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Pharmacy Services - Formulary
most appropriate, high quality and cost-effective drug therapies.
The Inland Empire Health Plan Pharmacy and Therapeutics (P & T) Subcommittee develops and monitors the Formulary. The P & T is composed of the IEHP Chief Medical Officer, Medical Directors, Director of Pharmaceutical Services, physicians from various medical specialties, local communities, and clinical pharmacists. This panel reviews the medications in all therapeutic categories based on safety, clinical efficacy, and cost-effectiveness and selects the most appropriate drugs in each class.
Formulary development and maintenance is a dynamic process. The IEHP P & T Subcommittee is responsible for developing, managing, updating and administering the Formulary. The Subcommittee also ensures that the IEHP Formulary remains responsive to the needs of our members and providers.
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IEHP Medi-Cal Formulary Items:
DHCS Noncapitated Physician Administered Drugs (PADs)
Medi-Cal Medical Benefit PA (PDF)
Medi-Cal Medical Benefit Formulary (PDF)
Referral Form for Medi-Cal Benefit (PDF)
Exceptions to criteria or requests for coverage of drugs not on the Medi-Cal Drug Benefit Formulary may be submitted by prescribers on the Referral Form for Medi-Cal Benefit.
Starting January 1, 2022, all IEHP Medi-Cal pharmacy services will be transitioned from managed care (MC) to fee for service (FFS). The Medi-Cal pharmacy benefits and services administered by the Department of Health Care Services (DHCS) will be identified collectively as "Medi-Cal Rx."
Magellan Medicaid Administration, Inc. (MMA) will assume operations for Medi-Cal Rx on behalf of DHCS.
For further information on Medi-Cal Rx, please visit: https://www.iehp.org/en/providers/pharmacy-services?target=medi-cal-rx
For more information on the Medi-Cal Rx Covered Drug List (CDL), please visit: https://medi-calrx.dhcs.ca.gov/home/cdl
IEHP DualChoice (HMO D-SNP) - Medicare-Medicaid Plan Items:
IEHP DualChoice (HMO D-SNP) Formulary Book (PDF)
Grievance Coverage Determination and Appeals Process
IEHP DualChoice (HMO D-SNP) Formulary Search Tool
10 Reasons Why You Should Be E-prescribing Brochure (PDF)
E-prescribing Tips (PDF)
Information on this page is current as of February 02, 2023
Plan Updates - Correspondence
here.
TITLE
DATE
RECIPIENTS
February 2023
UPDATE – Initial Health Appointment and Retirement of IHEBA/SHA
02/02
All Medi-Cal PCPs & IPAs
Transition to 30-day Coverage Determination Backdating
02/02
All LTC & SNF Providers
Redlands Community Hospital – Behavioral Health Unit Closed
02/01
All PCPs & BH Providers
UPDATE - Independent Medical Review Form
02/01
All Medicare IPAs
January 2023
KidsVaxGrant 3.0 Deadline to Apply is February 17, 2023
01/31
All Pediatricians and Family Practice PCPs
Effective February 1, 2023 - Call The Car Will Replace American Logistics Company (ACL) for ALL Member Transportation
01/31
All PCPs, Specialists, BH & IPAs
Provider Manual Acknowledgement of Receipt (AOR) Winners
01/27
All Providers
Crisis Recovery Resource Guide and Toolkit Available
01/27
All Community Support Services
REMINDER - BHT Providers Must Submit Exit Reports and Exit Letters!
01/27
All BHT (QASP) Providers
D-SNP Model of Care Incentive Program - 2023 Program Guide Release
01/26
All Medicare IPAs
Help Protect Members - Flu Vaccine Reminder
01/25
All PCPs
2023 Global Quality P4P PCP Kick Off Meeting
01/25
All Medi-Cal PCPs
2023 Global Quality P4P IPA Kick Off Meeting
01/25
All IPAs
An ECHO Learning Opportunity - Alzheimer's And Dementia Care - Weekly Sessions Begin Feb 16th
01/24
All PCPs
REMINDER - 2023 Global Quality P4P Program - CAIR2 Participation Requirement- PCPs
01/23
All Medi-Cal PCPs
REMINDER - 2023 Global Quality P4P Program - CAIR2 Participation Requirement- IPAs
01/23
All Medi-Cal IPAs
Response Requested by Thursday, January 26! - CBAS Emergency Remote Services (ERS)
01/23
All CBAS Providers
Global Quality P4P PCP Program - 2023 Program Guide Release
01/19
All Medi-Cal PCPs
UPDATE! Medi-Cal Letter Templates
01/17
All Medi-Cal IPAs
Emergency Resource Guide and Services – Flooding Services Available!
01/17
All Community Support Services Providers
Medicare P4P IEHP Direct – Blood Pressure Control Billing Guidance
01/13
All DualChoice PCPs
NEW! Regulatory Submission Response Files – MAO-004 XWalk
01/13
All Medicare IPAs
ALERT! 837 SBR04 Encounter Data Requirement Changes
01/13
All Medicare IPAs
IEHP DualChoice (D-SNP) Model of Care Training Requirement
01/12
All DualChoice Hospitals
IEHP DualChoice (D-SNP) Model of Care Training Requirement
01/10
All Medicare IPAs
IEHP DualChoice (D-SNP) Model of Care Training Requirement
01/10
All DualChoice Providers
IEHP Outbound 834 File Update
01/10
All 834 Trading Partners
IEHP HOLIDAY - Martin Luther King Jr. Day
01/09
All IEHP Providers
CORRECTION to Changes to Quarterly Workplan Requirements
01/05
All Medicare IPAs
LAST CHANCE to Win a $50 Gift Card - Submit 2023 Provider Policy and Provider Manual Acknowledgement of Receipt (AOR)
01/04
All IEHP Providers
2023 Population Health Management Academy
01/04
All Riverside County PCPs
CORRECTION - 2022 GQ P4P PCP - Quality Bonus Services Code Update
01/03
All Medi-Cal PCPs
December 2022
Outbound Eligibility File Delay on January 1, 2023
12/29
All IPAs and Ancillary Providers
REMINDER - CoverMyMeds - Prior Authorization Submission Method for Dual Choice Members– Effective January 1, 2023
12/29
All Dual Choice PCPs & Specialists
REMINDER - Pharmacy Benefits Manager (PBM) Change for DualChoice (HMO D-SNP) - Member Outreach in Process
12/29
All Dual Choice PCPS and Medicare IPAs
Access Standards – Appointment Availability - BH Providers
12/28
All Behavioral Health Providers
Mandatory Managed Care Enrollment (MMCE) Phase II - January 1, 2023
12/27
All Medi-Cal PCPs & Specialists
Access Standards – Appointment Availability - PCPs & OB/GYNs
12/27
All PCPs & OB/GYNs
Access Standards – Appointment Availability - Specialists
12/27
All Specialists
NEW! State Fair Hearing and Independent Medical Review Forms added to D-SNP Letter Templates (Effective January 2, 2023)
12/27
All Medicare IPAs
REMINDER - Help Your Members Update Their Contact Information!
