Provider Newsletter | Issue 31


COVID-19 treatments and Test to Treat locations

COVID-19 treatments

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.

The distribution system is managed by the U.S. Department of Health and Human Services. The state and local counties determine where therapeutics will be distributed and which providers will distribute them.

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 Medical Health Operational Area Coordinator (MHOAC).

Locate and order government-supplied treatments

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.

Member education

Please consider educating your patients about the importance of early testing and treatment for COVID-19. Here are a few key points to emphasize:

  • If patients are experiencing any symptoms of COVID-19, they should not wait to seek care. It is important for those with symptoms to talk to their doctor and test for COVID-19 as soon as possible.
  • In order to be effective, therapeutic treatments must be started as soon as possible after testing positive for 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 English, Spanish and Hmong. Please print and distribute.
  • The Alliance offers Health and Wellness rewards for members who keep up with their infant well-visits and child vaccinations. Members can get up to a $150 Target gift card.
  • The Alliance offers care-based incentives to providers for completing preventive care services.
  • Providers can access reports in the Alliance Provider Portal that identify members who have not had preventive care screenings.
  • Cultural and Linguistic Services 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 Facebook page.

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:

Developmental Screening Tool Name Category Topics Covered Age Time for Parent to Complete Cost
Developmental Screening Tools for CBI & Healthcare Effectiveness Data and Information Set (HEDIS) Compliance
Ages and Stages Questionnaire (ASQ-3)* Development Behavior, language development, motor, problem solving 1 month to 5 ½ years 10-15 minutes $240
Parents’ Evaluation of Developmental Status (PEDS) Development Behavior, language development, motor, problem solving, social-emotional development Birth to 8 years 2 minutes Starts at $36
Parents’ Evaluation of Developmental Status- Developmental Milestones (PEDS-DM) Development, social-emotional development Behavior, language development, motor, problem solving, social-emotional development Birth to 8 years 5 minutes $299
Survey of Well-being of Young Children (SWYC) Development, autism, social-emotional development, maternal depression, social determinants of health Autism, family stress, language development, maternal depression, motor, social-emotional development Children under 5 years of age 5-10 minutes Free

For more information, visit the resources below:

  • The Alliance Provider Portal. 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.
  • Our 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.

If you have any questions, please contact our Provider Services team at 800-700-3874, ext. 5504.