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Leadership Team - Jarrod McNaughton, MBA, FACHE
e, he works collaboratively with the IEHP Governing Board to set the strategic vision and provide executive leadership for one of the 10 largest Medicaid health plans and the largest not-for-profit Medicare-Medicaid Plan in the U.S. He cultivates IEHP’s strong partnership with Providers, hospitals and hundreds of community partners to deliver quality whole-person care to more than 1.5 million Members. He ensures financial stewardship and stability for IEHP’s more than $5.4 billion operational budget. A visionary health care leader, Mr. McNaughton joined IEHP in 2018 as Chief Operating Officer. In this role, he was responsible for the operations, claims, provider contracts, enrollment and eligibility, performance improvement and Member services departments, supporting IEHP’s organizational directives, advancing IEHP’s LEAN transformation, and ensuring IEHP’s mission to deliver quality service to our Members and Providers effectively and efficiently. Prior to IEHP, Mr. McNaughton served in several roles of increasing responsibility in hospitals and large hospital systems. For nearly 20 years, he has led multi-tiered operational strategies and innovation that consistently generated superior results. He has a well-established reputation for building dynamic teams, developing leaders and fostering key relationships in the community. His ability to remove obstacles and empower everyone, from frontline Team Members to Physicians, will help support IEHP’s position of strength in the ever-changing health care environment. Mr. McNaughton’s roles as President of Kettering Medical Center and Executive Vice President of Kettering Health Network demonstrated his strategic business acumen, empathy and visionary leadership. He developed a coordinated and detailed strategy for the entire network and spearheaded many forward-looking changes in services and delivery of care to patients at those facilities. The Kettering Health Network in Southwest Ohio includes eight hospitals, nine emergency departments, many outpatient clinics and over 11,000 employees. Prior to his role at Kettering Medical Center, Mr. McNaughton was Vice President at San Joaquin Community Hospital. Among his many achievements there, he developed and implemented a new mission and service department that helped increase patient satisfaction scores from the 40th percentile to the 85th percentile in less than a year. Mr. McNaughton’s strong commitment to the community fits well with IEHP’s mission and company culture. He is an Assistant Clinical Professor at Loma Linda University and a board member for several educational and non-profit agencies. A volunteer with Global Medical Missions, an international aid organization, he has led short-term mission teams to Kenya, Malawi, Nigeria, India, Nepal, Honduras and Mexico. Away from work, he enjoys singing, musical theater and flying single-engine planes. Mr. McNaughton pursued an undergraduate degree from Pacific Union College where he earned a bachelor’s degree. He earned his master’s degree in Business Administration from the University of La Verne, Graduate School of Business. In addition, he is a Fellow of the American College of Healthcare Executives.
Leadership Team - Susie White, MBA
ds the plan’s overall day-to-day operations and is responsible for implementing strategic initiatives and policies which support the Mission, Vision and Core Values of IEHP and the delivery of cost-effective and efficient care to its more than 1.5 million Members. Her areas of accountability include: Member Services, Provider Services, facilities management, security, business systems configuration and support, and delegation oversight. Ms. White has more than 20 years of experience at all levels of health plan operations. She has demonstrated progressive leadership with a focus on innovation, efficiency and transparency from a collaborative, process-based perspective. She is highly regarded for her commitment to driving IEHP’s team culture, developing new leaders and fostering key relationships across the organization and the community. Her vast knowledge of complex regulations covering Medi-Cal and Cal MediConnect Plan (Medicare-Medicaid Plan) membership, especially network administration and oversight, are integral to the operations and strategic direction of IEHP. Ms. White embodies the IEHP team culture and is committed to its Vision and Mission, having joined IEHP in 1998 and having served in various roles of increasing responsibility in the Provider Services department. In her position as Executive Director of Health & Provider Services, she directed multiple diverse teams in the integrated delivery of company wide strategic objectives, seamless medical (health care) service operations, process and system improvement and support of IEHP’s LEAN transformational journey. Ms. White was instrumental in the development of the organization’s Provider Call Center, which centralized calls into one location with an emphasis on improving customer service and increasing Provider satisfaction survey scores. She also spearheaded the innovative $45 million Network Expansion Fund (NEF), which resulted in the addition of more than 300 board-certified Primary Care Physicians (PCPs), Specialists and mid-level Providers to the Inland Empire. Ms. White earned both her Bachelor of Science degree in Health Care Management and her MBA in Management and Leadership from the University of La Verne.
Leadership Team - Vinil Devabhaktuni, MBA
n this role, Vinil will provide leadership for the overall information technology architecture, as well as the design, development, implementation, and support of IEHP’s systems. Vinil joins IEHP most recently from Health New England, where he served as the Chief Information and Technology Officer and was responsible for managing a unique portfolio and elevating the role of technology from a supportive function to a strategic partner that played a major part in the growth of the organization. Vinil also developed and executed an end-to-end operational roadmap for sales, underwriting and accounting. In addition, he rearchitected and streamlined production support and application development operations to bring stability, predictability, and optimizations to the organization. Prior to his role at Health New England, Vinil served as vice president, digital transformation officer at AIG in New York. While in this role, he led a $50M global digital transformation initiative, which included migration and consolidation of digital properties from 140 countries around the world. Vinil holds a Master of Business Administration degree from Bay Path University in Longmeadow.
Latest News - IEHP Welcomes New Chief Information Officer
ion Officer. In this role, Vinil will provide leadership for the overall information technology architecture, as well as the design, development, implementation, and support of IEHP’s systems. Vinil joins IEHP most recently from Health New England, where he served as the Chief Information and Technology Officer and was responsible for managing a unique portfolio and elevating the role of technology from a supportive function to a strategic partner that played a major part in the growth of the organization. Vinil also developed and executed an end-to-end operational roadmap for sales, underwriting and accounting. In addition, he rearchitected and streamlined production support and application development operations to bring stability, predictability, and optimizations to the organization. Prior to his role at Health New England, Vinil served as vice president, digital transformation officer at AIG in New York. While in this role, he led a $50M global digital transformation initiative, which included migration and consolidation of digital properties from 140 countries around the world. Vinil holds a Master of Business Administration degree from Bay Path University in Longmeadow, Massachusetts and is eager to join IEHP, “I look forward to joining the team and helping fulfill the IEHP mission through collaboration, innovation, and strategic support. There are no limits to what we can achieve for the members, providers, employees, and community when we work together”. “Vinil will make an excellent addition to the team and we are so excited to bring him on board,” said IEHP Chief Executive Officer Jarrod McNaughton. “Vinil’s experience and expertise in the field will support our efforts to enhance the effectiveness of the remarkable work IEHP does every day in an effort to heal and inspire the human spirit.”
