Correspondence

Please see the following PDF links below.

For Pharmacy Correspondences please click here.

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Last Updated: April 21, 2023

Coronavirus (COVID-19) Advisory 

The Centers for Disease Control and Prevention (CDC) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus that was first detected in China and which has now been detected in almost 70 locations internationally, including in the United States. The virus has been named "SARS-CoV-2" and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19"). IEHP will continually update you on the latest recommendations, news, and resources on COVID-19 as it becomes available.

COVID-19 Symptoms and Members Care

For a complete list of COVID-19 symptoms and step-by-step Member direction, visit our COVID-19 Member page.

COVID-19 Therapeutics Available for Members

In an effort to provide the most up-to-date treatments against COVID-19, IEHP continues to maintain a list of providers, including but not limited to infusion clinics, ancillary, hospital and non-hospital based infusion centers offering COVID-19 infusion therapy treatment. Under all Member coverage, outpatient COVID therapeutics will be offered immediately after a Member is determined to be clinically eligible under and Emergency Use Authorization (EUA).

For more information, Providers can utilize the COVID-19 Therapeutics Clinical Consult Line to connect with other clinicians for a free and confidential consultation on COVID-19 testing and treatment: 1-866-268-4322 (1-866-COVID-CA).

List of Infusion Sites

COVID-19 Infusion Treatments by Organization (PDF)

Test-To-Treat

COVID-19 Vaccine Reimbursement for Medi-Cal Providers

DHCS has carved out the COVID-19 vaccine from Medi-Cal managed care health plans and will reimburse providers under the Fee-for-Service (FFS) delivery system for both medical and pharmacy claims. Medi-Cal will reimburse the associated COVID-19 vaccine administration fee at the allowable Medicare rate for all claims (medical, outpatient, and pharmacy), based on the number of required doses for all Medi-Cal beneficiaries.

For further information:

• June 13, 2022 - DHCS COVID-19 Vaccine Administration Provider FAQs

 

FIND A TESTING AND VACCINATION SITE NEAR YOU TODAY!

RIVERSIDE

Riverside County Public Health COVID Testing Site Vaccine Information Vaccine Locations & Registration Registrations encouraged but not required for: The CDC recommends everyone ages 6 months and older get vaccinated against COVID-19 as well as a booster for everyone 5 years and older, if eligible. For more information, visit the Riverside Country Vaccine webpage. Teenagers 5 to 17 years old must register for a vaccination clinic that offers the Pfizer vaccine and be accompanied by a parent/legal guardian or present a signed written consent from a parent/legal guardian and be accompanied by an adult. Pfizer Minor Consent Form (PDF) | Spanish  The Moderna and Johnson & Johnson vaccines can only be given to individuals age 18 years and older. Johnson & Johnson Fact Sheet (PDF) | Spanish - Published April 26, 2021

SAN BERNARDINO

San Bernardino County Public Health COVID Testing Site Vaccine Locations & Registration Additional Dose and Boosters Information COVID-19 Vaccine Consent Form (PDF) | Spanish   The CDC recommends everyone ages 6 months and older get vaccinated against COVID-19 as well as a booster for everyone 5 years and older, if eligible. For more information, visit the San Bernardino County Pediatric COVID-19 Vaccination web page Walk-ins are now available at County-operated vaccination sites. Walk-in individuals will not need to bring any additional information to the site, however be prepared to register on site, which will include answering health screening questions. Walk-ins may experience longer wait times and availability may vary based on site demand.

Centers for Disease Control and Prevention (CDC)

• Clinical Care Guidance
• Vaccines
• Vaccination Plans
• January 10, 2022 - Continued Coverage of COVID-19 Diagnostic Testing (PDF)

CalVax

CalVax is a state-wide centralized system for health care Providers enrolled or interested in participating in the California COVID-19 Vaccination Program, developed by the California Department of Public Health (CDPH).

The new CalVax platform will provide a system to manage vaccine enrollment, ordering, inventory, administration, reporting and data analytics. Training materials such as job aids, videos, and recorded demos will be available to support all system users as they navigate through the new CalVax platform (mycavax.cdph.ca.gov). 

CA Notify

• CA Notify Flyer in English (PDF) and Spanish(PDF)
• CA Notify Shareable Tools for web and social media
• CA Notify Website 

Financial Assistance Resources

Riverside County Medical Association - COVID-19 Financial Toolkit for Medical Practice

U.S. Department of Health & Human Services (HHS) CARES Provider Relief Fund

• Learn more about the Provider Relief Fund (PRF)
• Provider Relief Fund (PRF) Portal

U.S. Small Business Administration. Borrowers may be eligible for Paycheck Protection Program (PPP) loan forgiveness. See if you're eligible here.