12/22
All PCPs
2022 GQ P4P PCP - Quality Bonus Services Code Update
12/22
All Medi-Cal PCPs & IPAs
UPDATED! D-SNP Letter Templates (Effective January 2, 2023)
12/21
All Medicare IPAs
Phase II Wave I– Prior Authorization Submission – January 20, 2023
12/21
Medi-Cal PCPs & Specialists
Crossing the Line - Examining Professional, Personal, & Ethical Boundaries
12/21
Riverside County PCPs & Specialists
IEHP Outbound Daily 834 Delta File Delay
12/20
All 834 Trading Partners
Revised UM Authorization Guidelines
12/19
All IPA Administrators & Medical Directors
REMINDER - IEHP DualChoice (HMO D-SNP) begins Jan 2023
12/19
All Medicare PCPs, Specialists & BH Providers
OB P4P Program - Early Postpartum Visit Update
12/19
All Medi-Cal OB/GYNs
My Life. My Choice. - An Online Advanced Care Planning Program
12/16
All Dual Choice PCPs
REMINDER - CoverMyMeds - Prior Authorization Submission Method for Dual Choice Members– Effective January 1, 2023
12/16
All Dual Choice PCPs & Specialists
IEHP 2022-2023 Holiday Hours
12/15
All Providers & IPAs
2022 Global Quality P4P Program – Data Submission Deadlines for PCPs!
12/15
All Medi-Cal PCPs
2022 Global Quality P4P Program – Data Submission Deadlines for IPAs!
12/15
All Medi-Cal IPAs
CORRECTION– New Fax Number for Physician Certification Statements for Non-Emergency Medical Transportation
12/09
All Hospitals and SNFs
Medicare Formulary Changes for 2023 IEHP DualChoice (HMO D-SNP)
12/08
All Medicare PCPs, Specialists & IPAs
Pharmacy Recalls, Withdrawals & Safety Alerts - November 2022
12/07
All PCPs
REMINDER - Physician Certification Statement (PCS) Requirement
12/06
All PCPs, Specialists, BH & IPAs
EVV Home Health Care Services Open Office Hours – December 16th
12/06
EVV Impacted Providers & Individual Nurse Practitioners
Mpox (formerly Monkeypox) Vaccine Available through Local Health Departments
12/05
All Medi-Cal PCPs & IPAs
IMPORTANT! DHCS Error – Members Will NOT be Disenrolled From IEHP
12/05
All Medicare PCPs & IPAs
Global Quality P4P PCP – 2022 Program Guide Update (Quality Bonus Services)
12/05
All Medi-Cal PCPs
The Alzheimer's Association Event - Resources for Improving Dementia Care in the Clinical Practice
12/02
All PCPs
CoverMyMeds - Prior Authorization Submission Method for Dual Choice Members– Effective January 1, 2023
12/02
All Dual Choice PCPs
REMINDER - IEHP Dual Choice (HMO D-SNP) begins Jan 2023
12/02
All Medicare PCPs, Specialists & BH Providers
Response Requested by December 6, 2022! - CBAS Emergency Remote Services - Reporting
12/02
All CBAS Providers
IEHP Formulary Changes - November P&T Update
12/02
All PCPs
November 2022 Pharmacy and Therapeutics Subcommittee Update
12/02
All PCPs
NEW! D-SNP Letter Templates - Claims (Effective January 2, 2023)
12/02
All Medicare IPAs
COVID-19 Isolation in SNF
12/01
All SNFs
Living the Mission Awards Nomination Form
12/01
All IEHP Providers
November 2022
Inland Empire Community Health Assessment
11/30
All PCPs, IPAs, Specialists, & Behavioral Health Providers
Pharmacy Benefits Manager (PBM) Change for DualChoice (HMO D-SNP) - Member Outreach in Process
11/29
All DualChoice PCPs & Medicare IPAs
ID Cards with Errors Reissued to Dual Choice Members
11/23
Select Dual Choice PCPs
Inland Caregiver Resource Center Informational Webinar - ECHO
11/23
All PCPs
IEHP’s Quarterly Behavioral Health Provider Training
11/18
All Behavioral Health (BH) Providers
Thanksgiving Holiday
11/18
All IEHP Providers
IEHP Outbound Daily 834 Delta File Delay
11/18
All 834 Trading Partners
CoverMyMeds - Prior Authorization Submission Method for Dual Choice Members– Effective January 1, 2023
11/17
All IEHP DualChoice PCPs
IEHP DualChoice (HMO D-SNP) 2023 Vision Benefits
11/17
All Vision Providers
Riverside County Medical Association's Physician Holiday Social
11/17
All Riverside County PCPs & Specialists
RUHS - PHA - Early Respiratory Syncytial Virus (RSV) and Seasonal Influenza Activity
11/17
All Riverside County PCPs
Global Quality P4P PCP Meeting - 2023 Program Preview
11/16
All Medi-Cal PCPs
BHT (QASP) Provider Training
11/15
All BHT (QASP) Providers
Reminder - BH Emergency Instruction Standards
11/15
All BH Providers
Reminder - PCP and Specialist Emergency Instruction Standards
11/15
All PCPs & Specialists
UPDATE! D-SNP Letter Templates (Effective January 2, 2023)
11/15
All Medicare IPAs
UPDATE - Revised UM Authorization Guidelines to November 3, 2022 - UM-BH 08
11/14
All Medi-Cal IPAs & BHT Providers
Pharmacy Recalls, Withdrawals & Safety Alerts - October 2022
11/14
All PCPs
REMINDER: IEHP DualChoice (HMO D-SNP) begins Jan 2023
11/10
All Medicare PCPs, Specialists & BH Providers
REMINDER: Help Your Members Update Their Contact Information!