Leadership Team - Takashi Wada, MD, MPH
021. He is responsible for providing clinical and strategic leadership through accountable, collaborative processes to improve the quality-of-care delivery as evidenced by improved external quality metrics. Dr. Wada leads and drives innovative solutions for program development and implementation to improve access, satisfaction and care outcomes that are sustainable and scalable. Dr. Wada joined IEHP in 2019 as Vice President of Population Health. In this capacity, he oversaw the internal departments of Behavioral Health & Care Management, Community & Family Health, Health Education, and Practice Transformation. He also played a key role in various statewide and regional population health initiatives. Prior to his role at IEHP, Dr. Wada served as Chief Medical Officer/ Deputy Chief Medical Officer for CenCal Health and Director/Health Officer for Santa Barbara County’s Health Department. Dr. Wada holds an undergraduate degree in biomedical sciences from University of California, Riverside and a master’s degree in public health from University of California, Los Angeles (UCLA). After receiving his medical degree at UCLA, he completed his graduate medical education at Kaiser Permanente Los Angeles Medical Center.
Leadership Team - Michelle Rai, MS
2020. She oversees IEHP’s communications and marketing programs and guides the development of long-term communication and marketing strategies. In addition, Ms. Rai oversees the strategic execution of IEHP’s community relations, media relations, internal communications, digital and social media. Ms. Rai has over 20 years of experience in public relations, communications, marketing, and media relations. Prior to joining IEHP, Ms. Rai served as Chair of the Communication Department at Pacific Union College in Napa Valley, Calif. Before her role as Chair, Ms. Rai acted as the College’s Public Relations Director and Public Information Officer. Ms. Rai holds a master’s degree in integrated marketing communications from Golden Gate University. She earned bachelor’s degrees in journalism and communications from Pacific Union College, where she received the prestigious Educator of the Year award in 2016. Ms. Rai’s leadership enables IEHP to increase its brand reach and social media presence, while enhancing perception of the organization and strengthening its place as an industry thought leader.
Leadership Team - Keenan Freeman, MBA
executive role, Mr. Freeman is responsible for the overall financial management of IEHP, its financial reporting and transparency, and for multiple plan financial functions including accounting, purchasing, capitation, cost recovery, risk management, and the coordination of fiscal and other operational audits. Mr. Freeman brings over 28 years of professional finance experience to IEHP which includes 16 years of strategic leadership in multiple functions including financial, operational and strategy development in a provider-owned health plan and a multi-specialty medical group with over 4,000 providers. Mr. Freeman served as Chief Financial Officer for Providence Medical Group in Oregon where he spent 5 years providing operational and financial leadership for over 1,200 physicians, physician assistants and nurse practitioners. In addition, he served for eight years as Chief Financial Officer and two years as Chief Operational Officer for First Care Health Plans in Austin Texas. Mr. Freeman understands the importance of developing external relationships with key physicians, health systems, and governmental entities. He enjoys building cross-functional teams to achieve short and long-term objectives and values the importance of developing external relationships with key physicians, health systems, and governmental entities. Mr. Freeman’s leadership in these areas, and in the annual budget process, keeps IEHP financially stable amid healthcare changes and economic volatility. Mr. Freeman holds a Bachelor’s degree in Administration and Accounting and a MBA from Texas Tech University.
Governing Board - Dawn Rowe
d to the Board of Supervisors in December of 2018. Prior to joining the Board of Supervisors, Dawn served on the Yucca Valley Town Council from 2010 to 2014. Dawn was re-elected by her Third District constituents and began her first elected four-year term on the Board of Supervisors in December 2020. In January 2021 she was appointed to the IEHP Governing Board. As the San Bernardino County Third District Supervisor, Rowe represents one of the largest districts in in the county, spanning the Mojave Basin to the mountain communities, and the city of Barstow to the valley communities. As County Supervisor, Rowe is focused on making San Bernardino County a business-friendly environment, improving infrastructure, and strengthening public safety.
