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COVID-19 - COVID-19 Vaccine
c9; border: none; color: white !important; padding: 15px 32px; margin: 25px 0; border-radius: 25px; display: inline-block; text-align: center; cursor: pointer; } COVID-19 Vaccines: Latest news and updates The COVID-19 vaccines are safe, effective and free for all IEHP Members. Recommended for everyone ages 5 and older, the vaccines can help protect people from severe illness, hospitalization and death due to COVID-19. The vaccines won’t make people sick or give them COVID-19. They may have some minor side effects, which are not harmful and should last no more than a few days. The vaccines can help us end the pandemic and save lives. Vaccinated people should keep wearing a mask, washing their hands often and maintaining at least 6 feet of distance in public places. IEHP Members can learn more by continuing to visit the IEHP website and or visiting the California Department of Health’s website. CLICK HERE TO FIND A VACCINE CLINIC NEAR YOU How vaccines build immunity While the COVID-19 vaccines are relatively new - the technology and science behind the vaccines have been in development for decades. In the video below, we demonstrate how years of vaccine research and advanced technology allowed researchers and scientists worldwide to be prepared to develop an mRNA vaccine that could help fight the spread of a global infectious disease. Please view our video to learn more on how vaccines build immunity. PFIZER VACCINE GETS FULL FDA APPROVAL On August 23, 2021, the U.S. Food and Drug Administration (FDA) approved the first COVID-19 vaccine – the Pfizer-BioNTech COVID-19 Vaccine (widely known as the Pfizer vaccine). The approved vaccine will now be marketed as Comirnaty (koe-mir’-na-tee) for the prevention of COVID-19 disease in people 16 years of age and older. Effective October 29, 2021 the Pfizer vaccine is available under emergency use authorization, including for use by children aged 5 through 18 years of age and for the administration of a booster dose in certain immunocompromised people. Please note, the Pfizer vaccine and Comirnaty are the same vaccine. The FDA reports that they have the same formulation and are interchangeable. Where can I get the vaccine? For Members who want the vaccine, there are several options: IEHP recommends My Turn online at myturn.ca.gov. My Turn online, a website from the California Department of Public Health, is a convenient, one-stop website where those who want a COVID-19 vaccine can: Set up their first, second and booster shot appointments Set up family or group appointments Find walk-in clinics in their area Set up in-home vaccinations (if needed) Arrange for transportation (if needed) For those without internet access, the California COVID-19 Hotline at 1-833-422-4255 can help provide the same services. Large pharmacy chains, like CVS and Walgreens provide the vaccine. Many have walk-in appointments available. IEHP recommends calling the pharmacy first to confirm. Vaccine appointment sign-ups are also available online through the public health department in your county. For Riverside County, visit www.ruhealth.org/covid-19-vaccine. For San Bernardino County, visit www.sbcovid19.com/vaccine/. Do I have to pay for the vaccine? No. The vaccine is free for everyone who wants it. Is the vaccine safe? Yes, the top medical experts in our nation and state agree that COVID-19 vaccines are safe and effective. The vaccines were tested in large clinical trials to make sure they meet safety standards. Many people from different ages, races, and ethnic groups, as well as those with different medical conditions, were part of the trials. Does the vaccine have side effects? Most people do not have serious problems after being vaccinated for COVID-19. Any minor symptoms that result usually go away on their own within a week. Call your Doctor immediately if you start to have any of the following symptoms: severe headache, abdominal pain, leg pain/swelling, or shortness of breath, chest pain, feelings of having a fast-beating, fluttering or pounding heart. Your Doctor or health care provider will explain any potential side effects and what you need to do about them. Since the emergency use authorization of the Moderna and Pfizer-BioNTech COVID-19 vaccines, myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining outside the heart) have occurred in some people who have received these vaccines. In most of these people, symptoms began within a few days following the second dose of these vaccines. There have been confirmed reports of myocarditis or pericarditis in individuals who received COVID -19 vaccine, particularly among males ages 30 and younger. While this is concerning and is under further investigation, myocarditis or pericarditis after COVID vaccination is extremely rare as more than 318 million doses of COVID-19 vaccines have been administered in the United States from December 14, 2020 through June 21, 2021. Will there be any long-term side effects? COVID-19 vaccines are being tested in large clinical trials to assess their safety. It will take time and more people will need to get the vaccine before we learn about very rare or long-term side effects. The Food and Drug Administration (FDA) and the U.S. Centers for Disease Control (CDC) will continue to monitor the safety of COVID-19 vaccines. Health care providers are