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Latest News - Inland Empire Health Plan Promotes Autism Awareness
rents of Members to feel confident in advocating for themselves, their children, and family members to access the behavioral healthcare they need. The health plan supports more than 7,500 Members who are utilizing behavioral health treatment services for autism spectrum disorder (ASD) and related conditions. Such services may include: applied behavioral analysis, speech therapy, physical therapy, occupational therapy, psychiatry services and more. “Having Autism or being on the spectrum is nothing to be afraid of,” said Heather Waters, IEHP’s Manager of Behavioral Health and Care Management. “As a health plan, we want to take the stigma out of asking or seeking behavioral healthcare and encourage our Members or parents of Members to trust their gut and ask for support as soon as they spot any signs or symptoms of possible developmental delays.” Waters shared that early treatment and recognition of symptoms, as early as one year of age and before a child enters school, can result in better health outcomes, especially for children. Signs and symptoms vary and can range from obsessive or compulsive behaviors to poor social skills, delayed milestones, and more. IEHP Medi-Cal Members can be referred to services and treatment for ASD symptoms by a Medical Doctor or a Licensed Psychologist. This allows Members under 21 years of age to access critically important behavioral and developmental therapies immediately, while they undergo the autism evaluation process. IEHP’s Internal Behavioral Health Team helps Members and their families navigate an ASD diagnosis through actively coordinating services and additional resources through partnerships with several provider groups and local agencies across the region. Recently, IEHP collaborated with the Inland Empire Autism Assessment Center of Excellence (AAC) to provide a Member in Indio with a complete Autism Diagnostic Evaluation through telehealth appointments. “Even with care coordination challenges like location and Member condition, the situation wasn’t impossible,” said Waters. “As the Member and their family connected with the AAC, our team checked in regularly to make sure the services were effective and to remind the family and Member that they were not alone in this journey.” To receive an evaluation or additional services, Members are encouraged to call IEHP’s Member Services at 1-800-440-4347 and ask for the Behavioral Health Department.
Latest News - IEHP and MALO ring in holiday cheer during resource fair
in their upcoming event, MALO ‘E OFA Christmas 2022 Extravaganza Resource Fair and Vaccine Clinic, from 10 a.m. to 4 p.m. on Saturday, Dec. 17, at First United Methodist Church of Ontario, in Ontario, Calif. The event will provide attendees with free vaccines, groceries, children’s toys and gifts, afternoon Zumba and lots of holiday cheer. Vaccines will include Moderna, Johnson & Johnson and Pfizer COVID-19 vaccines and boosters. Pediatric Moderna vaccines and boosters for children 6 months through 11 years old will also be available. Those who would like to receive a free COVID-19 vaccine are encouraged to make an appointment online here. MALO, a non-profit organization established in 2017, serves more than 2,000 Tongan Americans in the Inland Empire through youth mentorship, job readiness, resource literacy and cultural gathering events. “Our community has been under-resourced for decades – these partnerships are a sign of hope that our beautiful and deserving community will get the resources needed to live a life with good health and accessible health care,” said Lolofi Soakai, MALO founder and executive director. “Having partners in health care gives a peace of mind knowing that current health concerns are addressed, and preventive care is accessible” Through their years of partnership, MALO and IEHP have collaborated to distribute back-to-school backpacks, hosted various vaccine clinics, and provided personal protective equipment and household items during the COVID-19 pandemic. IEHP has also assisted MALO by providing information on health and wellness benefits. “Meeting our communities where they are and ensuring their access to vaccines and health and wellness resources is a cornerstone of who IEHP is,” said LuAnna Jauregui, IEHP community partnerships manager. “Partnering with organizations like MALO allows us to deliver on our promise to ‘heal and inspire the human spirit’ and support health equity in our region.” To learn more about MALO and their important work in the Inland Empire, visit malotongaie.org