Special Programs - Independent Living and Diversity Resources
A resource for health providers, IPAs and others interested in the Americans with Disabilities Act, California law as it related to accessibility and Universal Design. In partnership with our Provider Network, IEHP strives to break down barriers to medical care and promote health and wellness for Members with disabilities. With accessibility issues often cited as an obstacle to care, we publish this site to help all stakeholders in the health care system understand the barriers and in some cases the solutions. We invite you to browse these topics: Information on the Americans with Disabilities Act (ADA) Accessibility of Doctor's offices, clinics, and other health care providers is essential in providing medical care to people with Disabilities. Find out more by following the link to the ADA's Access Guide (PDF). The Federal Americans with Disabilities Act (ADA) of 1990 prohibits discrimination on the basis of disability and sets national standards for accessibility. Each page in this section gives you a summary of ADA related documents and a link to the actual Federal resource. By clicking on this link, you will be leaving the IEHP website. View the full text of the law at the ADA Website. Enforcement Lawsuits for ADA Violations U.S. Department of Justice (DOJ) 1994 Status reports, briefs, and settlement information will help you stay up-to-date on precedent-setting ADA litigation. Unsuccessful negotiations or mediation may lead to federal lawsuits. Courts can order compensatory damages, back pay, or civil penalties up to $55,000 for the first violation and $110,000 for any subsequent one. Read more about DOJ Litigation Alternative to Litigation U.S. Department of Justice (DOJ) Mediation Program Established: 1994 Mediation, which is confidential and voluntary, can resolve some ADA disputes quickly and satisfactorily – without the expense and delay of formal investigation and litigation. Read more about DOJ Mediation Facts and Information Diagnosing & Treating Members with Auditory Disability Communicating with People Who Are Deaf or Hard of Hearing in Hospital Settings U.S. Department of Justice (DOJ) Disability Rights Section, Civil Rights Division Published 2003 Interactive doctor-patient discussions with individuals who are deaf or hard-of-hearing may require an interpreter to ensure proper diagnosis and treatment. DOJ’s brief outlines the types of interpreter services including sign language, oral interpretation, cued speech, and Computer Assisted Real-time Transcription (CART). Read the Full Article: HTM PDF Phone Calls & Auditory/Speech Disabilities Phone Calls & Auditory/Speech Disabilities - Technology Breaks Communication Barriers Created by IEHP, 2006 Learn about FREE options for effective telephone communication with individuals who have auditory and/or speech disabilities: National Telecommunication Relay Service (TRS) – two-way translation between individuals using a TTY and a standard telephone Speech-to-Speech (STS) Relay Service – assistance for individuals with speech disabilities by repeating their message verbatim. Read the Full Article Fact Sheet - PDF Fact Sheet - TXT Dispelling ADA Myths Just the Facts on the ADA Adapted from 1995 DOJ fact sheet IEHP, 2006 Get the facts on common ADA misconceptions. ADA Myths & Facts PDF Text Accessibility Pays Off at Tax Time Tax Incentives for ADA Compliance Take advantage tax incentives that help eligible businesses comply with the Americans with Disabilities Act. The Federal and California state governments offer Tax Credits and/or Deductions for improving accessibility and/or employing persons with disabilities. Attorney General’s ADA Tax Incentives Packet Your practice/health care facility may be eligible for tax credits and/or deductions to help offset the costs of improving accessibility for patients and employees with disabilities. The Attorney General’s packet includes a fact sheet and Internal Revenue Service (IRS) form and instructions. Download IEHP's Fact Sheet PDF Text Download the Attorney General's information packet: Website Legal Obligations Standards for Accessible Design ADA Accessibility Guidelines U.S. Department of Justice (DOJ) 1991 The ADA Accessibility Guidelines (ADAAG) include stringent criteria for health care Providers as well as additional requirements based on building use (special application 6 – Medical Care Facilities). The Standards for Accessible Design apply to the architecture and construction of new buildings/facilities as well as alterations to existing structures. Download the Standards Standards - PDF Standards - HTM Download Special Application 6 (Health Care Facilities) Access to Medical Care for Individuals with Mobility Disabilities (PDF) Access to Medical Care for Individuals with Mobility Disabilities (HTM) Removing Existing Barriers Checklist for Readily Achievable Barrier Removal Adaptive Environments Center, Inc. and Barrier Free Environments, Inc. 1995 Identify accessibility problems and solutions for eliminating physical/architectural and communication barriers. Use this informal checklist as a guide to meet your obligations under the ADA (for existing facilities only, not new construction or alterations). Download the checklist for readily achievable barrier removal Checklist - PDF Checklist - HTM ADA Regulations for Health Care Providers Nondiscrimination on the Basis of Disability U.S. Department of Justice (DOJ) 1991 Federal regulations for accessibility at Health care facilities include standards for the architecture of buildings, alterations, and new construction (ADA, Title III). DOJ article - PDF DOJ article - HTM Basic ADA Requirements for Health Care Providers ADA Title III Highlights U.S. Department of Justice (DOJ) Disability Rights Section, Civil Rights Division Published 1990 This functional outline of the ADA’s Title III (section covering health care providers) helps you become familiar with key requirements that impact you and your patients. DOJ’s overview provides details in bullet format for quick reference. See the Full DOJ Article Practical Guidance for ADA Compliance Title III Technical Assistance Manual U.S. Department of Justice (DOJ) 1993 and 1994 This manual (with supplement) outlines ADA requirements for businesses to ensure access to goods, services, and facilities. The reader-friendly format offers: Lay terms and practical examples (limited legalese) Focused, systematic description of requirements Questions/answers and illustrations Read the full Manual Read the Supplement Technical Assistance DOJ ADA Information and Technical Assistance on the Americans with Disabilities Act The official ADA website of the U.S. Department of Justice (DOJ) offers the most up-to-date information and practical guidance on design, construction, and operation: Regulations and standards impacting Providers and Members Accessibility and reasonable accommodations guidelines Solutions for ensuring access within your budget Tax credits and incentives Technical assistance and materials/publications Visit DOJ's ADA Homepage Avoid Costly Building Mistakes Common ADA Errors and Omissions in New Construction and Alterations U.S. Department of Justice (DOJ) Disability Rights Section, Civil Rights Division Published 1997 Incorporating ADA Standards into initial building/alteration plans helps ensure patient safety as well as cost-effectiveness. Review some of the most common accessibility errors/omissions identified through DOJ’s ongoing enforcement efforts. Following each error/omission, you’ll find an explanation of its significance and reference to the appropriate requirement under the ADA Standards for Accessible Design. Online ADA Course Reaching Out to Customers with Disabilities U.S. Department of Justice (DOJ) with Representatives of Business and Disability Communities 2005 Learn about ADA compliance in an online course with 10 short lessons. Policies, Practices, and Procedures Communicating with Customers Who Have Disabilities New Buildings, Additions, and Remodeling Removing Barriers in Buildings That Are Not Being Remodeled Providing Access When Removing Barriers Is Not Readily Achievable Maintaining Accessibility