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n programs, and important reminders to help you live a better life. The Pulse: this newsletter is for adults and families with children and who have Medi-Cal with IEHP. Health Spotlight: this newsletter is for IEHP Members with both Medi-Cal and Medicare (CMC).  AccessAbility: this newsletter is for seniors and people with disabilities who have Medi-Cal with IEHP. 

out! You can take quizzes and learn tips on what you can do to stay healthy. Interactive Self-Management Tools Smoking Cessation Physical Activity Healthy Eating Managing Stress Avoiding At-Risk Drinking Identifying Depressive Symptoms Healthy Weight Additional Resources Self-Management Tool Booklet - This booklet covers information on the topics above. If you would like to request a printed copy of the Self-Management Tools Booklet, please call IEHP Health Education Department at 1-866-224-IEHP (4347) or 1-800-718-4347 for TTY users. Calculate your Body Mass Index (BMI) – for adults 20 years old and older Calculate your Body Mass Index (BMI) – for children ages 2 through 19 years old Watch the video below to learn how to register for Health Education classes on the IEHP website.    Watch the video below to learn how to register for Health Education classes on the Member Portal.   

mance and quality measures to help Medicare beneficiaries make informed decisions regarding health and prescription drug plans. As part of this effort, CMS adopted measures for High Risk Medication (HRM) endorsed by the Pharmacy Quality Alliance (PQA) and the National Quality Forum (NQF). The HRM was developed using existing HEDIS measurement “Drugs to be avoided in the elderly”.  The HRM rate analyzes the percentage of Medicare Part D beneficiaries 65 years or older who have received prescriptions for drugs with a high risk of serious side effects in the elderly. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking Adobe Acrobat Reader. By clicking on this link, you will be leaving the IEHP website. Notices 12/10/2021 IEHP Pharmacy Times (PDF) 01/13/2016 IEHP Pharmacy Times (PDF) 06/17/2013 IEHP Pharmacy Times (PDF) 02/11/2013 IEHP Pharmacy Times (PDF)   Reference IEHP High Risk Medication Drug Alternative(s) Reference Guide (PDF) AGS Beers Criteria 2019 (PDF)   Information on this page is current as of December 10, 2021.

Provider Staff Newsletter; keep you in the know about our newest programs, incentive opportunities, study results, and more.    Volume 34 - Summer 2022 (PDF) Volume 33 - Fall 2021 (PDF) Volume 32 - Spring 2021 (PDF) Volume 31 - Fall 2020 (PDF) Volume 30 - Fall 2019 (PDF)   Volume 34 - Winter 2022 (PDF) Volume 33 - Spring 2021 (PDF) Volume 32 - Winter 2021 (PDF) Volume 30 - Winter 2020 (PDF) Volume 29 - Spring 2019 (PDF) Volume 28 - Winter 2018 (PDF) Volume 27 - Summer 2018 (PDF) To access past Newsletters, please contact the Provider Relations Team at (909) 890-2054. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