Latest News - IEHP brings Winter Wonderland to Trona residents
ted town of Trona, California, is gearing up for much more than the holidays this year, making way for a healthier future. With community partners and a team of volunteers, Inland Empire Health Plan (IEHP) met Trona residents in the heart of their community to provide fresh produce, dental services, vaccines and other health resources at a Winter Wonderland event on Dec. 14. This is not the first, second or even third time IEHP has visited Trona – and it definitely won’t be the last, IEHP’s Senior Community Health Director Cesar Armendariz shared. Even before officially expanding its coverage to rural areas in January 2022, the health plan has worked closely with Trona residents. In fact, IEHP started regular feedback sessions in 2021 to listen and learn more about the area’s overall needs and care gaps. Through these engagements, IEHP helped establish bi-weekly fresh produce distributions in the area. Next up: connecting Trona residents to telehealth services and regular wellness programing. “As the leading health plan serving the Inland Empire, our goal is to help establish access to much needed resources and empower residents to advocate for their own health and well-being,” said Armendariz. “We do that by making connections between providers and communities and helping to create affinity between the two.” One of these new collaborations to support the Trona community is with Omni Family Health, which will provide residents with telehealth services and pharmacy needs. “In addition to providing services, vaccines and groceries at our Winter Wonderland event, we really wanted to take the time and teach the community how they can use their IEHP benefits to receive care from partners like Omni Family Health,” said LuAnna Jauregui, IEHP community partnerships manager. “Health is personal and being physically present to teach, share and guide the development of sustainable wellness in Trona is incredibly important to IEHP and the future of our care system,” added Jauregui. “To me, IEHP means stability,” said Rene, a Trona Resident and Senior Center volunteer. “It [IEHP] makes my foundation stronger. It helps me offer things to people that they’ve never heard they could apply for or even come and get. So as far as IEHP goes for me, it brings my stance, my foundation, my feet together in a really strong, thankful way,” added Rene. To learn more about IEHP, visit iehp.org.
Latest News - 683 Free COVID-19 Test Kits Distributed to Inland Empire Residents
helping to enhance access to testing in the region. Distributions were organized through the health plan’s Community Resource Centers in Riverside, San Bernardino and Victorville. In addition to the state’s on-going effort to provide tests to Medi-Cal Members through Medi-Cal enrolled pharmacies, IEHP was eager to provide additional testing access by purchasing and distributing tests directly to their Membership. Members received two test kits per family, which includes a total of four antigen tests. Earlier this year, at the height of the Omicron variant’s surge, rapid COVID-19 testing opportunities were in high demand while the supply was very limited. “Access to testing is essential to community health,” said Dr. Gabriel Uribe, IEHP’s Community Health Director. “Having access to COVID-19 testing reduces transmission in our region by helping residents make informed decisions about their health. Knowing whether or not you are positive for COVID-19 can make all the difference in the lives of your friends and family.” Tests distributed by the health plan are not PCR tests and are not acceptable for travel or events, but can be used for quick results. While only IEHP Members were eligible to receive COVID-19 tests through the health plan, Non-Members are encouraged to visit Riverside or San Bernardino County’s websites for test kit distribution locations. IEHP is also reminding Members that in-home COVID-19 test kits purchased between 3/11/21 and 1/31/22 can be reimbursed with a receipt using the DHCS claims process. “Providing our Members access to quality tests, care and support remains our largest priority,” said Dr. Takashi Wada, IEHP’s Chief Medical Officer. “As a community-based health plan, we are actively looking for new and innovative ways to fulfill our mission to heal and inspire spirit and will continue to do so, even in the face of this uncertain pandemic.” Upcoming distributions are scheduled for Tuesday, February 15 at all IEHP Community Resource Centers from 1:00pm to 5:00pm. Visit IEHP’s Facebook page for details.
