The Beat | Issue 4

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It’s flu shot season!

To protect the health of our communities, it is critical to communicate just how important the flu shot is for both children and adults—especially as we continue to navigate the effects of the pandemic.

During peak flu season, the Alliance is encouraging members six months and older to get a flu shot. We have also created tools, resources and incentives to make it easier to spread flu shot awareness. Please join us in this effort!

Flu shots are available at no cost for Alliance members. All members can get the flu shot by visiting their doctor. Members 19 years of age and older also have the option to get their shot at a local pharmacy. Members between 6 months and 8 years old may need two doses of the flu shot.

The Alliance is offering a new member Wellness Reward focused on increasing flu shot rates among toddlers. Children ages 7 to 24 months who complete both flu shot doses between September 2021 and May 2022 will be entered into a monthly raffle for a $100 Target gift card.

We are committed to getting flu shot information to members through various channels, including:

To help maximize flu shot rates among Alliance members, we’ve created a flu shot flyer to post or distribute to community members. The flyer is available for easy download in English, Spanish and Hmong.

The Alliance can also provide postcards to hand out to clients. Please contact Kayla Zoliniak, Administrative Specialist, at [email protected].

Note that the flu shot and the COVID-19 vaccine can be given at the same time. For more information and answers to FAQs regarding seasonal flu and COVID-19, visit the CDC website.

COVID-19 vaccine incentives

The Alliance is offering a $50 gift card incentive for eligible members who receive a single dose of the COVID-19 vaccine to increase vaccination rates among Medi-Cal recipients.

Incentive for members

$50 gift card incentive: Eligible Alliance members who get a single dose of the COVID-19 vaccine will receive a $50 Target gift card, either by mail or at vaccine sites participating in the Alliance Vaccine Incentive Program (selected locations only). This member reward is available for all members 12 years and older who get a single dose of the COVID-19 vaccine between September 1, 2021 and February 28, 2022. Our COVID-19 ”Crush COVID” webpage has information on how members can schedule their appointment and get their gift card. Members can also visit our general COVID-19 webpage for the latest on the COVID-19 vaccine, telehealth services, seeking medical care and filling prescriptions.

All individuals can find a walk-in clinic or schedule their vaccine appointment at myturn.ca.gov. If your client is not able to get to a clinic due to health or transportation issues, My Turn will assist with arrangements.

Incentives for providers

CalVax enrollment incentive: a one-time payment for enrollment in CalVax or HRSA to administer COVID-19 vaccinations.

Per member vaccine incentive: fee for service payment of $25.00 for each member who receives a COVID-19 vaccination (payment to be made to the primary care organization to whom the member is assigned at the time of vaccination).

Performance-based vaccination incentive: payment based on the total percentage of a primary care provider’s assigned panel that is vaccinated.

Our COVID-19 Information for Providers page has the latest information on provider incentives, as well as additional support and resources.

Coming Soon: Changes to Medi-Cal pharmacy benefit

Starting January 1, 2022, prescriptions that are filled at a pharmacy will be covered by Medi-Cal Rx. Medi-Cal Rx is a new program provided by the Department of Health Care Services (DHCS) to help with pharmacy needs for Medi-Cal members.

Most Alliance members will be able to use the same pharmacy they do now on January 1, 2022 and the Alliance will continue managing the Durable Medical Equipment (DME) benefit.

Our Medi-Cal Rx page provides more details, including contact information and downloadable educational flyers for members.

Behavioral health

Mental health is an important part of overall health and wellness. As we approach the holiday season, it is important to remember that for those coping with mental health challenges, the holidays can be a lonely or stressful time, filled with anxiety or depression.  The Alliance works with Beacon Health Options to connect members to mental health services and support. Visit our Behavioral Health Care page for more information about services available for Alliance members and additional resources available to all..

Medi-Cal redetermination suspended through end of year

To ensure continued access to health care services during the federal COVID-19 Public Health Emergency (PHE), the Department of Health Care Services (DHCS) suspended the Medi-Cal redetermination process, discontinuances and negative actions for the duration of the PHE. The PHE is currently scheduled to be in place through January 16, 2022. Once the PHE has ended, enrollment agencies will have 12 months to complete processing their redetermination backlogs.

If clients have questions about Medi-Cal eligibility or redetermination, Member Services is available Monday through Friday, from 8 a.m. to 5:30 p.m. at 800-700-3874.

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