required to report any problems or adverse events following vaccination to the Vaccine Adverse Event Reporting System (VAERS). What if I have side effects? Contact your Doctor right away. The CDC offers a smartphone-based tool called v-safe to check in on people’s health after they receive a COVID-19 vaccine. When you get your vaccine, you should also get a v-safe handout telling you how to enroll in the program. If you enroll, you will get regular text messages with links to surveys where you can report any problems or side effects after getting a COVID-19 vaccine. Can the vaccine give me COVID-19? No, the vaccine cannot give you COVID-19 because it does not contain an infectious virus. How many shots will be needed? The Pfizer and Moderna vaccines require two shots, 3 to 4 weeks apart. While the first shot helps build protection, you will need to come back a few weeks later for the second one to get the most protection the vaccine can offer. Your Doctor will advise you when you should return for the second shot, as it varies by type of vaccine. The J&J vaccine requires only one shot. Do I need the booster shot? Studies show after getting vaccinated against COVID-19, protection against the virus and the ability to prevent infection with variants may decrease over time and due to changes in variants. However, the booster shot may increase your immune response to COVID-19 and its variants, increasing prevention efforts against the virus. Who can get a booster shot? Booster shots are available to everyone ages 12 years and older who are fully vaccinated but the timing of the booster varies by vaccine and age group. When can I get the booster shot? If you received the Pfizer-BioNTech vaccine, everyone 12 years or older should get the booster at least five months after completing your primary COVID-19 vaccination series. If you received the Moderna vaccine, adults 18 years and older should get the booster at least six months after completing your primary COVID-19 vaccination series. If you received the Johnson & Johnson’s Janssen vaccine, adults 18 years and older should get the booster at least two months after receiving your J&J/Janssen COVID-19 vaccination. Does the booster shot have side effects? You may experience side effects after getting the booster shot. These are normal signs that your body is building protection against COVID-19. Do I need to keep wearing a mask and avoiding close contact with others once I get fully vaccinated? Yes. While experts learn more about the protection that COVID-19 vaccines provide, please keep using all the tools we know can help stop the spread of COVID-19. This means keep wearing a mask, washing your hands often, avoiding crowds, and maintaining at least 6 feet of distance in public places. Can children and babies get COVID-19? Yes. Children can get COVID-19. Most children with COVID-19 have mild symptoms, or they may have no symptoms at all, which is called being asymptomatic. Fewer children have been sick with COVID-19 compared to adults. But, infants (children younger than 1 year old) and children with certain medical conditions might have a higher risk for getting COVID-19. Can children get a COVID-19 vaccine? COVID-19 vaccines are approved for children 5 years old and older. To learn more, visit the CDC website and/or your county’s public health departments online: Click here for San Bernardino County Click here for Riverside County Can I take the COVID-19 vaccine and the flu vaccine at the same time? Yes. The CDC has approved the use of routine vaccines for children, adolescents and adults (including pregnant women) on the same day as COVID-19 vaccines (as well as within 14 days of each other). Talk to your Doctor about what’s best for you. If I have previously tested positive for COVID-19, can I still get the vaccine? Yes. People are advised to get a COVID-19 vaccine even if they have been sick with COVID-19 before. This is because re-infection with COVID-19 is possible. Those who had a diagnosis in the past three months, be sure to talk to your Doctor about when you should get the vaccine. Will IEHP provide transportation to a COVID-19 vaccine clinic? Yes, IEHP will provide transportation to a COVID-19 vaccine clinic in the county where you live. How do I request transportation? Contact IEHP Transportation Call Center at 1-800-440-4347. Will the drive wait with me? No, the driver will not wait. Transportation will be provided as a roundtrip. You will need to contact the transportation provider to request a return pickup once you are ready. Can I take my family members? IEHP will provide transportation to an IEHP Member and one other passenger. How much time is needed to request transportation? IEHP will assist with transportation to the COVID-19 vaccine clinic in fewer than 5 business days. However, we cannot guarantee same-day requests. Where can I learn about COVID-19 and COVID-19 vaccines? IEHP Members can learn more by visiting the IEHP website or the California Department of Health’s website. Members can also learn more about COVID-19 at the California Coronavirus Response website or the CDC’s website
Managing Your Illness - Prediabetes
ne 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 Text “DPP” to 313131, or Call Skinny Gene Project at (909) 922- 0022, Monday - Friday 8am – 5pm., or Email email@example.com Click on the video below to learn more about this program.