Latest News - IEHP Ranks 99th Percentile in Nation for Provider Satisfaction
the health plan in the 99th percentile for provider satisfaction nationwide. Administered to the health plan’s provider network by phone through a third party vendor, the annual survey measures provider satisfaction with the services and support received directly from IEHP. The survey included responses from primary care physicians, specialists and behavioral health providers. “To deliver the best care to our members, our providers need ongoing support from their health plan partner,” said Susie White, IEHP Chief Operating Officer. “Survey responses alert us to what areas we need to improve upon and where gaps lie so we can be effective in applying strategic solutions to support our providers. Ultimately we want to ensure our Providers are feeling secure and confident in the work and services they provide to our members. This survey provides great insight into that.” To gain actionable feedback from the plan’s provider network, the survey focused on key drivers of provider satisfaction. Top drivers included: access to case and care managers, timeliness of claims processing, and number of specialists in the network. A notable 98.1% of providers shared they would recommend IEHP to other physician practices. Broken down by category, IEHP ranked within the 99th percentile for provider relations, health plan call center staff, pharmacy, utilization and quality management, and coordination of care. The health plan also scored in the 99th percentile in the financial category, highlighting the health plan’s ability to resolve questions or discrepancies of payment. The survey provided additional insight for ways to improve support activities. “Our provider feedback pointed us to a really great opportunity to enhance access to resources and information supporting telehealth services,” said White. “As we continue to navigate our way through this pandemic together, reinforcing efforts in this area will be critical for our communities.” “The last two years have been an extraordinarily difficult time for our Providers as healthcare professionals and as human beings,” said Jarrod McNaughton, IEHP Chief Executive Officer. “I can’t begin to say how grateful we are for their work in our community and IEHP is committed to make every effort to support our Providers so our Members and Communities can enjoy the optimal care they deserve.”
Latest News - IEHP Offers Vaccine Clinic During International Tamale Festival
Indio, Calif., on Dec. 4 and 5. A long-time supporter of the festival, IEHP will provide health education resources and host a free vaccine clinic near the festival. In partnership with Kaiser Permanente, IEHP’s vaccine clinic will be located just two blocks away from the festival at 45720 Smurr St. in Indio and will offer free COVID-19 and flu vaccines to adults and children from 12-6 p.m. Appointments are not required. Indio’s International Tamale Festival began in 1992 and welcomes diverse crowds to enjoy handmade tamales from around the world. In addition to world-famous tamales, this year’s festival will feature live musical performances, entry to the World’s Biggest Bounce House, a roller rink, carnival rides and hundreds of booths. “Supporting the Indio Tamale Festival has become a tradition for IEHP for more than 15 years,” said Marci Coffey, IEHP’s Community Partnerships Director. “The festival provides fun, family-centered time for our community, and we’re always eager to provide benefit information and connections to resources. This year, we’re especially eager to get back to the festival and offer vaccines to the community.” Historically, hundreds of IEHP Team Members and their family members volunteered for the annual event and were bussed from the health plan’s corporate headquarters in Rancho Cucamonga to Indio. This year, IEHP’s community health teams will be spread throughout the region to support Indio’s Tamale Festival and additional community events in Rialto, Victorville and Needles. “We want our members and communities to enjoy all the fun during the holidays in the safest way possible,” said Cesar Armendariz, IEHP’s Senior Director of Community Health. “We’re grateful to have the resources and strategic partnerships in place to make vaccines accessible to those who need them and look forward to continuing to encourage optimal care and vibrant health in our region.”
Latest News - Top Health Care Leaders Gather at IEHP’s Inaugural Future of Health Summit
th care visionaries and thought leaders at the health plan’s headquarters on Oct. 13, to share supportive acceleration strategies for a more integrated and sustainable health system. The one-day event featured keynote conversations from industry leaders on trends and changes that are impacting the health care environment in the state and region. Featured speakers included: Author and Health Care Futurist Ian Morrison; California Health & Human Services Agency Secretary Dr. Mark Ghaly; University California Los Angeles Hospital and Clinic System Chief of Health Equity, Diversity and Inclusion Dr. Medell Briggs-Malonson; IEHP Chief Quality Officer Dr. Edward Juhn; President and Founder of MEDIS, LLC Dr. Michael Barr; and President of HC2 Strategies and Co-Chair of Stakeholder Health Dora Barilla. “The idea that this isn’t the summit of health care is really key. It’s the future of health. Health is more than health care,” shared Dr. Ghaly in his talk about California Health & Human Services’ vision and efforts. “There is an opportunity to constantly push ourselves and push our partners to think differently about how public and private partnerships can advance this concept of deep community health. It starts with conversations like this and bringing people together.” IEHP Chief Executive Officer Jarrod McNaughton said he hoped the day’s discussions will lead to real reflection and specific action plans. “We’re very serious about moving this community, in partnership with our providers, forward and moving the quality needle,” McNaughton added. “This kind of work can’t happen alone, and we are grateful for the tremendous showing of support and collaboration to ensure vibrant health in our communities for generations to come.”