ights laws. IEHP does not unlawfully discriminate, exclude people, or treat them differently because of sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, or sexual orientation. IEHP provides: Free aids and services to people with disabilities to communicate effectively with us, such as: Qualified sign language interpreters Written information in other formats (large print, audio, accessible electronic formats, other formats)   Free language services to people whose primary language is not English, such as: Qualified interpreters Information written in other languages If you need these services, contact IEHP Member Services between 8am-5pm (PST), by calling 1-800-440-IEHP (4347), 7 days a week, including holidays. If you cannot hear or speak well, please call 1-800-718-4347. Upon request, this document can be made available to you in braille, large print, audiocassette, or electronic form. To obtain a copy in one of these alternative formats, please call or write to: Inland Empire Health Plan 10801 6th St., Rancho Cucamonga, CA 91730-5987 1-800-440-4347 (TTY: 1-800-718-4347/California Relay 711) How to file a grievance If you believe that IEHP has failed to provide these services or unlawfully discriminated in another way on the basis of sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, or sexual orientation, you can file a grievance with IEHP’s Civil Rights Coordinator. You can file a grievance by phone, in writing, in person, or electronically: By phone: Contact IEHP’s Civil Rights Coordinator between 8am-5pm (PST), by calling 1- 800-440-4347. Or, if you cannot hear or speak well, please call TTY: 1-800-718-4347/California Relay 711. In writing: Fill out a complaint form or write a letter and send it to - IEHP’s Civil Rights Coordinator, 10801 6th St., Rancho Cucamonga, CA 91730-5987 In person: Visit your doctor’s office or IEHP and say you want to file a grievance. Electronically: File a grievance online. Office of Civil Rights - California Department of Health Care Services You can also file a civil rights complaint with the California Department of Health Care Services, Office of Civil Rights by phone, in writing, or electronically: By phone: Call (916) 440-7370. If you cannot speak or hear well, please call 711 (Telecommunications Relay Service). In writing: Fill out a complaint form or send a letter to - Deputy Director, Office of Civil Rights Department of Health Care Services Office of Civil Rights, P.O. Box 997413, MS 0009 Sacramento, CA 95899-7413 Electronically: Send an email to CivilRights@dhcs.ca.gov. Office of Civil Rights - U.S. Department of Health and Human Services If you believe you have been discriminated against on the basis of race, color, national origin, age, disability or sex, you can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights by phone, in writing, or electronically: By phone: Call 1-800-368-1019. If you cannot speak or hear well, please call TTY/TDD 1-800- 537-7697. In writing: Fill out a complaint form or send a letter to - U.S. Department of Health and Human Services, 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 Electronically: Visit the Office for Civil Rights Complaint Portal at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf LANGUAGE ASSISTANCE English ATTENTION: If you need help in your language call 1-800-440-4347 (TTY: 1-800-718-4347). Aids and services for people with disabilities, like documents in braille and large print, are also available. Call 1-800-440-4347 (TTY: 1-800-718-4347). These services are free of charge. الشعار بالعربي ة (Arabic) يُر جى الانتباه:ى إذا احتجت إلى المساعدة بلغتك، فاتصل ب 1-800-440-4347 (TTY: 1-800-718-4347) .ى تتوفر ا ً أيض المساعدات والخدمات للأشخاص ذوي الإعاقة، مث ى ل المستندات المكتوبة بطريقة بريل والخ ى ط الكب ري.ى اتصل ب 1-800-440-4347 (TTY: 1-800-718-4347) . هذه الخدمات مجانيةى. Հայերեն պիտակ (Armenian) ՈՒՇԱԴՐՈՒԹՅՈՒՆ: Եթե Ձեզ օգնություն է հարկավոր Ձեր լեզվով, զանգահարեք 1-800-440-4347 (TTY: 1-800-718-4347)։ Կան նաև օժանդակ միջոցներ ու ծառայություններ հաշմանդամություն ունեցող անձանց համար, օրինակ` Բրայլի գրատիպով ու խոշորատառ տպագրված նյութեր։ Զանգահարեք 1-800-440-4347 (TTY: 1-800-718-4347)։ Այդ ծառայություններն անվճար են։ ឃ្លាសម្គាល់ជាភាសាខ្មែរ (Cambodian) ចំណំ៖ ប ើអ្នក ត្រូវ ការជំនួយ ជាភាសា រ ស់អ្នក សូម ទូរស័ព្ទបៅបេខ 1-800-440-4347 (TTY: 1-800-718-4347)។ ជំនួយ និង បសវាកមម សត្ា ់ ជនព្ិការ ដូចជាឯកសារសរបសរជាអ្កសរផុស សត្ា ់ជនព្ិការភ្ននក ឬឯកសារសរបសរជាអ្កសរព្ុមពធំ ក៏អាចរកបានផងភ្ដរ។ ទូរស័ព្ទមកបេខ 1-800-440-4347 (TTY: 1-800-718-4347)។ បសវាកមមទំងបនេះមិនគិរថ្លៃប ើយ។ 简体中文标语(Chinese) 请注意：如果您需要以您的母语提供帮助，请致电1-800-440-4347 (TTY: 1-800-718-4347)。另外还提供针对残疾人士的帮助和服务，例如盲文和需要较大字体阅读，也是方便取用的。请致电1-800-440-4347 (TTY: 1-800-718-4347)。这些服务都是免费的。 (Farsi) مطلب به زبان فارسی توجه: اگر میخواهید به زبان خود کمک دریافت کنید، با 1-800-440-4347 (TTY: 1-800-718-4347) تماس بگیرید. کمکها و خدمات مخصوص افراد دارای معلولیت، مانند نسخههای خط بریل و چاپ با حروف بزرگ، نیز موجود است. با 1-800-440-4347 (TTY: 1-800-718-4347) تماس بگیرید. این خدمات رایگان ارائه میشوند. ह िंदी टैगलाइन (Hindi) ध्यान दें: अगर आपको अपनी भाषा में सहायता की आवश्यकता है 1-800-440-4347 (TTY: 1-800-718-4347) पर कॉल करें। अशक्तता वाले लोगोों के ललए सहायता और सेवाएों, जैसे ब्रेल और बडे लरोंट में भी दस्तावेज़ उपलब्ध हैं। 1-800-440-4347 (TTY: 1-800-718-4347) पर कॉल करें। ये सेवाएों लन: शुल्क हैं। Nqe Lus Hmoob Cob (Hmong) CEEB TOOM: Yog koj xav tau kev pab txhais koj hom lus hu rau 1-800-440-4347 (TTY: 1-800-718-4347). Muaj cov kev pab txhawb thiab kev pab cuam rau cov neeg xiam oob qhab, xws li puav leej muaj ua cov ntawv su thiab luam tawm ua tus ntawv loj. Hu rau 1-800-440-4347 (TTY: 1-800-718-4347). Cov kev pab cuam no yog pab dawb xwb. 日本語表記 (Japanese) 注意日本語での対応が必要な場合は 1-800-440-4347 (TTY: 1-800-718-4347)へお電話ください。点字の資料や文字の拡大表示など、障がいをお持ちの方のためのサービスも用意しています。1-800-440-4347 (TTY: 1-800-718-4347) へお電話ください。これらのサービスは無料で提供しています。 한국어 태그라인 (Korean) 유의사항: 귀하의 언어로 도움을 받고 싶으시면 1-800-440-4347 (TTY: 1-800-718-4347) 번으로 문의하십시오. 점자나 큰 활자로 된 문서와 같이 장애가 있는 분들을 위한 도움과 서비스도 이용 가능합니다. 1-800-440-4347 (TTY: 1-800-718-4347) 번으로 ___________문의하십시오. 이러한 서비스는 무료로 제공됩니다. ແທກໄລພາສາລາວ (Laotian) ປະກາດ: ຖ້າທ່ານຕ້ອງການຄວາມຊ່ວຍເຫ ຼືອໃນພາສາຂອງທ່ານໃຫ້ໂທຫາເບີ 1-800-440-4347 (TTY: 1-800-718-4347). ຍັງມີຄວາມຊ່ວຍເຫ ຼືອແລະການບໍລິການສໍາລັບຄົນພິການ ເຊັ່ນເອກະສານທີ່ເປັນອັກສອນນູນແລະມີໂຕພິມໃຫຍ່ ໃຫ້ໂທຫາເບີ 1-800-440-4347 (TTY: 1-800-718-4347). ການບໍລິການເຫ ົ່ານີ້ບໍ່ຕ້ອງເສຍຄ່າໃຊ້ຈ່າຍໃດໆ. Mien Tagline (Mien) LONGC HNYOUV JANGX LONGX OC: Beiv taux meih qiemx longc mienh tengx faan benx meih nyei waac nor douc waac daaih lorx taux 1-800-440-4347 (TTY: 1-800-718-4347). Liouh lorx jauv-louc tengx aengx caux nzie gong bun taux ninh mbuo wuaaic fangx mienh, beiv taux longc benx nzangc-pokc bun hluo mbiutc aengx caux aamz mborqv benx domh sou se mbenc nzoih bun longc. Douc waac daaih lorx 1-800-440-4347 (TTY: 1-800-718-4347). Naaiv deix nzie weih gong-bou jauv-louc se benx wang-henh tengx mv zuqc cuotv nyaanh oc. ਪੰਜਾਬੀ ਟੈਗਲਾਈਨ (Punjabi) ਧਿਆਨ ਧਿਓ: ਜੇ ਤੁਹਾਨ ੂੰ ਆਪਣੀ ਭਾਸਾ ਧ ਿੱਚ ਮਿਿ ਿੀ ਲੋੜ ਹੈ ਤਾਂ ਕਾਲ 1-800-440-4347 (TTY: 1-800-718-4347). ਅਪਾਹਜ ਲੋਕਾਂ ਲਈ ਸਹਾਇਤਾ ਅਤੇ ਸੇ ਾ ਾਂ, ਧਜ ੇਂ ਧਕ ਬ੍ਰੇਲ ਅਤੇ ਮੋਟੀ ਛਪਾਈ ਧ ਿੱਚ ਿਸਤਾ ੇਜ਼, ੀ ਉਪਲਬ੍ਿ ਹਨ| ਕਾਲ ਕਰੋ 1-800-440-4347 (TTY: 1-800-718-4347). ਇਹ ਸੇ ਾ ਾਂ ਮੁਫਤ ਹਨ| Русский слоган (Russian) ВНИМАНИЕ! Если вам нужна помощь на вашем родном языке, звоните по номеру 1-800-440-4347 (TTY: 1-800-718-4347). Также предоставляются средства и услуги для людей с ограниченными возможностями, например документы крупным шрифтом или шрифтом Брайля. Звоните по номеру 1-800-440-4347 (TTY: 1-800-718-4347). Такие услуги предоставляются бесплатно. Mensaje en español (Spanish) ATENCIÓN: si necesita ayuda en su idioma, llame al 1-800-440-4347 (TTY: 1-800-718-4347). También ofrecemos asistencia y servicios para personas con discapacidades, como documentos en braille y con letras grandes. Llame al 1-800-440-4347 (TTY: 1-800-718-4347). Estos servicios son gratuitos. Tagalog Tagline (Tagalog) ATENSIYON: Kung kailangan mo ng tulong sa iyong wika, tumawag sa 1-800-440-4347 (TTY: 1-800-718-4347). Mayroon ding mga tulong at serbisyo para sa mga taong may kapansanan,tulad ng mga dokumento sa braille at malaking print. Tumawag sa 1-800-440-4347 (TTY: 1-800-718-4347). Libre ang mga serbisyong ito. แท็กไลน์ภาษาไทย (Thai) โปรดทราบ: หากคุณต้องการความช่วยเหลือเป็นภาษาของคุณ กรุณาโทรศัพท์ไปที่หมายเลข 1-800-440-4347 (TTY: 1-800-718-4347)นอกจากนี้ ยังพร้อมให้ความช่วยเหลือและบริการต่าง ๆ สาหรับบุคคลที่มีความพิการ เช่น เอกสารต่าง ๆ ที่เป็นอักษรเบรลล์และเอกสารที่พิมพ์ด้วยตัวอักษรขนาดใหญ่ กรุณาโทรศัพท์ไปที่หมายเลข 1-800-440-4347 (TTY: 1-800-718-4347) ไม่มีค่าใช้จ่ายสาหรับบริการเหล่านี้ Примітка українською (Ukrainian) УВАГА! Якщо вам потрібна допомога вашою рідною мовою, телефонуйте на номер 1-800-440-4347 (TTY: 1-800-718-4347). Люди з обмеженими можливостями також можуть скористатися допоміжними засобами та послугами, наприклад, отримати документи, надруковані шрифтом Брайля та великим шрифтом. Телефонуйте на номер 1-800-440-4347 (TTY: 1-800-718-4347). Ці послуги безкоштовні. Khẩu hiệu tiếng Việt (Vietnamese) CHÚ Ý: Nếu quý vị cần trợ giúp bằng ngôn ngữ của mình, vui lòng gọi số 1-800-440-4347 (TTY: 1-800-718-4347). Chúng tôi cũng hỗ trợ và cung cấp các dịch vụ dành cho người khuyết tật, như tài liệu bằng chữ nổi Braille và chữ khổ lớn (chữ hoa). Vui lòng gọi số 1-800-440-4347 (TTY: 1-800-718-4347). Các dịch vụ này đều miễn phí.    