Transporting Customers ADA Compliance Costs and Tax Incentives Enforcement of the ADA Information Sources Take the ADA online course Pacific Region ADA Technical Assistance Disability Business Technical Assistance Center (DBTAC) Region IX National Institute on Disability and Rehabilitation Research U.S. Department of Education 1995 Get information on your compliance obligations, problem-solving assistance, and referrals from ADA experts – without the high cost of a consultant. The 10 regional ADA & IT Technical Assistance Centers serve strictly as educational entities to help you understand your rights and responsibilities and have no enforcement or advocacy responsibilities. Federal Region IX, Pacific, serves: Arizona, California, Hawaii, Nevada, and the Pacific Basin. Visit Pacific ADA Center Visit DBTAC Homepage Visit NIDRR Community Based Adult Services (CBAS) Reminder: Community-Based Adult Center (PDF) SPD Awareness Training By clicking on these links, you may be leaving the IEHP website. By making your facilities accessible you convey a sense of welcome for people with disabilities. Most of all, you comply with the requirements set by the Americans with Disabilities Act (ADA) of 1990. This is a civil rights law that prohibits discrimination against persons with disabilities on the basis of their disability in programs and services that receive federal financial assistance. Please see the resources below for more detailed information. Office Accessibility How to Make Your Medical Office More Accessible (PDF) Guidebook: How to Safely Transfer Patients with Disabilities to an Exam Table (PDF) Video #1: How to Safely Transfer Patients with Disabilities to an Exam Table Video #2: Using an Accessible Scale to Weigh Patients with Disabilities Accessibility Checklist (PDF) Community Resources Community Resources Guide (PDF) Disability Competency and Sensitive Training Disability Etiquette Guide (PDF) You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Report an Issue - Report Fraud and HIPAA Privacy Issues
ay have. To ensure that our Members receive the best care, we need them to report any issues. Issues can be, witnessing any type of fraud, or if a Member feels that their personal and private information has been misused. How Do I Report an Issue? To report fraud the following resources are available: waste or abuse, privacy issues, and other compliance issues. Compliance Hotline: (866) 355-9038 Fax: (909) 477-8536 E-mail: email@example.com Mail: IEHP Compliance Officer P.O. Box 1800 Rancho Cucamonga, CA 91729-1800 Click Report a Compliance Issue to report online. What is the Privacy Incident/Breach? IEHP has established a HIPAA Privacy Program to ensure that Member’s health information is properly protected, while allowing the flow of health information needed to provide and promote high-quality health care. What is a privacy breach? An unauthorized acquisition, access, use, or disclosure of protected health information (PHI) which puts at risk the security or privacy of such information. PHI is health information that relates to a Member’s past, present or future physical or mental health or condition. This includes the services of his/her health care, or payment for that care and contains personally identifiable information (PII) such as name, SSN, DOB, Member ID, address, or any other unique identifier related to the Member. This generally means that a breach occurs when PHI is accessed, used, or disclosed to an individual or entity that does not have a business reason to know that information. The law does allow information to be accessed, used, or disclosed when it is related to treatment, payment, or healthcare operations directly associated with the work that we do at IEHP on behalf of our Members. Click Report a Privacy Incident/Breach to report online. What is the Fraud, Waste, and Abuse (FWA) Program? IEHP has established a fraud, waste, and abuse program to detect, correct, and prevent fraud, waste, and abuse on part of IEHP Employees, IEHP Members, Providers, Vendors, delegated entities and any other entity doing business with IEHP. What is Fraud? Fraud is knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program, or to obtain, by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any health care benefit program. Examples include: The use of someone else's identification or insurance card to obtain services. Falsifying income or location to obtain insurance. Selling of prescription medication or medical equipment obtained through IEHP. What is Waste? Waste includes overuse of services, or other practices that, directly or indirectly, result in unnecessary costs. Waste is generally not considered to be caused by actions of criminal neglect but rather by the misuse of resources. Examples include: Frequent visits to the ER or Urgent care for standard doctor visits. Visiting multiple doctors or hospitals to obtain controlled medications. What is Abuse? Abuse includes actions that may, directly or indirectly, result in unnecessary costs and improper payment or services. Abuse involves payment for items or services when there is no legal entitlement to that payment and the provider has not knowingly and/or intentionally misrepresented facts to obtain payment. Examples include: Use of transportation benefits for non-medical purposes. Click Report Fraud/Waste/Abuse to report online.
Coronavirus (COVID-19) Announcements
of Phase 1A of its vaccination roadmap, vaccines will be distributed to caregivers with In-Home Support Services (IHSS), intermediate care centers, and public and community health centers, including facilities for mental health. Click here to learn more. 1/12/21: San Bernardino County introduces a coronavirus quarantine and isolation calculator. This tool allows people to determine how long they should self-isolate after testing positive for COVID-19, being sick with COVID-19, or being exposed to someone with COVID-19. Click here for more info. 12/7/20: The governor announced a stay at home order for Southern California regions, including Riverside and San Bernardino County, for a minimum of three weeks. This order is in response to a rapid growth in COVID-19 cases and a substantial increase in hospitalizations and ICU admissions. Click here to learn more. 9/11/20: To continue to help slow the spread of COVID-19, Riverside County is urging residents to get tested. In addition, increased testing will help the county move into the next level of the state’s reopening plan. For testing locations, visit gettested.ruhealth.org. 8/21/20: Health officials urge Riverside County residents to get tested for COVID-19, whether or not they are experiencing symptoms. For testing locations, visit gettested.ruhealth.org. 8/21/20: To stop the spread of COVID-19, San Bernardino County Public Health Director urges all residents to get tested. Watch this video to learn more. 7/24/20: Fraud reports have increased due to uncertainty surrounding COVID-19, leaving many San Bernardino residents unsure how to avoid scams or report them to authorities. Scams include fake at-home COVID-19 testing kits or vaccinations, IRS impersonators, illegal robocalls and fake charities. For more information visit the San Bernardino County Public Website. 6/29/20: San Bernardino County is encouraging all residents, including those who have not experienced symptoms of COVID-19, to be testing for the Coronavirus. Click here for testing locations. 6/19/20: Governor Newsom requires California residents to wear face coverings while in public. Click here to learn more. For information on how to wear a proper face covering, watch this short video. 6/12/20: A COVID-19 testing site returns to Blythe. Testing started on June 10th and will continue for two weeks. In addition, a testing site opens at the Edgemont Women’s Club in Moreno Valley and will operate June 17 through June 19th. Click here for more information. 5/29/20: Cooling Centers open throughout Riverside County, offering residents an escape from extreme heat and are open to the public at no cost. The centers will be available through October. Click here for more information. 