COVID-19 - Testing Locations
provider, and receive treatment for COVID-19 – all in one place at a Test to Treat site. If you have a medical condition which makes you more likely to get very sick from COVID-19, you may be eligible to receive treatments. Adults and Children over the age of 12 can receive treatments, but treatment must be started as soon as possible and within 5 days of symptom onset. Click here for more information on the COVID-19 Test to Treat Program. Walgreens Test to Treat Program Select Walgreens pharmacies are now dispensing oral antivirals for the treatment of COVID-19. Eligible members must have a valid prescription from their healthcare provider. Walgreens offers a variety of delivery options, like same day or free 2-day delivery. Most prescriptions are eligible for Same Day Delivery. Click here for more information. FREE at-home COVID-19 tests Every home in the U.S. is eligible to order one free COVID-19 test kit, which includes four at-home tests. The tests are completely free. Click here to order your free at-home tests from USPS. Effective 2/1/22, Medi-Cal Members can receive at-home COVID-19 tests from a Medi-Cal enrolled pharmacy. California Department of Health Care Services (DHCS) will cover up to 8 test kits per month per member. For information on which test kits are covered or if you need assistance with a prescription, please ask your Doctor or your Pharmacist. Medi-Cal Members will be reimbursed for at-home test kits purchased between March 11, 2021, and January 31, 2022, by DHCS the cost (with a receipt) using the process outlined here. San Bernardino County-facilitated testing sites will offer free at-home COVID-19 tests kits to people who live, work, or attend school in San Bernardino County (proof of residency or employment required). Click here to find a list of county-facilitated testing sites. Testing IEHP covers provider-ordered tests, regardless of whether it’s PCR, rapid, at-home, etc. If your doctor orders the test for you, IEHP will cover the cost of the test. Your provider is required to bill IEHP directly for these tests. IEHP does NOT reimburse Members who choose to pay for COVID tests that are not ordered by a provider. For information on COVID-19 testing sites in Riverside County, please visit the Riverside County Public Health website. For information on COVID-19 testing sites in San Bernardino County, please visit the San Bernardino County COVID Testing Sites.
Well-care Visit - Well-care Visit
our child stay healthy. During the well-care visit, the Doctor will complete a physical exam, and make sure you or your child are up to date on all shots. Please call your Doctor today and set up a well-care visit to get needed shots, screenings or exams. What do you need to do? Get a well-care visit with your or your child’s Doctor by 12/15/23.* The Doctor will send proof of the visit to IEHP. Once IEHP receives proof of the visit, a reward certificate will be mailed.** Choose your gift card from the list of major companies online, over the phone or by mail, and your $25 gift card will be mailed to you.*** 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. *Member must be eligible with IEHP on the day of the exam and at the time of gift card distribution. **Reward certificate may be mailed up to two weeks after IEHP receives proof of your exam. ***After choosing your gift card, please allow two to three weeks for delivery. Note: Gift card cannot be used to purchase alcohol, tobacco or firearms.