able to keep your health coverage regardless of any changes in your circumstances. However, once the COVID-19 Public Health Emergency (PHE) ends, your county will check to  see if you still qualify for free or low-cost Medi-Cal. If you or someone in your household receives a letter from the county asking for information about your Medi-Cal coverage, please provide the requested information as soon as possible. Change in Circumstances    Please continue to report any changes in your household to your local county office. This includes: Changes to your income Disability status Phone number or mailing address. If someone in your household becomes pregnant If someone moves in, or anything else that may affect your Medi-Cal eligibility Reporting these changes may help you continue to receive Medi-Cal coverage after the end of the COVID-19 PHE.  Reporting Contact Information  It is important for yourcounty to have your current contact information. Please report any changes in your contact information so you don’t miss important information about your Medi-Cal coverage. Please report all updated contact information, such as your phone number, email address, or home address, to your local county office or update your contact information online at BenefitsCal.com.  Riverside County Medi-Cal Office: 877:810-8827 San Bernardino County Medi-Cal Office: 877-410-8829 Requests for Information  If you or someone in your household receives a letter from the county asking for information about your Medi-Cal coverage, please provide it. This will help  your county ensure that your Medi-Cal coverage remains active.  Questions?  If you have any questions, or need help accessing your Medi-Cal coverage, or if your Medi-Cal was discontinued, please 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. 

members with highly complex needs. ECM is a benefit that provides extra services to help you get the care you need to stay healthy.  It coordinates the care you get from different doctors and others involved in your care. At IEHP, we understand that certain health conditions like diabetes, hypertension, or substance use disorder can be complex, confusing, and hard to manage. IEHP’s ECM offers supportive services to address your whole health–to care for your body and mind. You may qualify for ECM with IEHP if you meet certain criteria shown below and need more help with managing your health. Who is eligible? The IEHP ECM is for Members who have: Homelessness with complex health and/ or behavioral health needs Frequent hospital admissions, short-term skilled nursing facility stays, or emergency room visits A serious mental illness or substance use disorder with complex social needs Complex needs and are transitioning from incarceration in Riverside County If you qualify for ECM, you will have your own care team with a lead care manager that coordinates no-cost services, such as primary care, behavioral health, community-based long-term services and supports (LTSS), developmental health, oral health, and social services. Who is on your care team: Nurse Care Manager Behavioral Health Care Manager Care Coordinator Community Health Worker What IEHP’s ECM includes If you join ECM, your benefits will not change.  You can keep your Doctors and Providers and your care team will help: Find Doctors and get an appointment for physical, mental, and substance use health needs Keep all your Providers fully informed Set up transportation to your Doctor visits Get follow-up services after you leave the hospital Manage all your medicines Get help connecting to local resources such as food or other social services The ECM services are provided at no cost, and you can join or stop ECM at any time. Support when you need it Your care team can support you by phone or in person and may even go to your location. You are not alone with the IEHP ECM.  To join or stop ECM, 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.  

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e questions, 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. You can also email MemberServices@iehp.org. Medicare/Medi-Cal Members:  If you have questions, call IEHP DualChoice at 1-877-273-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. TTY users should call 1-800-718-4347. You can also email MemberServices@iehp.org. If you are a PROVIDER: If you need information, call the Provider Relations Team at (909) 890-2054, 8am-5pm, Monday-Friday. You can also email ProviderServices@iehp.org. To enroll with IEHP: If you need healthcare coverage, call 1-866-294-4347, 8am-5pm Monday-Friday. TTY users should call 1-800-720-4347. You’ll speak to one of our friendly bilingual Enrollment Advisors. To verify the employment status of an IEHP employee  Please submit your request to the IEHP Human Resources Department:  Email: Human_Resources@iehp.org. Fax: 909-477-8544 Phone: 909-890-2000 (and ask for Human Resources) Our Communities For general inquiries please call (909) 890-2000, 8am-5pm, Monday-Friday. TTY users should call (909) 890-0731. Prospective Vendors  If you are interested in becoming a vendor for IEHP, please visit our Procurement page. For all records processing Please contact the IEHP Legal Department. The Legal Department processes inquiries related to Protected Health Information (“PHI”), Subpoena, Guardianship, Public Records Act (“PRA”), and California Government Claims requests. The Legal Department is also IEHP’s designated Agent for Service of Process. Inland Empire Health Plan Attn: Legal Department 10801 Sixth Street Rancho Cucamonga, CA 91730 E-mail: legal@iehp.org Fax: (909) 477-8578 Authorization of Release (PDF) - This form authorizes IEHP to use and disclose Protected Health Information. If you are a reporter of the Media/Press  Please call our media contact: Chelsea Galvez Communications Strategist (909) 727-5263 press@iehp.org Our Location 10801 Sixth Street Rancho Cucamonga, CA 91730  Mailing Address P.O. Box 1800 Rancho Cucamonga, CA 91729-1800 Fax: (909) 890-2003 Claims Mailing Address for IEHP Direct Members Inland Empire Health Plan - Claims P.O. Box 4349 Rancho Cucamonga, CA 91729-4349 Claims Appeals and Disputes Mailing Address for IEHP Direct Members Inland Empire Health Plan - Claims Appeals and Disputes P.O. Box 4319 Rancho Cucamonga, CA 91729-4319