Clinical Information - Medication Therapy Management
MTM is a term to describe a broad range of services offered by Pharmacists on our health care team. The IEHP Clinical Pharmacy Team reviews the Members’ medicines, making sure they’re taking the right ones for their health conditions. If you are a Provider for IEHP Members who qualify for the MTM Program, you can let them know to look out for a letter from us. They will be enrolled automatically—unless they opt-out. MTM is offered to Members at no additional cost. IEHP's MTM services include these core elements: Medication therapy reviews Medication education Disease management A team of Pharmacists and Doctors developed these MTM services to help provide better prescription drug coverage for our Members. For example, MTM also helps identify possible medication errors. Medicare MTM Program This is a free program under Medicare Part D for IEHP DualChoice Members who have multiple medical conditions, take many prescription drugs, and have high drug costs to assist with better medication management and overall health. IEHP DualChoice Members’ enrollment includes a yearly comprehensive medication review (CMR) and regular targeted medication review (TMR) services throughout the year. MTM services include: Comprehensive Medication Review (CMR) An IEHP Clinical Pharmacist will provide an annual comprehensive review of the IEHP DualChoice Member’s medications over the phone. The Pharmacist will review IEHP DualChoice Member’s medications and make clinical recommendations to IEHP DualChoice Members and Providers. 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. Medicare MTM Program services may have limited eligibility criteria. They are available for the following conditions: 1. The IEHP DualChoice 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 IEHP DualChoice 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 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 (HMO-DSNP) at 1-877-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. TTY users should call 1-800-718-4347. For answers to frequently asked questions, please download the FAQ document below: MTM FAQs (PDF) For details, contact the IEHP Pharmaceutical Services Department at (909) 890-2049, Monday-Friday, 8am-5pm. IEHP DualChoice (HMO-D-SNP) [Medicare-Medicaid Plan] is a Health Plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. Information on this page is current as of March 2023. H5355_CMC_20_1900233_Accepted
Latest News - Statewide Initiative Supports Behavioral Health of I.E. Youth
h Molina Healthcare, County Behavioral Health, the Offices of Education in Riverside and San Bernardino counties, and select local school districts and charter schools to implement the Student Behavioral Health Incentive Program (SBHIP). The three-year program is in accordance with the California Department of Health Care Services’ (DHCS) goal to expand prevention and early intervention behavioral health services in schools and provides financial incentives to partnering school districts and charter schools. A total of $389 million has been allocated for California. Between both IEHP and Molina Healthcare, up to $50,845,334 can be utilized to support this program. According to the American Psychological Association, one in five young women and one in ten young men experience a major depressive episode before the age of 25. The COVID Collaborative also notes one in 330 California children have lost either a parent or caregiver in the last two years, adding significant stress and trauma to the lives of California’s youth, along with stay-at-home orders and remote learning. “If the past few years have taught us anything, it’s that we need to be proactive in addressing mental health and wellness needs early on, before traumas have a chance to manifest later in life,” said Amrita Rai, IEHP’s clinical director of community behavioral health. Through SBHIP efforts, existing mental health initiatives will be bolstered, and coordination between schools, managed care plans, county behavioral health and community partners aim to address the equity gap and improve access to mental health prevention and treatment for students. Resources will be directed to fill gaps in these areas throughout the participating schools and their respective communities. Services will be limited to schools who are participating in SBHIP and who receive funding. “We are well into a crisis when it comes to the mental health and wellness of our youth. Now is the time to be bold and work tirelessly for our children because what we do now will affect generations to come,” said Rai. “Why not focus our resources, our passion, and our commitment back into the community and schools? Our children spend most of their lives in school, which makes this multi-organizational partnership so worthwhile.” Partnerships with local education agencies and school sites include San Bernardino County Superintendent of Schools (SBCSS); Riverside County of Education; Palm Springs Unified School District; Hemet Unified School District; San Bernardino City