11/10
All IEHP PCPs
Maternal Wellness Event Flyer
11/09
All Medi-Cal PCPs, OB/GYNs, Peds, BH Providers & IPAs
Essure System - No Longer a Covered Benefit
11/09
All OB/GYNs
ACTION REQUIRED -Submit 2023 Provider Policy and Provider Manual Acknowledgement of Receipt (AOR) - Win a $50 Gift Card
11/08
All IEHP Providers
Veterans Day
11/04
All IEHP Providers & IPAs
Revised UM Authorization Guidelines
11/03
All BH Providers & IPAs
Pharmacy Recalls, Withdrawals & Safety Alerts - September 2022
11/02
All PCPs
October 2022
Medicare - Nondiscrimination Notice and Taglines Templates
10/31
All Medicare IPAs
REMINDER: IEHP Interpreter Services – A Covered Benefit!
10/31
All PCPs & IPAs
Continuous Glucose Monitors
10/28
All Medicare PCPs, Endocrinologists & IPAs
Health Education Classes Available in Riverside Area
10/27
All Riverside Area PCPs, Specialists & OBs
PHA - Outbreak of Ebola Virus Disease Due to Sudan Virus in Central Uganda
10/25
All Riverside County PCPs
834 Eligibility File Format Changes
10/25
All IHEP 834 Trading Partners
Global Quality P4P IPA Meeting – 2023 Program Preview
10/21
All Medi-Cal IPAs
REMINDER DHCS Hospice Rates – Prospective Calculation Based on Medicaid Rates
10/21
All Hospice Providers
NEW! D-SNP Letter Templates (Effective January 2, 2023)
10/21
All Medicare IPAs
Help Protect Your Members Against the Flu
10/20
All PCPs & IPAs
Public Health Emergency (PHE) Ending Soon – Help Your Members Reenroll!
10/19
All IEHP PCPs
REMINDER - Balance Billing of IEHP Members Not Permitted!
10/14
All IEHP Providers
ACTION REQUIRED - Correct Prioritization of Authorization Requests
10/14
All PCPs, Specialists & IPAs
Global Quality P4P PCP Meeting – 2023 Program Preview
10/13
All Medi-Cal PCPs
Flu Vaccine Notice -Access to Pharmacy Vaccine Network
10/13
All PCPs
Cal MediConnect Sunsets and IEHP Dual Choice (D-SNP) Begins
10/12
All PCPs
Academic Detailing Services Now Offered
10/11
All IEHP Providers & Pharmacies
REMINDER - ACTION REQUIRED - Electronic Visit Verification (EVV) Implementation Requirements – Self Registration Required by October 19, 2022
10/10
All Home Health Care Services (HHCS) Providers & Personal Care Services (PCS)
UPDATE - Independent Medical Review (IMR) Forms
10/10
All Medicare IPAs
UPDATE to September 8, 2022 Communication Authorization Timeframes
10/6
All Medi-Cal IPAs
Special Fraud Alert - Exercise Caution with Purported Telemedicine Companies
10/6
All IEHP Providers & IPAs
FAQs For Delegate Monitoring of Utilization Measures
10/5
All IPAs
September 2022
Global Quality P4P Programs – NEW 2022 Quality Bonus Services!
09/30
All Medi-Cal PCPs
Diversity Awareness Month - October 2022 - Please Join Us!
09/30
All IEHP Providers & IPAs
REMINDER - IEHP Coordination of Benefits Agreement (COBA) Implementation – Action Required!
09/30
All PCPs, Specialists, ANC & Hospitals
ICD-10-CM Risk Adjustment Code Changes for CMS HCC Code Capture
09/26
All Direct Dual Choice PCPs
UPDATE! – Continuous Glucose Monitoring (CGM) Systems (IPA)
09/23
All Medi-Cal IPAs
UPDATE! – Continuous Glucose Monitoring (CGM) Systems
09/22
All Medi-Cal PCPs & Endocrinologists
ACTION REQUIRED - Electronic Visit Verification (EVV) Implementation Requirements – Self Registration Required by October 19, 2022
09/22
All Home Health Care Services (HHCS) Providers & Personal Care Services (PCS)
UPDATED Medi-Cal Letter Templates
09/22
All Medi-Cal IPAs
URGENT ATTENTION: Phishing Email Alert
09/21
All IEHP Providers
Pharmacy Times - Medication Reconciliation
09/21
All Dual Choice PCPs
Grievance Process Updates - Grievance Summary Form - Due Date
09/15
All IPAs
Continuity of Care (COC) Rosters Now Available on SFTP
09/15
All IPAs
REMINDER - Enhanced Care Management Available for Members
09/15
All Medi-Cal ANC and Vision Providers
Coordination of Benefits Agreement (COBA) Implementation - Action Required
09/12
All PCPs, Specialists, ANC & Hospitals
REMINDER - Dilated Retinal Exam (DRE) for Diabetic Members
09/09
All PCPs & Vision Providers
Revised UM Authorization Guidelines
09/09
All IPA Administrators & Medical Directors
Annual BH&CM Medi-Cal IPA Training Survey
09/08
All Medi-Cal IPA Care Management Staff
IEHP Provider Portal Updates – Reports now Viewable by TIN
09/08
All Medi-Cal PCPs
NEW - Collecting Social Determinants of Health Data (SDOH)
09/08
All Medi-Cal PCPs, Specialists & BH Providers
Authorization Timeframes Notice of Action (NOA) Translation & Attachment
09/08
All Medi-Cal IPAs
Please Notify IEHP if Your Availability has Changed due to Area Fires
09/08
All Hemet and Big Bear Area Providers
Recalls, Withdrawals & Safety
09/08
All IEHP Providers & Pharmacies
IEHP Formulary Changes (P&T)
09/07
All IEHP PCPs
Access Standards - Appointment Availability - Specialists
09/02
All Specialists
Access Standards - Appointment Availability - PCP, Ob
09/02
All PCPs & Obs
Access Standards - Appointment Availability - BH
09/02
All Behavioral Health Providers