verside County residents under the age of 65 were uninsured based on the last count of the US census. Join the Riverside County health plan that puts its members at the center of their universe. IEHP will not rest until our communities enjoy optimal care and vibrant health. Together with state Medi-Cal, you can get access to thousands of doctors in your local area, all providing medical, dental, and vision services. Learn more about IEHP and Medi-Cal by calling us now. Medical Services in Riverside County Uninsured Americans are less likely to seek healthcare when they need it, which could increase existing medical problems. By choosing IEHP as your health plan through Medi-Cal, you have the chance to protect your health and the health of your family.   Low or no income is no longer a barrier to great healthcare. Get the coverage you deserve, with Medi-Cal managed by IEHP. Complete Medical Services Medi-Cal covers more than just basic medical services such as outpatient services, palliative care, emergency coverage, and hospitalization care. With IEHP and Medi-Cal coverage, Members have access to: Addiction treatment Pediatric care Newborn care Transgender support services Radiology coverage Laboratory services Through IEHP, you have access to over 8,000 doctors and specialists that are part of our network. Call IEHP today to find out about the benefits that are available to IEHP Members and learn how you can apply for Medi-Cal. Vision Services Poor vision can affect the quality of life. Getting the care you need is within reach with IEHP and Medi-Cal. When you become a member of the IEHP family, you get a free vision exam every 24 months, additional or more frequent eye exams are covered if medically necessary, such as those with diabetes. You also get a pair of eyeglasses, with both frames and lenses every 24 months, when you have a valid prescription. Contact lens testing and contact lenses may be covered if the use of eyeglasses is not possible due to eye disease or condition (i.e., missing an ear). Dental Services with Your Riverside County Medi-Cal Medi-Cal (through the Medi-Cal Dental Program) covers some dental services, including: Diagnostic and preventive dental hygiene (such as examinations, X-rays, and teeth cleanings) Emergency services for pain control Tooth extractions Root canal treatments (anterior/posterior Scaling and root planning Crowns (prefabricated/laboratory) Orthodontics for children who quality Complete and partial dentures Topical fluoride Dental care is as important as your medical care. If you have questions or want to learn more about dental services, call the Medi-Cal Dental Program at 1-800-322-6384 (TTY 1-800-735-2922 or 711). You may also visit the Medi-Cal Dental Program website at https://www.dental.dhcs.ca.gov or https://smilecalifornia.org/. Applying for Medi-Cal in Riverside County IEHP’s mission to heal and inspire the human spirit is made possible through its Vision—to not rest until our communities enjoy optimal care and vibrant health.   Everyone should have access to health care, and now more than ever, it is easy to get coverage. How to apply for Medi-Cal in Riverside County You have many options to apply for Medi-Cal, these include: Call IEHP Call 1-866-294-4347, 8am-5pm Monday-Friday. TTY users should call 1-800-720-4347. You’ll speak to one of IEHP’s friendly bilingual Enrollment Advisors. By Mail You can mail your completed and signed application to:   Covered California P.O. Box 989725 West Sacramento, CA 95798-9725 Or mail it to the Riverside County Medi-Cal Office. Apply in Person Click here to find the Riverside County Medi-Cal Office. Apply Online Click here to apply online. Get Health Coverage Now Become a member of the IEHP family and get access to the top-rated California state medical insurance. For more than 25 years, IEHP has proudly served hard-working citizens and their families. Join IEHP now and make your health our priority.

tioning of the brain and emotions and how that balance (or imbalance) affects behavior and thoughts.  What is the stigma around Mental Health? There is still too much stigma surrounding behavioral and mental health. Historically, “crazy” or “mad” folks have been ostracized from society. This has been due to ignorance about mental health.  Unfortunately, there is still too much fear and mis-understanding in our communities about mental health. Many people suffer from mental health disorders. And given the current COVID-19 crisis, many more people will suffer from mental illness. Too many people suffer in silence with mental illness The latest statistics before COVID stated that about 1 in 5 people were diagnosed with a mental illness in America Those numbers will increase now during the COVID-19 crisis Mental Health includes wellness, self-care, emotional regulations, relationship issues, and parenting among other facets of everyday life Mental well-being is important to everyone Mental illness can happen to anyone Everyone deserves access to mental health treatment. Things you can do to learn more or to get help Understand the importance of mental health wellness and what is a mental illness. Click here to learn more. Take a quick check up from the neck up. Click here to take an online screening.  Tips for staying mentally well during COVID-19 Self-care is critical: listen to your warning signs of struggling with your emotions and doing the basic things like showering, eating, sleeping, and exercise Do something that brings you enjoyment every day: play with your children or spouse, take walks, read a book, do something creative Connect with someone outside your home every day via telephone or other video technology Eat nutritiously, do not binge or eat too many sweets Avoid alcohol Continue to see your therapist via tele-health Continue to take care of your physical, financial, and spiritual needs Be patient with yourself and others Readily forgive yourself Exercise, do yoga, go for a walk.  Stay active, but do not overdo it Seek treatment for your mental health whenever needed At IEHP Behavioral Health, we put just as much importance on your mental health as on your physical health. Your mental health includes a balance of emotional, psychological and social well-being.  It affects how you think, what you feel, and how you act.  Your mind and body are connected and therefore, one can affect the other. When your mind suffers, your body suffers as well. At IEHP Behavioral Health, our goal is to help you live your best and healthiest life, both mentally and physically.   Mental illness is more common than you might think and IEHP is here to help and support. Did you know that one in five adults in the United States suffers from a mental illness that can be treated? These people are battling mental illnesses such as depression, anxiety, and even drug or alcohol abuse.   If you think you may be experiencing a behavioral or mental health challenge and want to seek treatment, schedule an appointment with your Doctor. If you don’t have a Doctor, you can find a behavioral health specialist in your area, 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 and ask to speak to the Behavioral Health Department. If you are experiencing thoughts of hurting yourself or someone else, please go to your closest emergency room, call 911, or reach out to the National Suicide Prevention Lifeline at 1-800-273-8255. Remember that you are not alone.   Many people are struggling or will struggle with mood and anxiety issues during this time. Reach out for help.   Mental health help is available and we want you to get help. Available Resources San Bernardino County Behavioral Health Riverside County Behavioral Health San Bernardino County Substance Use Riverside County Substance Use Psychiatry Walk-in Clinic (Montclair) Psychiatry Walk-in Clinic (Palm Desert) Psychiatry Walk-in Clinic (Victorville) Teen Mental Health Guide COVID-19 Maternal Mental Health FAQ Substance Abuse and Mental Health Services Administration Find a provider Maternal Mental Health & Wellness Resources  National Postpartum Support International Local Inland Empire Maternal Mental Health Collaborative Resources