Unified School District; Rialto Unified School District; Victor Valley Union High School; Ontario-Montclair School District; Leadership Military Academy; Nuview Union School District; Provisional Accelerated Learning Academy; and Riverside County Office of Education Alternative Education Program. While the initiative will begin at these partner sites, it is anticipated that learnings would benefit other schools and districts interested in implementing similar programs in the future. “San Bernardino County Superintendent of Schools recognizes the growing mental health crisis among our youth and supports this joint effort to address this critical issue,” said County Superintendent Ted Alejandre. “SBCSS seeks to build capacity within countywide systems and increase access to much needed support to ensure every child receives the services they need when they need them.” “Educators at the Riverside County Office of Education and within all Local Educational Agencies (LEA) in Riverside County, are vitally interested in addressing the needs of the whole student beyond the classroom. Linking arms with partners across the county via the Student Behavioral Health Incentive Program (SBHIP) will equitably provide mental health services to those who might not otherwise have access to this level of support,” said Riverside County Superintendent of Schools, Dr. Edwin Gomez. Selection of school districts and charter schools was dependent on DHCS guidelines and considered specific criteria, such as the number of students who received Medi-Cal, were foster youth or English learners, received free or reduced priced meals, were interested in participating in the program and other factors. “It’s the right thing to do. This program gives us a great opportunity to extend both heart and hand to children in our community,” said Dr. Takashi Wada, IEHP’s chief medical officer. “Working together, we can equip them with necessary skills, habits and care they can use today and through adulthood, setting them up for a healthier and happier tomorrow.” “The COVID-19 pandemic has exacerbated and elevated behavioral health needs in our communities, including in young people. Mental and emotional wellbeing make up a significant portion of overall health and healthy youth lead to improved community wellness. We are proud to partner with IEHP, local offices of education and mental health professionals to address the youth behavioral health crisis in tangible, preventative ways.” said Dr. Sayeed Khan, chief medical officer at Molina Healthcare. Program preparation began this year and will support a January 2023 launch at all 10 participating local education agencies. Through careful planning and implementation, the program will aim to build and support a sustainable system beyond the life of the program, which will end in December 2024. alt=" "="" src="-/media/7c6d40e217094fb1be8ec6cec9473878.ashx?h=233&w=350" class="" />
Latest News - Celebrity Chef Provides Healthy Cooking Demos to I.E. Residents
althy cooking to the Inland Empire (I.E.) by showing Members and community residents how to cook delicious, traditional meals with a healthy and spicy twist at the health plan’s Victorville Community Resource Center. A 2018 MasterChef Latino judge, Chef Mario is a Boyle Heights native and has expertise elevating the culinary experience of residents in and around the Los Angeles area. Chef Mario’s demonstrations highlight cooking with both new and familiar ingredients that are proven to address common health issues in the region, including diabetes and hypertension. “Healthy eating doesn’t need to mean bland or boring food and Chef Mario knows how to make that possible,” said IEHP’s Community Health Senior Director Cesar Armendariz. “We’re thrilled to connect Chef Mario to our Members and communities to learn how to better utilize spices and well-known ingredients to better manage our health and wellness in a vibrant, delicious manner.” Chef Mario’s cooking demonstrations are open to the community and take place in July every Tuesday from 12:30 p.m. - 1:30 p.m. Classes in August will be every Thursday from 10:30 a.m. - 11:30 a.m. at the health plan’s Victorville center, located at 12353 Mariposa Road, Suites C-2 & C-3. IEHP also plans to record demonstrations for public use in the coming months. “This partnership means so much to me on a personal level. A healthy way of life should be available to all – it’s such an important component of health care that is often ignored,” said Chef Mario. “Food is the connection to everything, from our physical well-being to our mental well-being. There has been no greater time than now to embrace healthy eating but not sacrifice the flavor. I'm so excited to partner with IEHP and have so many fun demos, recipes and other surprises coming.” In addition, IEHP will connect Chef Mario to community partners for additional cooking demonstrations and civic events. “IEHP is proud to provide education and resources to Members and community residents who want to learn how to better manage their health through cooking. We’re excited to have Chef Mario’s help as we continue to look for ways to serve our community,” said IEHP Chief Executive Officer Jarrod McNaughton. To learn more about IEHP’s Community Resource Centers or to find a nutrition class, visit the community resource page. alt=" "="" src="-/media/dc4dca59a6f446009bdb09836af76cc9.ashx?h=400&w=300" class="" />