Vaccination Clinic and Resource Fair - September 10
09/02
All Direct PCPs
IEHP Medi-Cal Medical Benefit Formulary
09/02
All Medi-Cal PCPs, Specialists & Psychiatrists
August 2022 P&T Update
09/02
All IEHP Providers & Pharmacies
August 2022
2022 - 2023 Flu Vaccination for IEHP Members
08/31
All IEHP Providers & Pharmacies
REMINDER: Medi-Cal Rx Gradual Reinstatement of PAs – Phase 1
08/31
All Medi-Cal PCPs & Specialists
Labor Day Holiday
08/30
All IEHP Providers & IPAs
REMINDER: Enhanced Care Management Available for Members
08/30
All Medi-Cal PCPs & IPAs
Final REMINDER: Submit the 2022 Provider Satisfaction Survey
08/29
All PCPs, Specialists & BH Providers
REMINDER: Community Supports Services Available for Members
08/29
All PCPs, Specialists & BH Providers
Medication Reconciliation Program
08/29
All IEHP Providers & Pharmacies
NOTICE: DHCS Approved Letter – Prior Authorization Not Required
08/26
All Medi-Cal IPAs
NOTICE: DHCS Approved Letter – Prior Authorization Not Required
08/26
All Medi-Cal PCPs, Specialists & Ambulatory Surgery Centers
REMINDER: Aug 2022 Provider Educational Series: “How to Navigate Rosters & Reports”
08/24
All Direct Medi-Cal PCPs
NEW: Health Education Classes Offered in Desert Hot Springs and Mecca
08/24
All Coachella Valley PCPs
ADVISORY: Updated Monkeypox Guidance
08/23
All Riverside County PCPs
San Bernardino County Public Health - Monkeypox Guidance
08/23
All San Bernardino County PCPs & Specialists
REMINDER: Medication Reconciliation
08/22
All IEHP Providers
REMINDER: 2022 Provider Satisfaction Survey
08/22
All PCPs, Specialists, & BH Providers
REMINDER: DHCS Quarterly Timely Access Survey
08/22
All Medi-Cal PCPs, Specialists, BH & Ancillary Providers
Medication Reconciliation Program
08/22
All IEHP Providers & Pharmacies
Reinstatement of PA Requirements for 11 Drug Classes
08/17
All Medi-Cal PCPs
REMINDER: Appropriate Billing for Dispensing of Vision Materials
08/17
All Vision Providers
REMINDER: Provider Directory Verification Form due August 26th
08/17
Select PCPs & Specialists
Medication Reconciliation Program
08/15
All IEHP Providers & Pharmacies
REMINDER: Timely Provision of Denial Packets
08/12
All Medicare IPAs
Member Grievance Updates: Medical Record Requests
08/12
All Direct PCPs, Specialists, & Ancillary
2022 Global Quality P4P Program Guide Updates - SDOH Rate Measure
08/12
All Medi-Cal PCPs & IPAs
Medi-Cal Letter Templates
08/11
All Medi-Cal IPAs
Recalls, Withdrawals & Safety
08/10
All IEHP Providers & Pharmacies
UPDATE: IEHP’s Network is Open to New QASP Providers
08/08
All BHT Providers
2022 Provider Educational Series – How to Navigate Rosters & Reports
08/08
All Direct Medi-Cal PCPs
Proposition 56 – Don’t Miss Out on Available Supplemental Payments
08/05
All Medi-Cal PCPs
2022 Provider Quality Resource Guide
08/05
All PCPs
Changes to Quarterly Workplan Requirements
08/03
All IPAs
REMINDER: Provider Preventable Conditions - Reporting Requirements
08/03
All IEHP Providers, Ambulatory Surgical Centers & IPAs
Webinar: COVID-19 In the Black and Brown Community and the Post Long-Term Effects
08/01
All PCPs & IPAs
Medication Reconciliation Program
08/01
All IEHP Providers & Pharmacies
July 2022
NEW DATE: Medi-Cal Rx Gradual Reinstatement of Prior Auths (PAs) – Phase 1 – September 16, 2022
07/29
All Med-Cal PCPs & Specialists
Practitioner Reporting Requirements - UB-04 Claim Form
07/29
All SNFs, Hospitals, & Ancillary
Free Webinar: It Takes a Village to Manage COVID-19
07/27
All PCPs & IPAs
REMINDER: Medi-Cal Rx Gradual Reinstatement of PAs – Phase 1 – August 1, 2022
07/25
All Medi-Cal PCPs & Specialists
ALERT: Hospice Policy and Procedures
07/25
Select Contract and Non-Contracted Hospice Providers
Inappropriate Treatment Delays and Denials for HIV PrEP and PEP
07/22
All Medi-Cal PCPs & Specialists
UPDATED: Telehealth Services FAQs
07/21
All PCPs, Specialists, BH, BHT Providers & IPAs
2022 Global Quality P4P Program – Provider Directory Verification
07/20
All Medi-Cal PCPs
NEW: Riverside County Public Health: Updated Monkeypox Guidance
07/20
All Riverside County PCPs & Specialists
DHCS Plan Data Feed Project – Files Available on SFTP
07/19
All IPAs
2022 Global Quality P4P PCP Program Guide- UPDATES
07/18
All Medi-Cal PCPs
2022 Global Quality P4P IPA Program Guide- UPDATES
07/18
All Medi-Cal IPAs
2022 Appointment Availability Survey – Fax Survey
07/15
All PCPs & IPAs
2022 Appointment Availability Survey – Fax Survey
07/15
All BH Providers
2022 Appointment Availability Survey – Fax Survey
07/14
All Specialists, Ancillary & IPAs
UPDATE: Diabetic Vision Outreach Campaign – EXTENDED to July 22, 2022
07/14
All Vision Providers
Medi-Cal Rx Gradual Reinstatement of PAs – Phase 1
07/11
All Medi-Cal PCPs & Specialists
2022 Global Quality P4P (GQ P4P) Interim Reports Data Refresh
07/11
All Medi-Cal PCPs & IPAs
Update: Risk Adjustment Telehealth and Telephone Services
07/11
All Dual Choice PCPs, Specialists & BH Providers