nd Empire Health Plan (IEHP) is now responsible for coverage of the Major Organ Transplant (MOT) benefit for adult and pediatric transplant recipients and donors, including related services such as organ procurement and living donor care.   What Transplant Services are Available for Members? Autologous Islet Cell Bone Marrow Cornea Heart Heart-Lung Liver Liver-Heart Liver-Intestinal Liver -Lung Lung Kidney Kidney-Liver Kidney - Pancreas Pancreas (after Kidney)   Centers of Excellence (COE) For transplant care, IEHP has partnered with various, local, Centers of Excellence (COE). A COE is a recognized program within an existing healthcare center that provides a concentration of specialized care,  delivered in a comprehensive, interdisciplinary manner. Their focused care in distinct areas provides exceptional, integrated care that can lead to better Member outcomes.   Bone Marrow - CHLA, City of Hope, LLUMC, UCSD, USC (Norris) Heart - USC (Keck), LLUMC, Rady's Children, Sharp Memorial, UCSD Intestinal - CHLA Kidney-Pancreas - LLUMC, UCI Liver- CHLA, LLUMC, USD, USC (Keck) Lung - UCSD      You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here  

MTM is a term used to describe a broad range of services offered by Pharmacists on our health care team. The IEHP Clinical Pharmacy Team reviews your medicines, making sure you’re taking the right ones for your health conditions. If you are a Member who qualifies for the MTM Program, you will receive a letter from us. You will be enrolled—unless you opt-out. The program costs $0 for those who qualify. Who might be eligible?  Some Members who have been identified for this program may have only Medi-Cal coverage with IEHP.   Or they may be enrolled in the IEHP DualChoice (HMO D-SNP). They must meet the criteria and will receive the services for the Medicare MTM Program. (See description below.)  What are MTM services?  IEHP’s MTM services include these core elements: Medicine therapy reviews Medicine education - includes a medication action plan Disease management Our IEHP Clinical Pharmacy Team reviews the Member’s medicines, family history, disease states, and goals for medicine therapy. Based on a full review, this team then offers recommendations to the Member and Providers.  A Team of registered Pharmacists and technicians work with your Doctor (or other Provider) and Pharmacies to offer full care. We also work with our Care Management teams to offer “whole health” care to our Members. Medicare MTM Program IEHP Clinical Pharmacy offers the MTM services at no extra cost for IEHP DualChoice Members who: have a number of health issues, and are taking many prescription drugs, and have high medicine costs Once enrolled in the program, you will get a packet by mail with details. You’ll also get information on how to disenroll, should you choose not to be in the program. If you decide not to take part in the program, your enrollment and eligibility with IEHP DualChoice will not change. We hope that if you qualify that you will take part in in this program that is offered free of charge—to help you better manage your medicines.  The MTM program includes a yearly comprehensive medication review (CMR) and targeted medication review (TMR). Here are some details on MTM services: Comprehensive Medication Review (CMR) An IEHP Clinical Pharmacist will give you a full yearly review of your meds by phone. The Pharmacist goes over your medicines to make sure you have the right ones for your condition and that you avoid drug interactions, and more.  Once your CMR is done, you will get your Medication Action Plan (MAP) and Personal Medication List (PML) by mail. MTM services documents, with a copy of a Personal Medication List, can be accessed by calling Member Services and asking to speak to the Clinical Pharmacy Team. Targeted Medication Review (TMR) The IEHP Clinical Pharmacy Team will also offer TMRs through the year by reviewing issues with the participating IEHP DualChoice Member’s medicines. The team will perform TMRs for all enrolled beneficiaries every three months. The beneficiary may get TMR recommendations by mail and their Primary Care Provider may receive recommendations by fax—if the IEHP Clinical Pharmacy Team deems it necessary. For more information, IEHP DualChoice Members eligible for CMR or TMR services can call 1-877-273-IEHP (4347), 8am-5pm (PST), 7 days a week, including holidays. TTY users should call 1-800-718-4347.  Click here for a blank personal medication list. Eligibility Criteria These MTM Program services may have limited eligibility criteria and are not considered a benefit. They are available for these conditions: 1. The Member has a minimum of three (3) disease states: Bone Disease-Arthritis-Osteoporosis Bone Disease-Arthritis-Rheumatoid Arthritis Chronic Heart Failure (CHF) Diabetes Dyslipidemia End-Stage Renal Disease (ESRD) Hypertension Mental Health Chronic/ Disabling Mental Health Conditions Respiratory Disease – Asthma Respiratory Disease – Chronic Obstructive Pulmonary Disease (COPD) 2. The Member is prescribed a minimum of five (5) different medications to treat those disease states: ACE-Inhibitors Angiotensin II Receptor Blockers (ARBs) Antidepressants Antihyperlipidemic Antihypertensives Antipsychotics Beta Blockers Biophosphonates Bronchodilators Calcium Channel Blockers Disease-Modifying Anti-Rheumatic Drugs (DMARDs) Diuretics Insulins Oral Hypoglycemics Selective Serotonin Reuptake Inhibitors (SSRIs) Tumor Necrosis Factors (TNFs) Inhaled Corticosteroids Calcimimetic Cardiac Glycoside Colony Stimulating Factors Glucagon-Like Peptide-1 Glucocorticosteroids Neprilysin Inhibitor NSAIDs Phosphate Binders Vitamin D Analogs  3. Drug costs of $1,233.75 (one-fourth of $4,935) for the previous three months are likely to be incurred. To learn more about MTM, call IEHP DualChoice at 1-877-273-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. TTY users should call 1-800-718-4347. Information on this page is current as of October 01, 2022. DSNP_23_3241532_M Pending Accepted  