Latest News - Dr. Takashi Wada Named IEHP Chief Medical Officer
a will oversee IEHP’s Health Services department and collaboratively lead the implementation of initiatives such as CalAIM, Home and Community-Based Services, the organization’s Strategic Plan, and more. In addition, Dr. Wada will provide clinical and strategic leadership through accountable processes to improve the quality-of-care delivery with improved external quality metrics. “With innovative healthcare initiatives rolling out at state and federal levels, I’m eager to lead and support our team’s work, so that we may contribute in new and meaningful ways that will positively impact the wellness of our own members and communities,” he said. Dr. Wada joined IEHP in 2019 as Vice President of Population Health. In this capacity, he oversaw the internal departments of Behavioral Health & Care Management, Community & Family Health, Health Education, and Practice Transformation. He also played a key role in various statewide and regional population health initiatives. Prior to his role at IEHP, Dr. Wada served as Chief Medical Officer/ Deputy Chief Medical Officer for CenCal Health and Director/Health Officer for Santa Barbara County’s Health Department. Dr. Wada received an undergraduate degree in biomedical sciences from University of California, Riverside, and a master’s degree in public health from University of California, Los Angeles (UCLA). He completed his medical degree from UCLA and his graduate medical education at Kaiser Permanente Los Angeles Medical Center. “Dr. Wada truly has a passion for this work,” said IEHP Chief Executive Officer Jarrod McNaughton. “I couldn’t be more thrilled that he is joining our Executive Team. We are absolutely looking forward to working with Dr. Wada in his new role and continuing our mission to heal and inspire the human spirit.”
COVID-19 - Coronavirus
symptoms of COVID-19 People with COVID-19 have had a wide range of symptoms reported, ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. Anyone can have mild to severe symptoms, including: Fever or chills Cough Shortness of breath or difficulty breathing Fatigue Muscle or body aches Headache New loss of taste or smell Sore throat Congestion or runny nose Nausea or vomiting Diarrhea Go to the hospital or seek emergency medical attention right away if you develop severe COVID-19 symptoms, including: Trouble breathing Persistent pain or pressure in the chest New confusion Inability to wake or stay awake Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone What to do if you are feeling sick If you are experiencing any of these symptoms, consider the following actions: Get tested for COVID-19: It is free. IEHP will also pay for members who receive standard COVID-19 testing and doctor-ordered tests, no matter what type of test. Your doctor is required to bill IEHP directly for these tests. Visit your doctor or an urgent care center either in-person or telehealth access within 24 hours of symptoms starting. For IEHP members, if you can’t reach your doctor or if it’s after-hours, you can call IEHP’s 24-Hour Nurse Advice Line at 1-888-244-4347 or 711 for TTY users, 24 hours a day, seven days a week. Our trained nurses offer medical advice and, if needed, will connect you with a doctor via phone or video chat. Facts about COVID-19 treatments Most COVID-19 treatments are pills that you take at home. COVID-19 medications are free in California. You don’t need to have insurance or be a U.S. citizen. COVID-19 medications work best when started as soon as possible, within the first 5-7 days of symptoms. If you think you may have COVID, don’t wait for symptoms to get worse. COVID-19 medications are safe and effective at stopping COVID-19 illness from getting serious. They can lower the risk of serious illness, hospitalization, and death from COVID-19 by half or more. COVID-19 medications may help you test negative sooner and may reduce the risk of long COVID symptoms.* COVID-19 medications are recommended for people 12 years and older who have certain health conditions or other common factors that increase risk. A doctor can tell you if you are eligible to receive COVID-19 medications and which type is best for you. COVID-19 medications are effective whether you are vaccinated or not. If you test positive for COVID-19, have symptoms, and meet the following criteria, you should seek treatment: You are 50 years old or older –OR– You are unvaccinated or not up to date with COVID-19 vaccinations –OR– You have a health condition or other factors that increase risk. These include obesity, asthma, diabetes, lack of physical activity, smoking, mental health conditions such as depression, being of a racial/ethnic minority, and