5/29/20: New COVID-19 testing sites open in San Bernardino County. They are scheduled to run through June with appointment registrations opening weekly. For a complete list of testing locations click here: Click here for a complete list of testing locations. 5/27/20: A drive up COVID-19 testing site will be opened at the old Sears parking lot in Riverside, replacing the testing location at Harvest Christian Fellowship that is closing. Click here for a complete list of testing. 5/22/20: Riverside County added three new COVID-19 testing sites in Corona, San Jacinto and Temecula. Click here for a complete list of testing locations. 4/30/20: Riverside County’s Public Health Officer is extending his order requiring residents to wear face coverings when outside and to continue practicing social distancing through June 19. Residents are still required to remain in their primary residence under Governor Newsom’s existing “stay at home” order unless they are engaged in an essential business or activity, such as grocery shopping or visiting the doctor. Click here for more information. 4/28/20: San Bernardino County opens up criteria for COVID-19 testing. Beginning April 30th, residents 65 and older, healthcare workers, emergency responders, and law enforcement can get tested without displaying symptoms of COVID-19. For testing information, visit the San Bernardino County website. 4/24/20: In response to an increasing number of requests for resources, Riverside County released an online map to connect residents to local food resources. Resources include senior meal sites, school district meal sites and food pantries. Click here to find food resources. 4/20/20: Testing for COVID-19 has been expanded to all Riverside County residents, including those who do not have any COVID-19 symptoms. In addition, a fifth COVID-19 testing site will be established at the Blythe Fairgrounds on April 22nd. All residents interested in testing must call 800-945-6171 for an appointment. Click here for more information. 4/13/20: A fourth drive-up COVID-19 testing site opens in Riverside County on Tuesday, April 14th. The site has been established at the Perris Fairgrounds, located at 18700 Lake Perris Drive. Perris, California. Residents who want to get tested must have symptoms to make an appointment, symptoms include fever, cough, sore throat, runny nose or cough. Residents must call 800-945-6171 to make an appointment. For more information on testing locations, visit the Riverside County Public Health website. 4/13/20: San Bernardino County Public Health will conduct a community drive-through event for COVID-19 testing in Montclair on Tuesday, April 14. This event is open to San Bernardino County residents by appointment only. Residents can make an appointment online at http://wp.sbcounty.gov/dph/coronavirus/ at 2 p.m. on Monday, April 13 or by calling (909) 387-3911. Additional community drive-through events are scheduled throughout this month in Yucaipa, Big Bear Lake, Joshua Tree, and Rancho Cucamonga, California. For more information visit the San Bernardino County website. 4/8/20: Arrowhead Regional Medical Center will begin a COVID-19 drive-thru testing site on Thursday, April 9th. Appointments are required. To make an appointment call 855-422-8029. For more information visit Arrowhead Regional Medical Center. 4/7/20: CalWORKs and CalFresh renewals and SAR 7 status reports do not need to be submitted for March, April or May. This does not apply to Transitional CalFresh or Transitional Nutrition benefits. To access your benefits, visit: c4youself.com or call 877-410-8829 (San Bernardino County) 877-410-8827 (Riverside County). 4/7/20: The San Bernardino County’s Acting Health Officer ordered everyone in San Bernardino County to wear face coverings when leaving home and interacting with other people. Face coverings may include homemade cloth ear loop covers, bandannas and handkerchiefs, and neck gaiters. Also, orders all religious services to be done electronically, including upcoming Easter celebrations.Click here for more information. 4/4/20: The Riverside County Public Health Officer orders the public to stay home and cover their face when leaving and interacting with other people, including essential workers. Face coverings can be bandanas, scarves, neck gaiters or other clothing that does not have visible holes. Click here to learn more. 4/4/20: The Small Business Association (SBA) is offering forgivable loans that help businesses keep their workforce employed during the Coronavirus (COVID-19) crisis. The Paycheck Protection Program is a loan designed to provide a direct incentive for small businesses to keep their workers on the payroll. The loan application period opens on Friday, April 3, 2020. For more information visit the SBA website. 3/31/20: San Bernardino County will conduct a drive-thru sample collection event for COVID-19 in the High Desert on April 2nd. This event is open to San Bernardino County residents only. Residents can request an appointment online at sbcovid19.com or by calling (909) 387-3911. For more information on this event visit: http://www.sbcounty.gov/main/default.aspx 3/30/20 – A third drive-up COVID-19 testing site opens in Riverside County on April 1st. The site has been established at Harvest Christian Fellowship church in Riverside. Residents must have symptoms to make an appointment, which include fever, cough, sore throat, runny nose or cough. Residents must call 800-945-6171 to make an appointment. For more information on testing locations, visit the Riverside County Public Health website. 3/30/20 – A COVID-19 testing site in Indian Wells will be relocated to the Riverside County Fairgrounds in Indio. The first day of testing at the fairgrounds is Tuesday (March 31). Residents must have symptoms to make an appointment, which include fever, cough, sore throat, runny nose or cough. Appointments must be scheduled by calling 800-945-6171. For more information on testing locations, visit the Riverside County Public Health website. 3/27/20: San Bernardino County Public Health will conduct a drive-thru specimen collection for COVID-19 on Friday, March 27. The specimen collection for COVID-19 testing will be available for the public by appointment only. Appointment sign-up and details will be available on the county website. 3/25/20: COVID-19 testing for IEHP Members is now available at SAC Health Systems in San Bernardino. IEHP Members must call (909) 771-2911 to schedule a telephone appointment with a Doctor. The Doctor will evaluate the Member and determine if they need COVID-19 testing and will provide details on how to obtain testing. 3/20/2020: Gov Gavin Newsom announces a California statewide order for residents to “stay at home,” excluding essential entities which include grocery stores, take-out and delivery and health care organizations. IEHP is an essential entity and will continue operations to support our Members and Providers through telephonic contact only. OUR BUILDINGS ARE CLOSED TO NON-EMPLOYEES. We highly encourage you (our Members and Providers) to call us if you need any services or have any questions. Continue to visit our website for frequent updates and news from Gov Gavin Newsom. 3/19/2020: IEHP Chief Medical Officer, Dr. Hansberger, has an important message for our Members in the Coachella Valley region about the COVID-19 situation and ways for them to protect their health. Click here. 3/18/2020: To help our IEHP Members stay home and avoid public places, we encourage Members to use mail order delivery service for both new and refill prescriptions. By using this service, Members can get medicines mailed to their home at no cost by using standard shipping. 3/13/2020: We are requesting when you (including Members, Providers, Community Partners, Vendors, and all Visitors) need IEHP services, please call IEHP or your IEHP contact directly to get the help you need. If you must visit IEHP in person, please ensure that you do not have a fever, cough or breathing problem. 3/13/2020: All classes and events at IEHP’s Community Resource Centers are canceled until further notice for the protection and safety of our community during the Coronavirus (COVID-19) situation. We apologize for any inconvenience and expect to resume classes as soon as possible.