oncerns without the support and care they need. But there is hope. The 988 Lifeline offers the opportunity to help a countless number of people struggling with suicidal thoughts and health-related distress each day.  What is 988? This is an easy-to-remember number that people in crisis can call. It will route them to the National Suicide Prevention Lifeline (now known as the 988 Suicide & Crisis Lifeline). It is a life-saving resource for people in crisis. It is a number to call to get in touch with trained crisis counselors, not police. When people call or text 988, they will be connected to trained counselors who are part of the existing Lifeline network. These counselors will listen, understand how problems are affecting the callers, provide support, and connect them to resources if necessary. How is 988 different than 911? 988 is not a new service, just a new number. The 988 code was set up to improve access to crisis services in a way that meets our country’s growing suicide and mental health-related crisis care needs. It provides easier access to the Lifeline network and related crisis resources, which are distinct from the public safety purposes of 911 (where the focus is on dispatching Emergency Medical Services, fire and police as needed). Is 988 available for substance use crisis? The Lifeline accepts calls from anyone who needs support for a suicidal, mental health and/or substance use crisis. Is the 988 Lifeline a free service? Yes, the Lifeline answers calls 24/7 in multiple languages. The 988 service also answers texts or chats (English only). Standard data rates from mobile carriers may apply to those who text to the Lifeline. If monetary help is needed for communications needs, please see www.fcc.gov/lifeline-consumers for details. Calls, texts, and chats are available to anyone who needs mental health-related or suicide crisis support.  Is Lifeline available for everyone?  It is offered to everyone in the United States, providing 24/7, free and confidential support to people in suicidal crisis or emotional distress. The 988 Lifeline offers the opportunity to help a countless number of people struggling with suicidal thoughts and health-related distress each day. If you or someone you know is in crisis, call your local crisis number below. 988 services nationwide continue to be in development, utilize your local resources as needed.  Riverside 1-800-273-TALK (951) 686-HELP (4357) 1-877-727-4747 and Crisis text line: 741-741. San Bernardino 24-Hour Crisis Line: (760) 365-6558 East Valley: (909) 421-9233 West Valley: (909) 458-9628 High Desert: (760) 956-2345 Mental Health Urgent Care Clinics Riverside Urgent Care Clinics Riverside (Adults ages 18 and over) 9990 County Farm Rd. Bldg. 2, Riverside, CA 92503 (951) 509-2499 Perris (Youth and Adults ages 13 and older) 85 Ramona Expressway, Suites 1-3, Perris, CA 92571 (951) 349-4195 San Bernardino Urgent Care Clinics Victorville (Crisis Walk-in Center) 12240 Hesperia Rd., Ste. A, Victorville, CA 92395 (760) 245-8837 Yucca Valley (Crisis Walk-in Center) 7293 Dumosa Ave., Ste. 2, Yucca Valley, CA 92284 (760) 365-2233 Merrill Center - Fontana (Crisis Stabilization Units) 14677 Merrill Ave., Fontana, CA 92335 (951) 643-2340 Windsor Center - San Bernardino (Crisis Stabilization Units) 1481 N. Windsor Dr., San Bernardino, CA 92404 (909) 361-6470 Additional Resources Take My Hand, a Mental Health Peer Support Chat Line Medi-Cal Mental Health Services CARES LINE 1-800-499-3008.

(the “Services”) is governed by the terms and conditions below.  Use of the Services means that you have agreed to accept these terms, which are effective on the date you agree to participate. When you opt-in, you can expect to receive different healthcare notifications, such as, how to access care with IEHP, important health reminders, and we will inform you about health education and wellness program. Message frequency varies.  These terms and conditions may be subject to change.  IEHP reserves the right to update or amend these Terms and Conditions at any time. IEHP or its service provider may, at its sole discretion, terminate, adjust, or suspend the Services or any portion thereof, for any user for any reason.  You can also terminate or suspend the Services at any time by texting the word “STOP” to 90902 or by email at texthelp@iehp.org to unsubscribe. For Help text HELP to 90902 or you can also call 1-800-440-4347 to reach IEHP Member Services. You must be at least 13 years old to be eligible to use the Services. However, if you are at least 13 years old but not yet 18, you may use the Services if, and only if, you have your parents' or guardians' prior permission. No one under age 13 may use the Services under any circumstances.  IEHP does not charge for the Services, however, message and data rates may apply. For example, your pager or cellular phone service provider may charge you to receive Wireless Text Messages. Neither IEHP, nor its contractors, will be held responsible for any charges related to the use of the Services.  You agree that you are responsible for paying your carrier’s charges to use the Services, or if you are under 18, you have permission to use the Services from the adult responsible for paying the carrier’s charges. Carriers are not liable for delayed or undelivered messages. IEHP PROVIDES THE SERVICES "AS IS" WITH NO WARRANTIES OF ANY KIND. IEHP EXPRESSLY DISCLAIMS ANY WARRANTY, EXPRESS OR IMPLIED, REGARDING THE SERVICES, INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, OR THAT THE SERVICES WILL BE SECURE, UNINTERRUPTED OR FREE OF ERRORS, VIRUSES OR OTHER HARMFUL COMPONENTS. * Some states do not allow the disclaimer of implied warranties, so the foregoing disclaimer may not apply to you. UNDER NO CIRCUMSTANCES WILL IEHP OR ITS EMPLOYEES, OFFICERS, OR DIRECTORS BE LIABLE TO YOU FOR ANY INDIRECT, INCIDENTAL, CONSEQUENTIAL, SPECIAL OR EXEMPLARY DAMAGES ARISING OUT OF OR IN CONNECTION WITH USE OF THE SERVICES WHETHER OR NOT IEHP HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. If you are dissatisfied with the Services or any content on any of IEHP website properties, or with these Terms and Conditions, your sole and exclusive remedy is to discontinue using the Services. You acknowledge, by your use of the Services, that your use of the Services is at your sole risk. You agree to indemnify, defend and hold harmless IEHP, its partners, clients, employees, officers and directors, from and against any and all claims, liabilities, penalties, settlements, judgments, fees (including reasonable attorneys' fees) arising from (i) any content that you or anyone using your account may submit, post or transmit to the web site; (ii) your use of the Services; (iii) your violation of the terms of these Terms and Conditions; and (iv) any violation or failure by you to comply with all laws and regulations in connection with the Services. You may not assign any of your rights or delegate any obligations hereunder, in whole or in part, whether voluntarily or by operation of law, without the prior written consent of IEHP. Any such purported assignment or delegation by you without the appropriate prior written consent of IEHP will be null and void and of no force or effect. IEHP is committed to your privacy. Our Privacy Policy can be found here. Contact Info 10801 Sixth Street, Rancho Cucamonga, CA 91730 1-800-440-IEHP (4347) 1-800-718-IEHP (4347) for TTY Users 8AM-5PM PST    

