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Boletín del proveedor | Número 31

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Tratamientos de COVID-19 y ubicaciones de prueba para tratar

Tratamientos para el COVID-19

Several therapies have received Emergency Use Authorization (EUA) from the Food and Drug Administration (FDA). The FDA has authorized both monoclonal antibody treatments and antiviral treatments.

El sistema de distribución está gestionado por el Departamento de Salud y Servicios Humanos de EE. UU. Los condados estatales y locales determinan dónde se distribuirán las terapias y qué proveedores las distribuirán.

Providers must sign up for the distribution program. Facilities that can operationalize COVID-19 therapeutics and would like to be considered for product allocations should contact their Coordinador del Área Operativa de Salud Médica (MHOAC).

Localizar y solicitar tratamientos proporcionados por el gobierno

Please use the resources below to locate sites that have government-supplied COVID-19 therapeutics and to learn how to order therapeutics. Note: therapies are available for specific locations only.

As of March 21, 2022, the following therapeutics are being supplied free to providers by the federal government:

  • Paxlovid.
  • Molnupiravir.
  • Bebtelovimab.

Remdesivir may also be used to treat COVID-19, but it is only available to purchase directly from the distributor. Reimbursement requests for Remdesivir may be submitted to the Alliance.

Educación de miembros

Considere educar a sus pacientes sobre la importancia de las pruebas y el tratamiento tempranos para COVID-19. Aquí hay algunos puntos clave para enfatizar:

  • Si los pacientes experimentan algún síntoma de COVID-19, no deben esperar para buscar atención. Es importante que quienes presenten síntomas hablen con su médico y se hagan la prueba de COVID-19 lo antes posible.
  • Para que sean efectivos, los tratamientos terapéuticos deben iniciarse lo antes posible después de dar positivo por COVID-19.

Starting treatment

COVID-19 treatments must be started as soon as possible and within the specified time range after symptom onset:

  • Nirmatrelvir with ritonavir (Paxlovid) and molnupiravir must be started within 5 days of symptom onset.
  • Remdesivir (Veklury) and bebtelovimab must be started within 7 days of symptom onset.

Dosing Information

  • Paxlovid: two 150 mg nirmatrelvir tablets (300 mg total) together with one 100 mg ritonavir tablet, twice daily for 5 days. 30 tablets per prescription.
  • Molnupiravir: four 200 mg capsules (800 mg total) taken every 12 hours for 5 days. 40 capsules per prescription.

For more information on COVID-19 treatments, including product fact sheets and patient-facing communication, visit the California Department of Public Health’s COVID-19 Treatments page.

Test to Treat Locations

The federal government has launched a Test to Treat program, whereby participating locations will offer COVID-19 testing and subsequent treatment prescriptions at the same site. A Test to Treat website is expected to launch soon. In the meantime, you can find more information on the U.S. Department of Health & Human Services (HHS) Test to Treat webpage.

Check In, Check Up: Encouraging doctor visits

It is now more important than ever to reinforce the importance of regular doctor visits. With many individuals avoiding the doctor’s office during the pandemic, it is critical for patients to resume care so they can prevent disease and stay healthy.

The first step is for individuals to establish or re-establish a trusted relationship with their primary care provider to get them on track with their health goals. Additionally, we are encouraging members with children to talk to their child’s pediatrician about getting caught up on vaccines and assessing their child’s growth and development.

There are a variety of resources available to encourage and optimize well-visits:

  • We have a Check In, Check Up flyer for members in Inglés, Español y Hmong. Please print and distribute.
  • La Alianza ofrece Salud y Bienestar rewards for members who keep up with their infant well-visits and child vaccinations. Members can get up to a $150 Target gift card.
  • La Alianza ofrece care-based incentives to providers for completing preventive care services.
  • Providers can access reports in the Portal de proveedores de la alianza that identify members who have not had preventive care screenings.
  • Servicios Culturales y Lingüísticos are available to help our members get the most out of their well-visits. Services include language assistance and interpreter services, which are available at no cost.
  • We are also regularly promoting well-visits to members on our pagina de Facebook.

Thank you for partnering with us in this effort to encourage Healthy People, Healthy Communities!

Newest PCP Data Submission Tool type: Developmental Screening

In January 2022, the Alliance released the most recent Data Submission Tool type: Developmental Screening. CPT code 96110 is accepted through the Provider Portal for developmental testing, with interpretation and report. Developmental Screening in the First 3 Years is a Care-Based Incentive measure for members ages 1-3 years who have been screened for risk of developmental, behavioral and social delays using a standardized screening tool.

Examples of standardized screening tools include the following:

Nombre de la herramienta de evaluación del desarrollo Categoría Tópicos cubiertos Edad Tiempo para que los padres completen Costo
Herramientas de detección del desarrollo para el cumplimiento del CBI y del conjunto de datos e información sobre eficacia de la atención sanitaria (HEDIS)
Cuestionario de Edades y Etapas (ASQ-3)* Desarrollo Comportamiento, desarrollo del lenguaje, motricidad, resolución de problemas. 1 mes a 5 ½ años 10-15 minutos $240
Evaluación de los padres sobre el estado de desarrollo (PEDS) Desarrollo Comportamiento, desarrollo del lenguaje, motricidad, resolución de problemas, desarrollo socioemocional. Nacimiento a 8 años 2 minutos Comienza en $36
Evaluación de los padres sobre el estado del desarrollo: hitos del desarrollo (PEDS-DM) Desarrollo, desarrollo socioemocional. Comportamiento, desarrollo del lenguaje, motricidad, resolución de problemas, desarrollo socioemocional. Nacimiento a 8 años 5 minutos $299
Encuesta sobre el bienestar de los niños pequeños (SWYC) Desarrollo, autismo, desarrollo socioemocional, depresión materna, determinantes sociales de la salud. Autismo, estrés familiar, desarrollo del lenguaje, depresión materna, desarrollo motor, socioemocional Niños menores de 5 años 5-10 minutos Gratis

For more information, visit the resources below:

  • La Alianza Portal del Proveedor. You can access the Data Submission Tool Guide in the Provider Portal. This resource provides more information on Developmental Screening submission requirements, including file layout and CPT codes.
  • Nuestra Developmental Screening in the First 3 Years Tip Sheet. This tip sheet details measure eligibility, coding requirements, data submission and best practices for the measure.

Si tiene alguna pregunta, comuníquese con nuestro equipo de Servicios para proveedores al 800-700-3874, ext. 5504.