Governing Board - Karen Spiegel
sworn into office on January 8, 2019. The Second District includes the unincorporated communities of Coronita, El Cerrito, Home Gardens and Highgrove, and the cities of Corona, Eastvale, Jurupa Valley, Norco, and the western half of the City of Riverside. In February 2019 she was appointed to the IEHP Governing Board, appointed Vice-chair in 2020, and served as Chair in 2021. Karen Spiegel began her political career as the elected City Treasurer for the City of Corona in 1996. After six years as Treasurer, she embraced the City Council elections in 2002 and served the City of Corona as Council Member for 16 years, serving as Mayor four terms. Her actions speak volumes and her unique passion for service truly sets her apart. She encourages community participation with City and County government and has introduced many new programs. Karen has been credited for her leadership in regional transportation issues, collaboration and regional partnerships. In addition to the service in her District, Karen represents Riverside County on the Regional and State level in many organizations and has served in a leadership role on several. She is an energetic member of the community and her "roll-up your sleeves" attitude has led her to immerse herself in many civic, business and community activities. She has been honored for her service with numerous awards and recognitions over the years.
Governing Board - Andrew Williams
Healthcare Scholarship Fund - About the Healthcare Scholarship Fund
p Fund is the health plan’s partnership with local academic institutions to help remove the barrier of debt for medical students and develop a growing workforce for healthcare professionals to care for the Inland Empire’s growing Medi-Cal population. Why is the Healthcare Scholarship Fund needed? According to the California Healthcare Foundation, the Inland Empire has one of the lowest ratios of Primary Care Physicians (PCPs) and specialty physicians per 100,000 people in California. In addition, the Inland Empire lacks adequate Specialty and Behavioral Health practitioner capacity to serve the current growing population. With the average cost of a four-year medical degree standing firm at $276,800, pursuing a career in the medical field is out of reach for more and more each year. The HSF will aid students by helping to remove the financial burden of medical school that often restricts the choices of many aspiring healthcare professionals and allow recipients to immediately pursue careers in healthcare. I am a student and am interested in becoming a Doctor, what should I do? Students interested in the IEHP Healthcare Scholarship Fund are encouraged to contact the academic institutions below for more information on how apply. While each institution may have differing eligibility requirements, all Healthcare Scholarship Fund scholarships require students commit to practicing in the Inland Empire for 5 years after graduation. Participating schools and programs include: Loma Linda University Medical School University of California Riverside California University of Science and Medicine
Medical Benefits & Coverage Of Medi-Cal In California
d services as a Member of IEHP. Your covered services are at no cost if they are medically necessary, and you get the approved services from our Provider network. “Medically necessary” means it is reasonable and needed to protect life, to keep you from becoming seriously ill or disabled, or to reduce pain from a diagnosed disease, illness or injury. To learn more about IEHP’s benefits and services, read Chapter 4 of the IEHP Medi-Cal Member Handbook (PDF) or call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347. IEHP offers these types of services: Outpatient (ambulatory) services* Emergency services Transgender services* Hospice and palliative care* Hospitalization* Maternity and newborn care Mental health services Prescription drugs Rehabilitative and habilitative services and devices* Laboratory and radiology services, such as X-rays* Preventive and wellness services and chronic disease management Sensitive services Substance use disorder treatment services Pediatric services Vision services* Non-emergency medical transportation (NEMT) Non-medical transportation (NMT) Long-term services and supports (LTSS) Telehealth services Some of the services listed are covered only if IEHP or your IPA approves first. Covered services that may need an approval from IEHP or your IPA or medical group first are marked by an asterisk (*). Vision services The plan covers: Routine eye exam once every 24 months; IEHP may pre-approve (prior authorization) additional services as medically necessary. Eyeglasses (frames and lens) once every 24 months; contact lens when required for medical conditions such as aphakia, aniridia and keratoconus Limitations Single vision lenses only. Members under 18 automatically get polycarbonate lenses. Contacts in lieu of glasses only if medically necessary. Dental services The Medi-Cal Dental Program covers some dental services, such as: Diagnostic and preventive dental hygiene (e.g., examinations, x-rays, and teeth cleanings) Emergency services for pain control Tooth extractions Fillings Root canal treatments Prosthetic appliances Orthodontics for children who qualify Members can access dental services through providers enrolled in the Medi-Cal Dental Program. They will advise you on the best course of treatment and when these services may be attained. To learn more about dental services, call the Medi-Cal Dental Program at 1-800-440-IEHP (4347) / TTY (800) 718-4347. You may also visit the Denti-Cal website at www.smilecalifornia.org. Transportation services Your Medi-Cal benefits include round trip transportation for plan-covered health services and Medi-Cal-covered services, such as mental health, substance abuse and dental, within San Bernardino and Riverside counties. The plan covers: Visits to your Primary Care Doctor, Specialists and urgent