Guidance Regarding Monoclonal Antibody Treatment for COVID-19

Even with decreasing cases and hospitalizations, those with high-risk conditions who have tested positive for COVID-19 are encouraged to get monoclonal antibody treatment at Riverside University Health System (RUHS) – Medical Center.

In January, the U.S. Food and Drug Administration (FDA) limited the use of certain monoclonal antibody therapies that were ineffective against the omicron variant. In response, RUHS – Medical Center is administering sotrovimab, an IV infusion shown to be effective against omicron and other variants.

• January 14, 2022 - RUHS-Medical Center Offers Monoclonal Antibodies Treatment

If you do not have the ability to collect specimens for COVID-19, please refer to your County Public Health resources for guidance on directing Members for testing.  

Telehealth

IEHP is strongly encouraging the utilization of telehealth for visits that can be conducted over the phone or via other audiovisual telecommunications.  IEHP has published a telehealth FAQ which is available here: Telehealth Services Due to Limiting Exposure to COVID-19 (PDF)- October 17, 2022

Remember:

• IEHP Provider Telehealth Information (PDF)
• IEHP expects that Providers will offer telehealth services and support to their Members during their published business hours. 
• Existing authorizations are valid and do not need to be changed even if services are being provided via telehealth
• You can request a POS 02 or POS 10 on your authorization however if you do not, you can still utilize the authorization for telehealth services even if a different POS was approved. When billing the claim for the service, you will utilize a POS 02 or POS 10.
• ONLY Services that are deemed clinically appropriate to provide via telehealth should be provided via telehealth. If there are treatments, exams, procedures or other services that cannot be provided via telehealth, those are not eligible to be provided via telehealth. 

2023

Medicare Beneficiary Identifier (MBI)

The MACRA Act of 2015, mandates Centers for Medicare & Medicaid Services (CMS) to remove Social Security Numbers (SSN) from all Medicare cards to address the risk of Medicare beneficiary medical identity theft. CMS will mail out new Medicare Cards to Medicare Beneficiaries starting April 2018 through April 2019. 

By clicking on the CMS web links below, you will be leaving the IEHP website.

For more information regarding the new Medicare cards, please visit https://www.cms.gov/medicare/new-medicare-card/nmc-home.html.

For an overview of the new Medicare cards, please visit https://www.cms.gov/medicare/new-medicare-card/nmc-home.

New Medicare card resources:

• New Medicare Card: Information for Partners & Stakeholders (PPT)
• You're getting a new Medicare card! (PDF)
• New Card! New Number! (PDF)
• "10 Things to Know About Your New Medicare Card" (PDF)
• Your New Medicare Card: Information for People with Medicare (PPT)

For additional resources regarding the new Medicare cards, please visit https://www.cms.gov/Medicare/New-Medicare-Card/Partners-and-Employers/Partners-and-Employers.html.

You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

Newsletters

Don't miss out on the latest news! The Heartbeat, IEHP's Provider Newsletter; ScrubTalk, Provider Staff Newsletter; keep you in the know about our newest programs, incentive opportunities, study results, and more. 

Public Health Advisory

• May 18, 2023 - Mosquito Borne Disease Update (PDF)
• March 17, 2023 - Riverside University Health Systems - Increased Enteric Disease Activity - Shigella (PDF)
• November 11, 2022 - Riverside University Health Systems - Early Respiratory Syncytial Virus (RSV) and Seasonal Influenza Activity (PDF)
• October 25, 2022 - Riverside University Health Systems - Outbreak of Ebola Virus Disease Due to Sudan Virus in Central Uganda (PDF)
• October 21, 2022 - Riverside University Health Systems - Influenza (PDF)
• August 18, 2022 - Updated Monkeypox Guidance (PDF)
• August 18, 2022 - Riverside University Health System - Monkeypox Home Isolation Instructions (PDF)
• August 18, 2022 - CDC - Dear Colleague: 2022 Monkeypox Outbreak (PDF)
• July 19, 2022 - Updated Monkeypox Guidance (PDF)
• March 14, 2022 - Riverside County Legionnaires' Disease Advisory (PDF)

By clicking on the links below, you will be leaving the IEHP website.

Regulatory Updates 

Read APL 17-009 (PDF) and DPL 17-002 (PDF) for information regarding Provider-Preventable Conditions. Visit Reporting of Provider Preventable Conditions for DHCS instructions for online reporting. By clicking on these links, you will be leaving the IEHP website.

Medicare Outpatient Observation Notice (MOON)

In the event any Medicare recipient has been in a status of outpatient observation for greater than 24 hours, Acute Hospitals are required to provide Medicare Members with a Medicare Outpatient Observation Notice (MOON). Medicare recipients must receive the MOON within 36 hours of admission to observation level of care.