Cal MediConnect Sunsets and IEHP Dual Choice (D-SNP) Begins
07/08
All Medicare PCPs, Specialists & BH Providers
2022 Provider Satisfaction Survey
07/07
All PCPs, Specialists & BH Providers
2022 Provider Educational Series - Provider Directory Verification Process (Virtual)
07/07
All Medi-Cal PCPs
Recalls, Withdrawals & Safety
07/07
All IEHP Providers & Pharmacies
IEHP Medi-Cal Medical Benefit Formulary
07/01
All Medi-Cal PCPs, Specialists & Psychiatrists
IEHP Providers Can Post Jobs and Find Candidates for Free on SoCalDocJobs.com
07/01
All PCPs
June 2022
ALERT: No Prior Authorization for Biomarker Testing for Stage 3 and 4 Metastatic Cancers
06/29
All PCPs, Specialists & IPAs
REMINDER – KidVaxGrant Application Deadline Approaching
06/29
All Medi-Cal PCPs
REMINDER - 2022 Provider Educational Series: Provider Directory Verification Process
06/28
All Direct Medi-Cal PCPs
DHCS Plan Data Feed Project
06/27
All IPAs
Alzheimer’s and Dementia Care: A FREE CME Project Echo Opportunity
06/27
All IEHP Family Practice & Internal Medicine Providers
Independence Day Holiday
06/27
All IEHP Providers & IPAs
Standards for Determining Threshold Languages, Nondiscrimination Requirements, and Language Assistance Service
06/27
All Medi-Cal IPAs
UPDATED - Telehealth Services POS Code Updates
06/26
All PCPs, Specialists & BH Providers
Clinical Practice Guidelines
06/24
All PCPs & IPAs
Access Standards – Appointment Availability for Specialists
06/24
All Specialists
NOTICE: No Prior Authorizations for Preventive Services - IPAs
06/23
All Medi-Cal IPAs
NOTICE: No Prior Authorizations for Preventive Services - Providers
06/23
Direct Medi-Cal PCPs & Specialists
Billing of IEHP Members Guidance
06/22
All IEHP Providers & IPAs
May 2022 P&T Update
06/22
All IEHP Providers & Pharmacies
REMINDER - 2022 Provider Educational Series: Provider Directory Verification Process
06/21
All Direct Medi-Cal PCPs
Access Standards – Appointment Availability for PCPs and OB Providers
06/21
All PCPs & OB Providers
Access Standards – Appointment Availability for BH Providers
06/21
All Behavioral Health Providers
REMINDER – Authorizations Required for All Follow-up Visits!
06/17
All BH & BHT Providers
REMINDER: 2022 Global Quality P4P Program – CAIR2 Participation Requirement
06/17
All Medi-Cal PCPs
Member Campaign on Preventive Care Services
06/17
All Medi-Cal PCPs & IPAs
Updates/Amendments to AB 1184: Confidential Communication of Medical Information Involving Sensitive Services
06/16
All Medi-Cal Providers & IPAs
IEHP Alternative Format Requirement Overview
06/14
All IEHP Providers & IPAs
Juneteenth Holiday
06/13
All IEHP Providers & IPAs
REMINDER - Authorizations Required for Vision Services
06/10
All Vision Providers
Alcohol and Drug Screening Assessment Brief Interventions and Referral to Treatment (SABIRT)
06/10
All PCPs & IPAs
2022 Provider Educational Series - Provider Directory Verification Process
06/10
All Direct Medi-Cal PCPs
Navigating the Formula Crisis Webinar
06/08
All Medi-Cal PCPs & OB/GYN
MTM Medi-Cal Provider Mailing Campaign
06/08
All IEHP Providers & Pharmacies
MTM Medicare Provider Mailing Campaign
06/08
All IEHP Providers & Pharmacies
Recalls, Withdrawals & Safety
06/05
All IEHP Providers & Pharmacies
Academic Detailing Services Now Offered
06/04
All IEHP Providers & Pharmacies
Medi-Cal Rx Billing Policy for Physician Administered Drugs (PADs)
06/03
All Medi-Cal PCPs, Specialists & IPAs
New and Revised UM Authorization Guidelines
06/03
All IPA & BHT Providers
UPDATES COMING SOON – Changes to UM Semi-Annual and Annual Reporting Requirements
06/01
All IPAs
UPDATE - Facility Site Review (FSR) and Medical Record Review (MRR) Tools and Standards – Effective July 1, 2022
06/01
All PCPs & IPAs
May 2022
IEHP’s Bi-Annual BHT Provider Training
05/27
All Behavioral Health Treatment (BHT) Providers
Memorial Day Holiday
05/23
All Providers & IPAs
REMINDER: CMC Transition to D-SNP - Model of Care Early Preview Meeting - June 13, 2002
05/23
All IPA CM & Quality Staff
2022 Global Quality P4P Program - NEW 2022 Interim Reports
05/20
All Medi-Cal PCPs
IEHP UM Department Availability
05/20
All PCPs, Specialists & BH
Care Coordination REMINDER – Review the Early Start Roster on IEHP’s Portal
05/17
All Medi-Cal PCPs & IPAs
CMC Transition to D-SNP - Model of Care Early Preview Meeting - June 13, 2002
05/16
All IPA CM & Quality Departments
REMINDER: 2022 Global Quality P4P Program – CAIR2 Participation Requirement
05/16
All Medi-Cal PCPs
REMINDER: 2022 Global Quality P4P Program – Manifest MedEx Connectivity
05/16
All Medi-Cal PCPs
eReferral Submission to IEHP now available for IPA assigned Medi-Cal Members: Transplants (MOT) and Community Support Services
05/13
All Medi-Cal PCPs & IPAs
Applied Changes for Medicare Members on the 835 Files
05/10
IEHP Trading Partners
Sunsetting of Proposition 56: Value Based Payment Program
05/09
All Medi-Cal PCPs, Specialists, BH & IPAs
HIV/AIDS Specialist Survey
05/06
All Specialists