and achieve health goals. IEHP’s Health & Wellness Programs help Members learn how to manage their health and make healthy lifestyle changes. You can refer your IEHP Members to these programs anytime by logging into the Secure Provider Website and completing the Health Education Program Request Form. Health Resources Kids and Teens Managing Your Illness Pregnancy and Postpartum Senior Health Weight Management Health & Wellness Brochures and Handouts Inland Empire Health Plan (IEHP) offers many Wellness Programs that focus on the health and well-being of our Members. All of our programs are free, join us at our next session and learn ways to stay healthy.  Get information on important health topics through our health education brochures and handouts: Controlling Asthma (PDF) Diabetes. What's next? (PDF) Eat Healthy, Feel Better (PDF) Fever in Children (PDF) Flu Decision Guide (PDF) Flu Shot (PDF) High Blood Pressure (PDF) Immunizations - English (PDF) Immunizations - Spanish (PDF) Immunizations - Chinese (PDF) Immunizations - Vietnamese (PDF) PAP and HPV Tests: What to Expect (PDF) Diabetes Prevention Program (DPP) - Live the Life You Love Format: Online (small group) Duration: One year Ages: 18 years and over This online year-long lifestyle change program helps you make real changes that last.  During the first 6 months, you will meet weekly with a small online group to learn how to make healthy choices into your life. In the second 6 months, you will meet monthly to practice what you have learned. No person is alike, so the program will be tailored to meet your needs and honor your customs and values. You will also be paired with a health coach for one year to help you set your goals, such as how to: Eat healthier Add physical activity into your daily life Reduce stress Improve problem-solving and coping skills Studies have shown that those who finish the program can lose weight and prevent Type 2 Diabetes. Small changes can have big results! Let's start living the best version of you and living the life you love. Find out if you qualify! Click here to visit the Skinny Gene Project online, or Call Skinny Gene Project at (909) 922- 0022, Monday - Friday 8am – 5pm., or Email hello@skinnygeneproject.org For Providers DPP Rx Pad (PDF) Educational Resources 2021 Population Needs Assessment (PNA) Report IEHP’s Population Needs Assessment (PNA) identifies Member health status and behaviors, Member health education priorities, cultural/linguistics needs, health disparities, and gaps in service related to these issues. The findings of the PNA may help Providers better understand and serve our Members. For questions, please contact IEHP Health Education Department at healthed@iehp.org 2021 Population Needs Assessment (PNA) Report Loving Support Program IEHP supports and sponsors the Loving Support Program that is run by Riverside University Health System (RUHS). Loving Support is a program committed to helping mothers achieve their breastfeeding goals. This service offers help and support with the first days at home, return to work, support groups, and timely answers to challenges nursing mothers face. Members can directly contact the Loving Support 24/7 Helpline at 888-451-2499. No referral is necessary. English and Spanish-speaking certified lactation specialists and Internationally Board Certified Lactation Consultants (IBCLCs) are available 24 hours a day, 7 days a week to answer questions. Messages are recorded after hours and promptly addressed. Member Education Resources The following websites are good sources of easy-to-read patient information that can be downloaded, printed, or ordered. By clicking on these links, you will be leaving the IEHP website.  RESOURCE  DESCRIPTION Medline Plus A service of the US National Library of Medicine and the National Institutes of Health. Easy to read information and audio tutorials on many health topics in English and Spanish. Topics are available in multiple languages. Food and Drug Administration - Office of Women's Health Easy-to-read handouts in English, Spanish and other languages on nutrition, diabetes, depression, and other topics related to women’s health. Learning About Diabetes, Inc. Easy to read “Handouts and Visual Aids” in color on diabetes care and nutrition to help patients eat the right foods to control blood sugar. Weight Control Information Network An extensive list of health education materials about healthy weight and physical activity in English and Spanish. Materials can be printed or ordered. Health Information Translations Easy-to-read educational handouts on many health topics and in multiple languages.   You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

d by APL 19-004, all Providers currently in IEHP's network and those looking to join the network are mandated to enroll in the Medi-Cal Program. This requirement to enroll in the Medi-Cal Program applies to all IEHP Providers, including those participating through an IPA. If a Provider currently active with IEHP fails or declines to complete their enrollment in the Medi-Cal Program, IEHP will be required to terminate their participation from the network.  How to Enroll The Provider Enrollment Division (PED), a unit within the Department of Health Care Services (DHCS), is responsible for the timely enrollment of Providers into the Medi-Cal Program. PED now offers an improved web-based application via their Provider Application and Validation Enrollment (PAVE) portal. Please note the current PAVE release may not support specific Provider types or submissions from new out-of-state Providers. PAVE is being implemented in a series of releases to include Provider types and enrollment actions. Here is a current list of Provider types supported in PAVE. Provider Resources All Plan Letter 19-004 This APL supersedes 17-019, the APL mandating Providers to enroll in the Medi-Cal Program. All Plan Letter 17-019 Access the APL on DHCS's website regarding the screening and enrollment of all Providers rendering services to Medi-Cal beneficiaries.  California Health & Human Services (CHHS) Agency Open Data Portal Utilize the Open Data Portal to identify Providers who have successfully enrolled in the Medi-Cal Program through DHCS. The portal is maintained and updated by PED monthly. Frequently Asked Questions (FAQ) The document contains responses from DHCS to frequently asked questions regarding screening and enrollment requirements. Provider Resources from DHCS Access to PAVE Provider Types, PAVE 101 Training Slides, Provider Job Aides, FAQs, PAVE Support Resources Contact Information Department of Healthcare Services Attn:  Provider Enrollment Division MS4704 PO BOX 997412 Sacramento, CA 95899-7412 PED Message Center (916) 323-1945 After reaching the welcome message, please select Option 4, then Option 1 to speak with a live agent. PAVE Technical Assistance (866) 252-1949 PAVE@dhcs.ca.gov PED Policy Assistance PEDCORR@dhcs.ca.gov IEHP Provider Assistance ProviderNetwork@iehp.org

e important phone numbers including your Doctor, IEHP DualChoice Member Services, and IEHP’s 24-Hour Nurse Advice Line. Be sure to complete your health risk assessment (HRA). When you first join our plan, you get a health risk assessment (HRA) within 90 days before or after your effective enrollment date.  We must complete an HRA for you. This HRA is the basis for developing your care plan. The HRA include questions to identify your medical, LTSS, and behavioral health and functional needs.  We reach out to you to complete the HRA. We can complete the HRA by an in-person visit, telephone call, or mail. We’ll send you more information about this HRA upon your enrollment with the plan.  If our plan is new for you, you can keep using the doctors you use now for a certain amount of time, if they are not in our network. We call this continuity of care. If they are not in our network, you can keep your current providers and service authorizations at the time you enroll for up to 12 months if all of the following conditions are met:  You, your representative, or your provider asks us to let you keep using your current provider.  We establish that you had an existing relationship with a primary or specialty care provider, with some exceptions. When we say “existing relationship,” it means that you saw an out-of-network provider at least once for a non-emergency visit during the 12 months before the date of your initial enrollment in our plan. We determine an existing relationship by reviewing your available health information available or information you give us. We have 30 days to respond to your request. You can ask us to make a faster decision, and we must respond in 15 days. You or your provider must show documentation of an existing relationship and agree to certain terms when you make the request. Note: You can only make this request for services of Durable Medical Equipment (DME), transportation, or other ancillary services not included in our plan. You cannot make this request for providers of DME, transportation or other ancillary providers. After the continuity of care period ends, you will need to use doctors and other providers in the IEHP DualChoice network that are affiliated with your primary care provider’s medical group, unless we make an agreement with your out-of-network doctor. A network provider is a provider who works with the health plan. Our plan’s PCPs are affiliated with medical groups or Independent Physicians Associations (IPA). When you choose your PCP, you are also choosing the affiliated medical group. This means that your PCP will be referring you to specialists and services that are affiliated with their medical group. A medical group or IPA is a group of physicians, specialists, and other providers of health services that see IEHP Members. Your PCP, along with the medical group or IPA, provides your medical care. This includes getting authorization to see specialists or medical services such as lab tests, x-rays, and/or hospital admittance. In some cases, IEHP is your medical group or IPA. Refer to Chapter 3 of your Member Handbook for more information on getting care. Be prepared for important health decisions Get the My Life. My Choice. app today. It stores all your advance care planning documents in one place online. Advance care planning (ACP) involves shared decision making to write down-in an advance care directive-a person’s wishes about their future medical care. ACP and the advance health care directive can bridge the gap between the care someone wants and the care they receive if they lose the capacity to make their own decisions. With this app, you or a designated person with Power of Attorney can access your advance health care directives at any time from a home computer or smartphone. Sign up for the free app through our secure Member portal. IEHP DualChoice (HMO D-SNP) is a HMO Plan with a Medicare contract. Enrollment in IEHP DualChoice (HMO D-SNP) is dependent on contract renewal. This is not a complete list. Information on this page is current as of October 01, 2022. H8894_DSNP_23_3241532_M  