Please refer to the following website for further details on MOON requirements at https://www.federalregister.gov/articles/2016/08/22/2016-18476/medicare-program-hospital-inpatient-prospective-payment-system-for-acute-care-hospitals-etc.  By clicking on this link, you will be leaving the IEHP website.

Document Catalog:

1. MOON FAQs (PDF)
2. MOON Instruction Summary (PDF)
3. CMS Manual System 10611_Pub 100-04 Medicare Claims Processing MOON Instructions (PDF)
4. MOON Forms
   • MOON English (PDF)
   • MOON Spanish (PDF)
5. MOON Correspondence (PDF)

You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

Medicare-Medicaid (MMP) Quality Withhold Measures

• California Specific Quality Withhold Technical Notes for DY 2 to 8 (PDF)
• Core Quality Withhold Technical Notes for DY 2 to 10 (PDF)

Riverside University Health System - Health Advisory

• Public Health Advisory - Respiratory Viruses (PDF)

A Message From IEHP Medical Director, Dr. Takashi Wada

The 2022-2023 influenza season continues to coincide with circulation of COVID-19 virus (SARS-CoV-2). As of August 2022, approximately 94.2 million cases of COVID-19 had been reported in the United States. Influenza vaccination remains an important tool for the prevention of potentially severe respiratory illness, which helps decrease the stress on the U.S. health care system. IEHP DualChoice members who are 18 years of age or older may obtain flu vaccines through the IEHP Pharmacy Vaccine Network.

• Vaccine Notice: Access to Pharmacy Vaccine Network (PDF)

Mpox Vaccination Locations

San Bernardino County: Monkeypox (mpox) – Department of Public Health

Riverside County: Mpox Vaccine Locations – Riverside University Health System

Please advise members to call before going in for a vaccination as some locations are only available with appointments. Members may make appointments for the JYNNEOS vaccine at https://myturn.ca.gov/.

Mpox Testing

As of December 8, 2022, no commercial testing is available for the diagnosis of Mpox. Providers may contact CDC in the diagnosis, management of patients with suspected Mpox, and for any additional information regarding Mpox connect with the CDC Emergency Operations Center.

• Phone: 1-770-488-7100, Monday through Friday, 8:00 AM to 4:30 PM EST
• After Hours Phone: 1-404-639-2888

Treatment

Mpox patients usually recover fully within 2-4 weeks without the need for medical treatment. While there are no treatments specifically for Mpox, the virus that causes Mpox is similar to the smallpox virus and therefore antiviral drugs developed to protect against smallpox may be used. The antiviral drug, tecovirimat (TPOXX), has been approved by the FDA to treat smallpox in adults and children.

If you prescribe tecovirimat to treat members with Mpox the member must sign a consent form stating tecovirimat is an investigational drug that has not yet been approved by the FDA for treatment of Mpox.

• More information about tecovirimat visit https://www.cdc.gov/poxvirus/monkeypox/if-sick/treatment.html.

Frequently Asked Influenza (Flu) Questions: 2022-2023 Season (CDC Recommendations)

What’s New for 2022-2023

 By clicking on these links, you will be leaving the IEHP website.

• The composition of flu vaccines has been updated.
• For the 2022-2023 flu season, there are three flu vaccines that are preferentially recommended for people 65 years and older. These are Fluzone High-Dose Quadrivalent vaccine, Flublok Quadrivalent recombinant flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine.
• The recommended timing of vaccination is similar to last season. For most people who need only one dose for the season, September and October are generally good times to get vaccinated. Vaccination in July and August is not recommended for most adults but can be considered for some groups. While ideally it’s recommended to get vaccinated by the end of October, it’s important to know that vaccination after October can still provide protection during the peak of flu season.
• The age indication for the cell culture-based inactivated flu vaccine, Flucelvax Quadrivalent (ccIIV4), changed from 2 years and older to 6 months and older.
• Pre-filled Afluria Quadrivalent flu shots for children are not expected to be available this season. However, children can receive this vaccine from a multidose vial at the recommended dose.

Preventive Services

Immunizations

 By clicking on these links, you will be leaving the IEHP website.

• CDC ACIP Vaccine Recommendations and Guidelines: https://www.cdc.gov/vaccines/hcp/acip-recs/index.html
• CDC ACIP Immunization Schedule for Children: https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html
• CDC ACIP Immunization Schedule for Adults: https://www.cdc.gov/vaccines/schedules/hcp/adult.html
• USPSTF Task Force's Immunization Recommendations: https://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=immunization
• California Immunization Registry Portal (CAIR): https://cair.cdph.ca.gov/CAPRD/portalInfoManager.do
• Immunization Timing 2022 (PDF)

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