UPDATED FAQs: Members with Other Health Coverage (OHC)
05/06
All Providers & IPAs
Revised/Retired UM Authorization Guidelines
05/06
All Medi-Cal IPAs & BH
Community Supports Services Modifier Guidance
05/06
All Medi-Cal PCPs, Specialists, BH & IPAs
Recalls, Withdrawals & Safety Alerts
05/05
All IEHP Providers & Pharmacies Providers
REMINDER: No Prior Authorizations Needed for Preventive Services
05/03
All IPAs
Alzheimer’s and Dementia Care: A Project Echo Opportunity
05/03
All PCPs
Webinar - IWIN COVID and the Community
05/02
San Bernardino County PCPs
April 2022
2022 Global Quality P4P Program - Manifest MedEx Connectivity Reminder
04/29
All Medi-Cal PCPs
Maternal Wellness Events - May 2022 - IEHP Community Resource Centers
04/28
All Medi-Cal PCPs, OB/GYN, Peds, BH & IPAs
Letter to Primary Care Providers RE-Response to GSF
04/27
All Medi-Cal PCPs
Letter to Providers RE-Response to GSF
04/26
All Medi-Cal IPAs & Specialists
Initial Health Assessment (IHA) Roster
04/22
All Medi-Cal PCPs & IPAs
REMINDER: IEHP Interpreter Services – Benefit for Members!
04/20
All PCPs & IPAs
REMINDER - 2022 Global Quality P4P Program – CAIR2 Participation Requirement
04/15
All Medi-Cal PCPs
COVID-19 “Test to Treat” Initiative
04/13
All PCPs & IPAs
Revised UM Authorization Guideline
04/12
All Medi-Cal IPA Administrators and Medical Directors & BH Providers
Public Health Service (PHS) 340B Participating Provider Billing Reminder
04/12
All FQHCs and DSHs
Care Plans and Health Risk Assessments (HRAs) Reminder
04/08
All PCPs, Specialists, SNFs & CBAS
2nd Round of Free At-Home COVID-19 Test Kits Available
04/08
All Medi-Cal PCPs
Misdirected Claims Testing – Meeting Request
04/07
IEHP Trading Partners
Alzheimer’s and Dementia Care: A Project Echo Opportunity
04/06
All IEHP PCPs
Standing Orders Enrollment - Respond Today!
04/06
All Medicare PCPs
Medicare P4P IEHP Direct – Blood Pressure Control Billing Guidance
04/05
All Direct DualChoice PCPs
Important Notice: Proton Pump Inhibitor Overutilization
04/05
All IEHP Providers & Pharmacies
Recalls, Withdrawals & Safety Alerts
04/05
All IEHP Providers & Pharmacies
March 2022
CORRECTION - Standing Orders Enrollment- Respond Today!
03/31
All Medi-Cal PCPs
Complex Case Management (CCM) Program – Severe Chronic Conditions
03/30
All Medi-Cal PCPs, Specialists, BH Providers & IPAs
Major Organ Transplants (MOT) and TAR Approval DATE Impact
03/29
All Medi-Cal IPAs & COEs
Standing Orders Enrollment - Respond Today!
03/29
All Medi-Cal PCPs
MTM Medi-Cal Provider Mailing Campaign
03/29
All IEHP Providers & Pharmacies
MTM Medicare Provider Mailing Campaign
03/29
All IEHP Providers & Pharmacies
Initial Health Assessment (IHA)
03/28
All Medi-Cal PCPs
REMINDER - 2022 OB P4P Kickoff Meeting – March 31, 2022!
03/28
All Medi-Cal OB/GYNs
CMS Signature Requirement Guidelines for Member Medical Records
03/25
All IPAs, PCPs, Specialists & BH Providers
REMINDER: IEHP Claims, Appeals/Disputes and Audit Recovery Mailing Addresses
03/25
All Direct PCPs, Specialists & BH Providers
2021 GQ P4P Program- Data Submission Extension Until March 31, 2022
03/22
All Medi-Cal PCPs
REMINDER: IEHP Wants to Know Your Interest in Pilot Program to Implement a Community Electronic Health Record (EHR)
03/22
All Medi-Cal PCPs
REMINDER - American Rescue Plan Act – Extension of Postpartum Care Coverage
03/21
All Medi-Cal PCPs, OBs & IPAs
Behavioral Health Access Standards – Appointment Availability
03/16
All Behavioral Health Providers
New DHCS DUR Board Educational Article
03/16
All IEHP Providers & Pharmacies
IEHP Wants to Know: Interest in Pilot Program to Implement a Community Electronic Health Record (EHR)?
03/15
All Medi-Cal PCPs
REMINDER - 2022 Global Quality P4P Program – CAIR2 Participation Requirement
03/14
All Medi-Cal PCPs & IPAs
Riverside County Legionnaires' Disease Advisory
03/14
All PCPs & IPAs
Coordination of Benefits with Other Health Coverage (OHC) – Medi-Medi Coverage Added to Provider Portal
03/11
All IEHP Providers & IPAs
Notice of Dismissal of Coverage Letter Updates & Attestation Form
03/11
All Medicare IPAs
Process for IEHP Medi-Cal Members: Continuous Glucose Monitors (CGM)
03/10
All Medi-Cal PCPs
UPDATED Integrated Denial Notice Medicare Letter Templates
03/08
All Medicare IPAs
Process for IEHP Medi-Cal Members: Blood Pressure Monitors and Nebulizers
03/07
All Medi-Cal PCPs
Recalls, Withdrawals & Safety Alerts
03/07
All IEHP Providers & Pharmacies
IEHP’s Quarterly BH Provider Training
03/04
All Behavioral Health Providers
Update: Enhanced Care Management Roster Available on Provider Portal
03/01
All Medi-Cal PCPs & IPAs
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Governing Board - Karen Spiegel
ities of Canyon Lake, Corona, Eastvale, Jurupa Valley, Lake Elsinore, and Norco, along with the unincorporated communities of Coronita, El Cerrito, Gavilan Hills, Home Gardens, Lake Mathews, Lakeland Village, Temescal Valley, Warm Springs, Woodcrest.