care clinics. Visit for dental, mental health, substance abuse and other services. Exclusions and Limitations IEHP does not cover: One-way trips and non-medical visits. Visits to Social Security, Workers Compensation Claims, Personal Injury cases, Courts, Parole or Probation or Social Services Offices. IEHP offers two types of transportation: Bus passes* for Non-Medical Transportation (NMT): approved when you do not have any physical or medical issue that does not allow you to travel by bus, car, taxi or other forms of public transportation. Uber for Non-Medical Transportation (NMT): approved when your area doesn’t support bus passes, or you are crossing counties. For this type of transportation, you need to wait for your ride at the curb. Non-Emergent Medical Transportation (NEMT): approved when your medical or physical issue does not allow you to travel by bus, car, taxi or other forms of public transportation. For this type of transportation, your Doctor must submit a Physicians’ Certification Statement online. Effective March 1, 2020, transportation for routine medical visits including Behavioral Health and Substance Use must be scheduled five business days before your appointment. To set up transportation, call IEHP Transportation Department at 1-800-440-4347 (option two), Monday – Friday, 8am – 5pm. TTY users should call 1-800-718-4347 (option two). *For bus passes, call American Logistics Company at 855-673-3195 selection option 1. Once you get your bus pass, you can use this for all of your health care visits. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. To download a free copy click Adobe Acrobat Reader. The Postpartum Care Extension Program The Postpartum Care Extension Program provides extended coverage for Medi-Cal members during both the pregnancy and after pregnancy. The Postpartum Care Extension Program extends coverage by IEHP for up to 12 months after the end of the pregnancy regardless of income, citizenship, or immigration status and no additional action is needed. Rapid Whole Genome Sequencing Rapid Whole Genome Sequencing (rWGS), including individual sequencing, trio sequencing for a parent or parents and their baby, and ultra-rapid sequencing, is a covered benefit for any Medi-Cal member who is one year of age or younger and is receiving inpatient hospital services in an intensive care unit. rWGS is an emerging method of diagnosing conditions in time to affect ICU care of children one year of age or younger. If your child is eligible for California Children’s Services (CCS), CCS may be responsible for covering the hospital stay and the rWGS. Referrals For some types of care, your PCP or specialist will need to ask IEHP for permission before you get the care. This is called asking for prior authorization, prior approval, or pre-approval. It means that IEHP must make sure that the care is medically necessary or needed based on appropriateness of care and services and existence of coverage. Care is medically necessary if it is reasonable and necessary to protect your life, keeps you from becoming seriously ill or disabled, or reduces severe pain from a diagnosed disease, illness or injury. For some services, you need pre-approval (prior authorization). Under Health and Safety Code Section 1367.01(h)(2), IEHP will decide routine pre-approvals within 5 working days of when IEHP gets the information reasonably needed to decide. For requests in which a provider indicates or IEHP determines that following the standard timeframe could seriously jeopardize your life or health or ability to attain, maintain, or regain maximum function, IEHP will make an expedited (fast) pre-approval decision. IEHP will give notice as quickly as your health condition requires and no later than 72 hours after receiving the request for services. If IEHP does not approve the request, IEHP will send you a Notice of Action (NOA) letter. The NOA letter will tell you how to file an appeal if you do not agree with the decision. IEHP will contact you if IEHP needs more information or more time to review your request. Continuity of Care If you now go to providers who are not in the IEHP network (out-of-network), in certain cases you may get continuity of care and be able to go to them for up to 12 months. If your providers do not join the IEHP network by the end of 12 months, you will need to switch to providers in the IEHP network. If you are a new Member, you may request to keep getting medical services from an out of network provider if you were getting this care before enrolling in IEHP. IEHP will decide if this treatment with an out of network provider is medically appropriate. Continuity of care does not extend to durable medical equipment, transportation, ancillary services, carved out services or services not covered by Medi-Cal. To learn more about continuity of care and eligibility qualifications, call IEHP Member Services at 1-800-440-IEHP (4347). Prescription drugs Most prescription drugs are covered by Medi-Cal Rx, some drugs may be covered by IEHP. Your provider can prescribe you drugs that are on the Medi-Cal Rx Contract Drugs List. To find out if a drug is on the Contract Drug List or to get a copy of the Contract Drug List, call Medi-Cal Rx at 1-800-977-2273 (TTY 1-800-977-2273 and press 5 or 711), visit the Medi-Cal Rx website at www.MediCalRx.dhcs.ca.gov/home/, or call IEHP Member Services at 1-800-440-IEHP (4347), Monday-Friday, 8am-5pm. TTY users should call 1-800-718-4347 or 711. Pharmacies If you are filling or refilling a prescription, you must get your prescribed drugs from a pharmacy that works with Medi-Cal Rx. You can find a list of pharmacies that work with Medi-Cal Rx in the Medi-Cal Rx Pharmacy Directory at www.Medi-CalRx.hcs.ca.gov/home/. You can also find a pharmacy near you by calling Medi-Cal Rx at 1-800-977-2273 (TTY 1-800-977-2273 and press 5 or 711). Or call IEHP Member Services at 1-800-440-IEHP (4347), Monday-Friday, 8am-5pm. TTY users should call 1-800-718-4347 or 711.
