Services Medi-Cal Managed Care Quality Strategy
More informationMark your calendar: Bargaining meetings start soon
From the California Faculty Association CFA HEADLINES August 31, 2016 Weekly news digest from CFA Welcome back CSU Channel Islands, Maritime Academy, Northridge, Sacramento, San Diego, and San Marcos!
More information1.3: Joint Operation Committee Meetings for PPGs & Hospitals Only
SECTION 1: PROVIDER NETWORK OPERATIONS The Provider Network Operations Department is dedicated to educating, training, and ensuring all participating providers have a resource to voice any concern they
More informationLegislative/Public Policy Platform for 2017
LEGISLATION & PUBLIC INFORMATION UNIT 1831 K Street Sacramento, CA 95811-4114 Tel: (916) 504-5800 TTY: (800) 719-5798 Intake Line: (800) 776-5746 Fax: (916) 504-5807 www.disabilityrightsca.org Legislative/Public
More information