She was appointed to the IEHP Governing Board in February 2019, became vice chair in January 2020 and chair in 2021. Supervisor Spiegel began her political career as the elected city treasurer for the city of Corona in 1996. She continued her service in Corona as a council member for 16 years and as mayor for four terms.
Pharmacy Communications - Pharmacy Communications
or later to view the PDF files. You can download a free copy by clicking here. By clicking on this link, you will be leaving the IEHP website.
TITLE
DATE
RECIPIENTS
February 2023
Transition to 30-day Coverage Determination Backdating
02/02
All LTC & SNF Providers
January 2023
IEHP DualChoice (HMO D-SNP): Over-the-Counter Drugs
01/09-01/30
All IEHP Pharmacy Providers
IEHP DualChoice (HMO D-SNP): Medicare Part B Coinsurance Billing
01/05-01/13
All IEHP Pharmacy Providers
IEHP DualChoice (HMO D-SNP): PBM Update and Medicare Part B Coinsurance
01/02-01/20
All IEHP Pharmacy Providers
IEHP DualChoice (HMO D-SNP) Members - Medication Overrides
01/02
All IEHP Pharmacy Providers
December 2022
Cal MediConnect (CMC) to Medi-Cal Rx/HMO D-SNP Transition
12/22
All IEHP Pharmacy Providers
Claims Rejected in Error
12/19
All IEHP Pharmacy Providers
PBM Change & Prior Authorization Submission Method - for DualChoice (HMO D-SNP) Members (Effective January 1, 2023)
12/13-12/29
All IEHP Pharmacy Providers
Pharmacy Recalls, Withdrawals & Safety Alerts - November 2022
12/07
All IEHP Pharmacy Providers
CoverMyMeds - Prior Authorization Submission Method for DualChoice Members (Effective January 1, 2023)
12/01-12/12
All IEHP Pharmacy Providers
November 2022
Recalls, Withdrawals & Safety Alerts - October 2022
11/14
All IEHP Pharmacy Providers
Recalls, Withdrawals & Safety Alerts - September 2022
11/02
All IEHP Pharmacy Providers
COVID-19: Test to Treat Monoclonal Antibodies
11/01
All IEHP Pharmacy Providers
October 2022
Cal MediConnect to Medi-Cal Rx Transition (D-SNP)
10/28
All IEHP Pharmacy Providers
September 2022
Recalls, Withdrawals & Safety Alerts
09/08
All IEHP Pharmacy Providers
August 2022
2022-2023 Flu Vaccination for IEHP Members
08/31
All IEHP Pharmacy Providers
Reminder: Medi-Cal Rx Gradual Reinstatement of PAs - Phase 1
08/31
All IEHP Pharmacy Providers
30-Day Countdown: Reinstatement of PA Requirements for 11 Drug Classes
08/18
All IEHP Pharmacy Providers
30-Day Countdown: Reinstatement of PA Requirements for 11 Drug Classes
08/17
All IEHP Pharmacy Providers
Recalls, Withdrawals & Safety Alerts
08/10
All IEHP Pharmacy Providers
July 2022
Academic Detailing Services Now Offered
07/15
All IEHP Pharmacy Providers
DHCS Medi-Cal Rx Update: Postponement of Implementation of NCPDP Reject Code 80
07/13
All IEHP Pharmacy Providers
Recalls, Withdrawals & Safety Alerts
07/07
All IEHP Pharmacy Providers
June 2022
New DHCS DUR Board Educational Article
06/22
All IEHP Pharmacy Providers
MTM Medicare Pharmacy Mailing Campaign
06/08
All IEHP Pharmacy Providers
Recalls, Withdrawals & Safety Alerts
06/05
All IEHP Pharmacy Providers
Academic Detailing Services Now Offered
06/04
All IEHP Pharmacy Providers
Medi-Cal Rx Transition: Blood Pressure Monitors and Cuffs
06/03
All IEHP Pharmacy Providers
Important Notice: COVID-19 Oral Antivirals Billing
06/01
All IEHP Pharmacy Providers
May 2022
Recalls, Withdrawals & Safety Alerts
05/05
All IEHP Pharmacy Providers
April 2022
Rejected Claims Due To Prescriber Error Codes
04/06
All IEHP Pharmacy Providers
Recalls, Withdrawals & Safety Alerts
04/05
All IEHP Pharmacy Providers
MTM COVID-19: Test to Treat
04/04
All IEHP Pharmacy Providers
March 2022
MTM Medicare Pharmacy Mailing Campaign
03/29
All IEHP Pharmacy Providers
New DHCS DUR Board Educational Article
03/16
All IEHP Pharmacy Providers
Medi-Cal Rx Transition: How To Assist IEHP Members
03/28-03/31
All IEHP Pharmacy Providers
Medi-Cal Rx Transition: How To Assist IEHP Members
03/21-03/25
All IEHP Pharmacy Providers
Medi-Cal Rx Transition: How To Assist IEHP Members
03/14-03/18
All IEHP Pharmacy Providers
Medi-Cal Rx Transition: How To Assist IEHP Members
03/07-03/11
All IEHP Pharmacy Providers
Recalls, Withdrawals & Safety Alerts
03/07
All IEHP Pharmacy Providers
IEHP Contracted DME Pharmacies: CGM, BP Monitor, Nebulizer
03/02
All IEHP Pharmacy Providers
February 2022
Medi-Cal Rx Transition: How To Assist IEHP Members
02/28-03/04
All IEHP Pharmacy Providers
Medi-Cal Rx Transition: How To Assist IEHP Members
02/22-02/25
All IEHP Pharmacy Providers
Medi-Cal Rx Transition: How To Assist IEHP Members
02/14-02/18
All IEHP Pharmacy Providers
Medi-Cal Rx Transition: How To Assist IEHP Members
02/10-02/11
All IEHP Pharmacy Providers
Pharmacy Empowerment Program
02/08
All IEHP Pharmacy Providers
Recalls, Withdrawals & Safety Alerts
02/07
All IEHP Pharmacy Providers
New DHCS DUR Board Educational Article
02/02
All IEHP Pharmacy Providers
January 2022
Free OTC COVID-19 Antigen Test Kits Available
01/31
All IEHP Pharmacy Providers
Medi-Cal Rx Transition Implementation
01/17-01/21
All IEHP Pharmacy Providers
Medi-Cal Rx Transition Implementation
01/10-01/14
All IEHP Pharmacy Providers
Medi-Cal Rx Transition Implementation
01/07
All IEHP Pharmacy Providers
Recalls, Withdrawals & Safety Alerts
01/05
All IEHP Pharmacy Providers
Community Resource Centers - About Us
HP Community Resource Centers (CRC) are your local resource for healthcare information in Riverside, San Bernardino and Victorville. Our friendly, bilingual staff can help you take free classes, learn about health care, and about health coverage programs. Our doors are open to IEHP Members and the community.