How to Get Care - How to Get Care
l care, like: Routine checkups Sick visits, such as colds, flu and fever Chronic illnesses, like asthma and diabetes Order medical tests Your Doctor also handles your preventive care, such as vaccines, shots, health screenings and other tests. Preventive care is about preventing disease. Regular checkups, even when you are not sick, can help your Doctor spot a health problem early, and treat it before it gets worse. 2. Getting care from a Specialist When you need specialty care, your Doctor will refer you to a Specialist. This is how referrals work: When the request is received by IEHP, a decision will be made within 5 business days for a regular referral. For an urgent referral, this is done within 72 business hours. For a regular referral, expect a letter from your medical group or IEHP within 2 days after a decision has been made. When the request is approved, call your Specialist to make an appointment. If the request is denied, talk to your Doctor or call IEHP Member Services at (800) 440-4347 or (800) 718-4347 (TTY) to learn more. 3. Getting your medicine You can fill your prescription at any IEHP contracted pharmacy. There are more than 760 pharmacies in our network. From major chains, like Walgreens, CVS, Rite Aid, Walmart and many others. To find one close to you, check your IEHP Doctor Directory or click the Provider Search link. Helpful tips to help your treatment: Be sure to call the pharmacy five days before you run out of medicine. Take your medicine the way your Doctor tells you to. 4. Find a Doctor To find more information on Primary Care Physician's (PCPs), Specialists, Pharmacies, etc., click here to visit the Doctor search. 5. Getting help from Member Services If you need help, call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347. The call is toll free. If you reach IEHP Member Services after hours, you will be able to leave a secure voice message. Calls will be returned the next working day. If you call after midnight and leave a secure voice message, we will return your call the same working day. Resources Barriers to Care: We all have our own cultural, religious or health beliefs. This document includes some common beliefs that may keep you from getting the care you need—along with some facts to help you make informed decisions about your health.
Awards and Recognitions
ence and access to care for the low-income working residents of the Inland Empire. These recognitions honor our steadfast commitment to improving access to quality, wellness-based healthcare services when and where members need it. NCQA Accreditation IEHP was the first Medicaid-only health plan in California to earn accreditation from the National Committee for Quality Assurance (NCQA) for its Medi-Cal health plan, in 2000. We have retained NCQA accreditation every year since. Innovation Awards from DHCS In November 2021, IEHP received the “Innovation Award - Runner Up 2021” for the Medi-Cal PCP Auto Assignment Redesign, which focused on directing Members to Providers with higher quality scores. In November 2020, IEHP was awarded the prestigious California Department of Healthcare Services (DHCS) Innovation Award. The award was based on IEHP’s groundbreaking work using location intelligence to reach high-risk members and providers in geographic areas affected by power outages, wildfires, and other natural disasters. This is the fourth time the health plan has received this honor. In 2018, IEHP received the Innovation Award from Department of Health Care Services (DHCS), for its Housing Initiative, which provides permanent supportive housing and intensive case management services to homeless, high utilizing Members. In October 2017 IEHP won a California Department of Health Care Services (DHCS) Innovation Award for improving the health of low-income members through a program that coordinates their complex physical and behavioral health care needs across the healthcare system in Riverside and San Bernardino counties. In 2015 IEHP won the first annual Innovation Award from DHCS for its Transitional Care Program, which strives to reduce emergency room usage and curtails the re-admission rates of members recently discharged from the hospital IEHP Receives the CORE Certification Seal In April 2022, IEHP received the CORE Certification Seal for the Eligibility & Benefits, Claim Status, and Payment & Remittance CAQH CORE Operating Rule Sets. As a CAQH CORE-certified entity, IEHP has demonstrated that they follow a set of national operating rules and standards which improve business processes in healthcare — going above and beyond what is federally required. The CORE Seal is widely recognized as the industry gold standard. IEHP Receives Rancho Cucamonga Fire District’s Business Partner of the Year Award In September 2021, IEHP was awarded Business Partner of the Year by the Rancho Cucamonga Fire District at the City’s Fire and Police Recognition. The distinguished award recognizes the health plan’s partnership with the City and County of San Bernardino to host an ongoing super vaccine clinic at the health plan’s headquarters. IEHP Receives Health Equity Award for Engaging Communication In 2020, IEHP received the Health Equity Award for their ability to engage and connect with members via text message during Governor Newsom’s social isolation order. The award was given by mPulse Mobile, a leader in conversational AI solutions for healthcare, during their annual Activate Awards. Click here to learn more. IEHP DualChoice Cal MediConnect Plan Earns Top Customer Satisfaction Score in the Nation The IEHP DualChoice Cal MediConnect Plan had the third-highest score in the country in the 2016 MMP CAHPS survey from the Centers for Medicare and Medicaid Services (CMS), which assesses the experiences patients have with their health plans. In 2016 there were 40 Medicare-Medicaid Plans (MMP) in the nation (called Cal MediConnect plans in California). Annual Excellence Award In 2016, IEHP received the Excellence Award from the Pharmacy Benefit Management Institute (PBMI) for its Pharmacy Pay for Performance Program, which leverages IEHP network pharmacies to offer clinical education to its members. Top Physician Satisfaction Doctors and other medical providers ranked IEHP at or above the 90th percentile in most areas on a 2016 satisfaction survey administered by an independent survey vendor. They ranked IEHP at the: 99th percentile for “IEHP Compared to All Other Health Plans” 98th percentile for “Overall Satisfaction with Call Center Staff” 98th percentile for “Overall Satisfaction with Financial Services” 97th percentile for “Recommend IEHP to Other Physicians’ Practices” IEHP Receives Workplace of the Year Award from Advisory Board in March 2018 Inland Empire Health Plan (IEHP) has been awarded the Advisory Board 2018 Workplace of the Year Award. The annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. IEHP is one of only 20 organizations nationwide to receive the award. Favorite Employer IEHP was voted “Favorite Overall Company to Work For,” “Favorite Training Program” and “Favorite Workplace Culture” by Los Angeles News Group Readers in the 2014 Winning Workplaces survey. “Access to Caring” Award IEHP was recognized for making a difference in advancing health care access and availability to people with disabilities by the Western University of Health Sciences, in 2014. Energy Star Award for Superior Energy Performance IEHP’s corporate headquarters (“The Atrium”) in Rancho Cucamonga, Calif. earned the U.S. Environmental Protection Agency’s ENERGY STAR® certification for superior energy performance in 2017, demonstrating IEHP’s commitment to continued energy savings and environmental responsibility. “Gold Standard” Certification for Electronic Payments and Claims Processing In 2016 IEHP achieved Phase III certification for accurate and efficient electronic provider payments and claims reconciliation from the Council for Affordable Quality Healthcare (CAQH) and the Committee on Operating Rules for Information Exchange (CORE). The voluntary certification is widely viewed as the industry “gold standard” for provider payments and claims processing.