Member Services at (877) 273-IEHP (4347) and ask for a Member Complaint Form. If you need help to fill out the form, IEHP Member Services can assist you. You can complete the Member Complaint Form online. You can give the completed form to any IEHP Provider or mail it to: P.O Box 1800, Rancho Cucamonga, CA 91729-1800 You can fax the completed form to (909) 890-5877. You can file a grievance online. This form is for IEHP DualChoice as well as other IEHP programs.  For some types of problems, you need to use the process for coverage decisions and making appeals. For other types of problems you need to use the process for making complaints. Both of these processes have been approved by Medicare. To ensure fairness and prompt handling of your problems, each process has a set of rules, procedures, and deadlines that must be followed by us and by you. Long-Term Services and Supports: If you are having a problem with your care, you can call the Office of Ombudsman at 1-888-452-8609 for help. For problems and concerns regarding eligibility determinations, assessments, and care delivered by our contracted Community Based Adult Services (CBAS) centers,  or Nursing Facilities/Sub-Acute Care Facilities, you should follow the process outlined below. Community Based Adult Services (CBAS) You can call IEHP Member Services at (877) 273-IEHP (4347) and ask for a Member Complaint Form. If you need help to fill out the form, IEHP Member Services can assist you. You can give the completed form to any IEHP Provider or mail it to: P.O Box 1800 Rancho Cucamonga, CA 91729-1800 You can fax the completed form to (909) 890-5877. You can file a grievance online. This form is for IEHP DualChoice as well as other IEHP programs. Help in Handling a Problem You can contact Medicare. Here are two ways to get information directly from Medicare: You can call (800) MEDICARE (800) 633-4227, 24 hours a day, 7 days a week, TTY (877) 486-2048. You can visit the Medicare website By clicking on this link, you will be leaving the IEHP DualChoice website. Get Help from an Independent Government Organization We are always available to help you. But in some situations, you may also want help or guidance from someone who is not connected with us. You can always contact your State Health Insurance Assistance Program (SHIP). This government program has trained counselors in every state. The program is not connected with us or with any insurance company or health plan. The counselors at this program can help you understand which process you should use to handle a problem you are having. They can also answer your questions, give you more information, and offer guidance on what to do. The services of SHIP counselors are free. You can call SHIP at 1-800-434-0222. Get Help and Information from DHCS Call: (916) 445-4171 MCI from TDD at (800) 735-2929 MCI from Voice Telephone: (800) 735-2922 Sprint from TDD at (800) 877-5378 Sprint from Voice Telephone: (800) 877-5379 Write to: Department of Health Care Services 1501 Capitol Ave., P.O. Box 997413 Sacramento, CA 95899-7413 Website:www.dhcs.ca.gov By clicking on this link, you will be leaving the IEHP DualChoice website. Get Help and Information from Medi-Cal The Office of the Ombudsman Program can answer your questions and help you understand what to do to handle your problem. The Office of the Ombudsman is not connected with us or with any insurance company or health plan. They can help you understand which process to use. Call: 1-888-452-8609 (TTY 711) Monday through Friday, 9 a.m. to 5 p.m. Visit their website at: www.healthconsumer.org/ By clicking on this link, you will be leaving the IEHP DualChoice website. Get Help and Information from Livanta Our state has an organization called Livanta Beneficiary & Family Centered Care (BFCC) Quality Improvement Organization (QIO). This is a group of doctors and other health care professionals who help improve the quality of care for people with Medicare. Livanta is not connect with our plan. Call: (877) 588-1123, TTY (855) 887-6668 For appeals: (855) 694-2929 For all other reviews: (844) 420-6672 Write to: Livanta BFCC-QIO Program 10820 Guilford Road, Suite 202 Annapolis Junction, Maryland 20701 Website: www.livanta.com By clicking on this link, you will be leaving the IEHP DualChoice website. How to obtain an aggregate number of grievances, appeals, and exceptions filed with IEHP DualChoice (HMO D-SNP)? Please call or write to IEHP DualChoice Member Services. Call: (877) 273-IEHP (4347). Calls to this number are free. 8am - 8pm (PST), 7 days a week, including holidays, TTY: (800) 718-4347. This number requires special telephone equipment. Calls to this number are free. Fax: (909) 890-5877 Write: IEHP DualChoice, P.O. Box 1800 Rancho Cucamonga, CA 91729-1800 Email: memberservices@iehp.org Visit: 10801 Sixth Street, Suite 120, Rancho Cucamonga, CA 91730 IEHP DualChoice (HMO D-SNP) is a HMO Plan with a Medicare contract. Enrollment in IEHP DualChoice (HMO D-SNP) is dependent on contract renewal. This is not a complete list.  Information on this page is current as of October 01, 2022. H8894_DSNP_23_3241532_M

OS June 30, 2022, payments will run out through June 2023. The Proposition 56 VBP Program provided direct payments incentivizing Providers to meet specific measures aimed at delivering key quality healthcare services that improve the quality of care to Medi-Cal beneficiaries. Targeted areas were behavioral health integration, chronic disease management, prenatal/post-partum care and early childhood prevention. For more information about the VBP Program, please visit the DHCS website at https://www.dhcs.ca.gov/provgovpart/Pages/VBP_Measures_19.aspx. By clicking on this link, you will be leaving the IEHP website.  Value Based Payments Program Guide Value Based Payments (VBP) Program Guide (PDF) - Published: January 01, 2022 Value Based Payments Dispute Forms Value Based Payments Program - Paid Claims Dispute Request (PDF) Published: January 19, 2022 Value Based Payments Program - Encounter Dispute Request (PDF) Published: January 19, 2022 Please e-mail completed forms to ValueBasedPaymentsProgram@iehp.org At-Risk Condition Codes The At-Risk Condition Codes list includes diagnosis codes to identify Serious Mental Illness, Substance Use Disorder or Homelessness Conditions for the VBP Program. These conditions qualify Providers for an additional payment amount for VBP services. Please refer to page 4 of the VBP Program Guide for additional details. At-Risk Condition Codes (PDF) Published: March 25, 2020 You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.