We Have In-Person and Online Classes
Fitness Classes
Stay active with classes like Yoga, Zumba (all levels), Tai Chi, Line Dance, Yoga for Seniors & People with Disabilities, Meditation, Aerobic Box, Latin Dance, Strength and Conditioning, and Kid Aerobics.
Wellness Classes
Learn about nutrition, managing asthma symptoms, controlling diabetes, stress management, breathing and relaxation.
Where can I find Classes?
In Person: Riverside | San Bernardino | Victorville
Online: Virtual Classes
Riverside Community Resource Center
VIEW OUR MONTHLY RIVERSIDE CRC CALENDAR
Click to Download PDF
Click Para Descargar PDF
Riverside CRC Address:
3590 Tyler Street, Suite 101, Riverside, CA 92503
Riverside CRC Phone:
1-866-228-4347
TTY users should call 711
View Our Other CRC Locations:
San Bernardino CRC
Victorville CRC
Virtual/Online
Click to view in Google Maps
San Bernardino Community Resource Center
VIEW OUR MONTHLY SAN BERNARDINO CRC CALENDAR
Click to Download PDF
Click Para Descargar PDF
San Bernardino CRC Address:
805 West 2nd Street, Suite C, San Bernardino, CA 92410
San Bernardino CRC Phone:
1-866-228-4347
TTY users should call 711
View Our Other CRC Locations:
Riverside CRC
Victorville CRC
Virtual/Online
Click to view in Google Maps
Victorville Community Resource Center
VIEW OUR MONTHLY VICTORVILLE CRC CALENDAR
Click to Download PDF
Click Para Descargar PDF
Victorville CRC Address:
12353 Mariposa Road, Suites C-2 & C-3, Victorville, CA 92395
Victorville CRC Phone:
1-866-228-4347
TTY users should call 711
View Our Other CRC Locations:
Riverside CRC
San Bernardino CRC
Virtual/Online
Click to view in Google Maps
Visit our on-site partner agencies for the following services:
Goodwill Southern California: A workforce provider helping individuals empower themselves with the skills and job support services they need and want to thrive.
Housing Authority of the County of San Bernardino: Affordable housing provider and rental assistance to low-income families via vouchers or affordable housing units.
Young Visionaires Youth Leadership Academy: Mentorship enriching lives of young people through life building activities and instruction in the areas of education, employment, health, mentoring, and community service.
Community Action Partnership of San Bernardino County: Providing Home Energy Assistance Program (HEAP) and Housing Assistance for San Bernardino County residents.
TODEC: Provides legal immigration services, advocacy, community organizing, and civic engagement.
Virtual Classes
VIEW OUR MONTHLY ONLINE CLASSES CALENDAR
Click to Download PDF
Click Para Descargar PDF
Join the Classes via Facebook:
Our Community Resource Centers are now offering virtual classes via Facebook. Join a class today.
Join the Classes via WebEx:
Webex Classes (Password: 12345):
Apple Users
Android Users
PC Users
Upcoming Events - Healthy Heart : Get Energized! Say Yes to Physical Activity + Control Your Blood Pressure (Victorville)
Upcoming Events - Living Well in the Community: Healthy Communication (Victorville)
Upcoming Events - Understanding Diabetes: Taking Medication (San Bernardino)
Upcoming Events - Living Well in the Community: Healthy Communication (San Bernardino)
Upcoming Events - Living Well in the Community: Staying on Course (San Bernardino)
Upcoming Events - Healthy Heart : Get Energized! Say Yes to Physical Activity + Control Your Blood Pressure (San Bernardino)
Upcoming Events - Breathe Well, Live Well (San Bernardino)
Upcoming Events - Understanding Diabetes:Healthy Eating Pt. 1 (Perris)
two parts. In Part 1, we will show you which foods affect blood sugar levels the most (and the least) and which foods (and fats) are better options for blood sugar control. Plus, get tips to cut fat and cholesterol.
Click here to register for this in-person class
Location
Mead Valley Family Resource Center
21091 Rider Street.
Perris, CA 92570
Upcoming Events - Healthy Heart : Get Energized! Say Yes to Physical Activity + Control Your Blood Pressure (Perris)
Upcoming Events - Understanding Diabetes: Healthy Eating Pt. 1 (Mecca)
o two parts. In Part 1, we will show you which foods affect blood sugar levels the most (and the least) and which foods (and fats) are better options for blood sugar control. Plus, get tips to cut fat and cholesterol.
Click here to register for this in-person class
Location
Mecca Family and Farmworkers Service Center
Inside Mecca Community Center
91275 66th Ave.
Mecca, CA 92254