All Plan Letters
The latest legislative updates are available from the Department of Health Care Services (DHCS). For more information, please contact your Provider Relations representative.
- All
- 2024
- 2023
- 2022
Date: Oct 26, 2022
Proposition 56 Behavioral Health Integration Incentive Program
Date: Oct 21, 2022
- Qualified CBAS providers are required to provide Emergency Remote Services (ERS) as a mode of service delivery when members experience emergencies for up to three consecutive months. Emergencies may be public (state/local disasters) or personal (serious illness/injury, crisis, care transition)
- Contracted CBAS providers must obtain ERS approval and provide each participant’s discharge plan to the Alliance within 30 days of discharge. Additional reporting & documentation requirements are within the APL.
- ERS for an emergency occurrence may not exceed three consecutive months, either within or crossing over an authorized period, without assessment and review for possible continued need for remote/telehealth delivery of services and supports as part of the reauthorization of the individual’s care plan.
This is in the Alliance Provider Manual: Section 6, pages 45-48
Date: Oct 10, 2022
Proposition 56 Value-Based Payment Program Directed Payments (Supersedes APL 20-014)
Date: Sep 28, 2022
Skilled Nursing Facilities — Long Term Care Benefit Standardization and Transition of Members to Managed Care
Superseded by 23-004
Date: Sep 22, 2022
Primary Care Provider Site Reviews: Facility Site Review and Medical Record Review (Supersedes APL 20-006)
Date: Sep 2, 2022
- Provides guidance regarding the qualifications for becoming a Community Health Worker (CHW), the definitions of eligible populations for CHW services, and descriptions of applicable conditions for the CHW benefit.
- CHW services can be provided as individual or group sessions. The services can also be provided virtually or in-person with locations in any setting including, but not limited to, outpatient clinics, hospitals, homes, or community settings. There are no service location limits. Supervising Providers should refer to the Telehealth section in Part 2 of the Provider Manual for guidance regarding providing services via telehealth. Services include Health Education, Health Navigation, Screening and Assessment, Individual Support or Advocacy.
- The Alliance encourages Network Providers to communicate about the availability of these services with Alliance members.
- Watch for a new Provider Training that will review the referral process and billing requirements in the coming months.
- Please refer to the Provider Manual and following Policies for more information.
Date: Aug 24, 2022
Enforcement Actions: Administrative and Monetary Sanctions (Supersedes APL 18-003)
Superseded by 23-012
Date: Jul 21, 2022
Electronic Visit Verification Implementation Requirements
Date: Jul 19, 2022
Provider Credentialing/Re-Credentialing and Screening/Enrollment (Supersedes APL 19-004)
Date: Jul 11, 2022
Governor’s Executive Order N-01-19, Regarding Transitioning Medi-Cal Pharmacy Benefits from Managed Care to Medi-Cal RX (Supersedes APL 20-020)
Date: Jun 23, 2022
Proposition 56 Directed Payments for Family Planning Services (Supersedes APL 20-013)
Superseded by 23-008
Date: Jun 22, 2022
Cancer Biomarker Testing
Date: Jun 13, 2022
COVID-19 Guidance for Medi-Cal Managed Care Health Plans
Date: May 18, 2022
Non-Emergency Medical and Non-Medical Transportation Services and Related Travel Expenses (Supersedes APL 17-010)
Date: May 5, 2022
California Housing and Homelessness Incentive Program
Date: Apr 8, 2022
Medi-Cal Managed Care Health Plan Responsibilities for Non-Specialty Mental Health Services (Supersedes APL 17-018)
Date: Mar 30, 2022
No Wrong Door for Mental Health Services Policy
Date: Mar 17, 2022
Strategic Approaches for Use By Managed Care Plans to Maximize Continuity of Coverage as Normal Eligibility and Enrollment Operations Resume
Date: Mar 17, 2022
Medi-Cal Managed Care Health Plan Responsibility to Provide Services to Members with Eating Disorders
Date: Mar 14, 2022
Alternative Format Selection for Members with Visual Impairments