more. Learn more about medical conditions that increase the risk of serious illness from COVID-19. Click here for more information on mental health and mood conditions. * Early evidence suggests that the COVID-19 medication Paxlovid may decrease the risk of developing long COVID symptoms. These symptoms can last for weeks, months or years after a COVID-19 infection. How to get tested for COVID-19 It’s important to know how and when to test for COVID-19. Testing can give you peace of mind, provide you with information to help you make decisions about your health and help slow the spread of the virus in our community. Where to get tested for COVID-19 Visit our link for more information: https://www.iehp.org/en/members/covid-19?target=covid-19-testing-sites What if you test positive for COVID-19 Self-isolate to avoid spreading the virus to others; click here for tips about isolation and precautions for people with COVID-19 Immediately seek treatment options How to get treatment Contact your doctor’s office Contact your pharmacy Visit a test-to-treat location
P4P - Proposition 56 - GEMT - Proposition 56 & GEMT
2016, now includes proposed supplemental payments for physicians participating in Medi-Cal Fee-For-Service (FFS) and Medi-Cal Managed Care. Proposition 56 FAQs SFY 19/20 (PDF) Published: October 24, 2022 Click on the following links to jump to that specific section: Electronic Payments Ground Emergency Medical Transport (GEMT) Payment Adverse Childhood Experiences Screening (ACES) Services HYDE Developmental Screening Services Proposition 56 and GEMT Payment Schedule Family Planning Services Proposition 56 Payment Dispute Process Electronic Payments With the current public health situation that our country is experiencing, it is necessary for IEHP to take additional precautions to ensure the health and well-being of our community. These precautions are being reviewed, and discussed daily, by our Executive leadership team and will be implemented as deemed necessary. Future COVID-19 precautions may include reduced on-site staffing and prioritization of electronic payments over printed checks. To minimize any disruption or delay in payment, we recommend that you sign up for electronic payments as soon as possible if you have not done so already. Our team is available to assist you with the necessary paperwork required to make this change or to answer any questions you may have. The team can be reached by e-mailing email@example.com or by calling (909) 294-3928 and selecting Option 1. Our priority remains keeping our Members, Providers, Vendors, and Team Members safe while doing what we can to minimize the potential spread of the virus. We will continue to work hard to provide you with the level of service you have come to expect during this uncertain time. (Back to Prop 56 Menu) Adverse Childhood Experiences Screening (ACES) Services Proposition 56 Adverse Childhood Experience Screening (ACES) Services (PDF) Published: May 15, 2020 FAQs on Proposition 56 Payment - Adverse Childhood Experience Screening (ACES) Services (PDF) Published: October 14, 2021 PSA Videos: Do More Ask Resilience (Back to Prop 56 Menu) Developmental Screening Services Proposition 56 Developmental Screening Services (PDF) Published: March 19, 2020 FAQs on Proposition 56 - Developmental Screening Services (PDF) Published: October 14, 2021 (Back to Prop 56 Menu) Family Planning Services Proposition 56 - Family Planning Services (PDF) Published: June 1, 2022 FAQs on Proposition 56 - Family Planning Screening Services (PDF) Published: October 13, 2022 (Back to Prop 56 Menu) Ground Emergency Medical Transport (GEMT) Payment The Department of Health Care Services (DHCS) has established a Ground Emergency Medical Transport (GEMT) Quality Assurance Fee (QAF) program. In accordance with 42 USC Section 1396u-2(b)(2)(D), Title 42 of the Code of Federal Regulations part 438.114(c), and WIC Sections 14129-14129.7, Medi-Cal Managed Care Health Plans must provide increased reimbursement rates for specified GEMT services to non-contracted GEMT providers. SPA 18-004 implements a one-year QAF program and reimbursement add-on for GEMT provided by emergency medical transportation providers effective for State Fiscal Year (SFY) 2018-19 from July 1, 2018, to June 30, 2019. GEMT Program Overview (PDF) FAQs on GEMT (PDF) GEMT Dispute Request Form (PDF) Please email completed forms to Prop56Inquiry@iehp.org or fax to (909) 296-3550. (Back to Prop 56 Menu) HYDE Proposition 56 HYDE Services (PDF) Published: May 15, 2020 FAQs on Proposition 56 - HYDE Services (PDF) Published: October 14, 2021 (Back to Prop 56 Menu) Proposition 56 and GEMT Payment Schedule Proposition 56 and GEMT Supplemental Payment Schedule CY2023 Updated: January 6, 2023 (Back to Prop 56 Menu) Proposition 56 Payment Dispute Process Proposition 56 - Paid Claims Dispute Request Form (PDF) Proposition 56 - Encounter Dispute Request Form (PDF) Please email completed forms to Prop56Inquiry@iehp.org or fax to (909) 296-3550. (Back to Prop 56 Menu) You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.