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Provider Digest | Issue 19

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Don’t miss: updates to Medi-Cal enrollment, behavioral health and medically tailored meals

Providers enrolled in Medi-Cal during PHE must submit complete application by June 27

During the pandemic, DHCS established amended enrollment requirements and procedures for providers to temporarily and provisionally enroll in the Medi-Cal program during the COVID-19 public health emergency (PHE). Effective March 29, 2023, DHCS is discontinuing these provider enrollment flexibilities.

If you are a provider who was temporarily and provisionally enrolled, you must:

  • Submit an application for enrollment via the Provider Application and Validation for Enrollment (PAVE) portal by June 27. If you do not submit an application by the June 27 deadline, you will have your temporary enrollment deactivated effective June 28.
  • Email PED at [email protected] with your PAVE Application ID to ensure your application is identified for processing and assistance.
  • Meet all program requirements if you have not already done so.

For more information on Medi-Cal provider enrollment, visit the DHCS Provider Enrollment page.

 

New name, same mental health services

Effective March 1, Beacon Health Options has changed its name to Carelon Behavioral Health. The services and contact information for Alliance members’ behavioral health benefit are the same.

To ensure that members understand the name change and continuation of their behavioral health benefits, we are updating our materials and informing members via multiple channels, including the member newsletter and our Facebook page. We will also be updating information for providers to reflect the new name.

Members can reach Carelon Behavioral Health at 855-765-9700. This toll-free number is available 24 hours a day, 7 days a week.

For more information on mental health support for Alliance members, visit our provider-facing Behavioral Health page.

Expansions to Medically Tailored Meals service

Medically Tailored Meals are part of the Community Supports services offered by the Alliance. As of Jan. 1, 2023, more people will be eligible to receive Medically Tailored Meals. Eligible populations include:

  1. Individuals with chronic conditions such as but not limited to:
    • Diabetes
    • Cardiovascular disorders.
    • Congestive heart failure.
    • Stroke.
    • Human immunodeficiency virus (HIV).
    • Cancer.
    • High risk perinatal conditions.
    • Chronic or disabling mental/behavioral health disorders.
  2. Individuals being discharged from the hospital or a skilled nursing facility.
  3. Individuals at high risk of hospitalization or nursing facility placement.
  4. Individuals receiving Enhanced Care Management or Complex Case Management services.

How Medically Tailored Meals work

The Medically Tailored Meals benefit will be available once per year, with a possibility of twice per year if there is a discharge from a hospital as either the first or second qualifying event.

If approved to receive Medically Tailored Meals, the member will receive 2 meals per day for 12 weeks with associated nutritional counseling. Meals are tailored based on the member’s medical condition and include gluten-free and vegetation menu options.

For more information on these services and how to refer members, visit our Enhanced Care Management and Community Supports webpage. You can also call the Alliance Enhanced Care Management team at 831-430-5512 or email [email protected].

Pursuing health equity for our members

The Alliance is committed to achieving health equity for our members. To fully address health inequities, we must seek to understand root causes of health disparities, particularly those experienced by members in marginalized populations. We will accomplish this by embracing diversity, inclusion and belonging in our workforce, partnering with providers and engaging with members to inform and guide our actions.

In addition, we will focus prevention efforts on children and youth and work to increase members’ access to culturally and linguistically appropriate health care to eliminate health disparities and achieve optimal health outcomes.

You can read more about this work in our new Health Equity Booklet, which we are sharing with our providers, government officials and community partners. The booklet includes a high-level summary of recent activities, including:

  • The DEIB priority initiative for our Alliance workforce.
  • Targeted incentives, awareness campaigns, member outreach and engagement.
  • Data-driven provider support.
  • How we’re addressing provider workforce shortages.
  • Provider training and support.

We are looking forward to our continued partnership with you as well as community-based organizations to achieve more equitable health outcomes for our members. Thank you for joining us in this important work!