Diabetic eye exam
s with your retinas over time. Your retinas are parts of your eyes that help you see. Over a long period of time, blood sugar levels can damage blood vessels in your retinas, leading to retinopathy. This can cause symptoms like swelling, blurred vision or vision loss. Even if you have no symptoms, it’s still a good idea to get a full eye exam to screen for that is not normal. What do you need to do? If you don’t have an IEHP Eye Doctor yet, visit our Provider Search Tool (select Vision Services) to find one near you. Make an appointment with your IEHP Eye Doctor and get a dilated or retinal eye exam by 12/15/2023. The IEHP Eye Doctor will send proof of your exam to IEHP.* Once IEHP gets proof of your exam, we will mail you a reward certificate.** Choose your gift card from the list of major companies online, over the phone or by mail, and your $25 gift card will be mailed to you.** 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 must be eligible with IEHP on the day of your exam or service and at the time the gift card is sent. **Reward may be mailed up to two weeks after IEHP receives proof of your exam. ***After choosing your gift card, please allow two to three weeks for delivery. Note: Gift card cannot be used to purchase alcohol, tobacco or firearms.
How to Get Care - Medicine Safety
Answers What can happen if I take a few medicines at the same time? When you take two or more medicines, they will likely mix well. On certain occasions, you might have what’s called a “drug-to-drug interaction.” This means that some medicines you take together may cause an adverse reaction in your body. For example, a “drug-to-drug” interaction could: make your medicines not work as well (weaken them) make one or more of the medicines too strong and cause unwanted side effects, which could be deadly TIP: Talk to your Pharmacist about all medicines you take and ask if they mix well together. What are some reasons that I might have a harmful effect from taking one or more medicines at the same time? These reasons might include: dose may be too high interaction with other drugs Note: Everyone can react differently – based on age, weight, gender, etc. TIP: To avoid problems when taking two or more medicines together, tell your health care Provider and Pharmacist about all the medicines (and other remedies) you are taking. How do I know if I’m taking the right medicine – at the right dose, at the right time to control my symptoms? Any medicine taken the wrong way might put your health at risk. A drug maker has to show research data to the FDA to get each medicine approved. This research could be about: how the medicine works why it is safe to take (or not) what dose works best with the fewest side effects Could a medicine taken at a high dose be harmful? Yes. That is why your Pharmacist checks your medicines to make sure you are on the right dose. Don’t forget to ask your Doctor or Pharmacist any questions about your medicine. Taking higher than recommended doses of certain over-the-counter (OTC) and prescription medicines – including abuse or misuse of the medicines – can cause serious health problems. It could even lead to death. Also, a dose that is safe for you may not be safe for someone else. Who most often needs to have their medicine dose changed and why? Certain people need to have their dose changed, so that they don’t take too much (called “overdosing”). These include the elderly, children, and women who are pregnant or mothers who are breastfeeding, and people with chronic health conditions. Always ask your Pharmacist if the medicines are safe for you to take at the prescribed doses. Don’t share your medicines with friends or family. What are “duplicate drug therapies”? Why do I need to know about this? You might have different Doctors who have prescribed medicines that work in the same way for you. When medicines have similar active ingredients, they could be: the same medicine with different names (for example, one could have a brand name and the other might have a generic name), or two medicines of similar nature TIP: Be cautious about taking the same medicine twice – as you could have two bottles of the same medicine! TIP: It’s important for you to keep a full list of each medicine, vitamin and herbal remedy you are taking. Please show this list to your Pharmacist or your Doctor. The list helps your health care Provider check for any unwanted effects between drugs and check that the two or more medicines work well for you or not. What happens if my medicine is recalled? A recall may be issued if a medication is: A health hazard: If there is some health risk associated with the medication. Mislabeled or packaged poorly: If there is a problem with the dosing tool provided with the drug. Poorly manufactured: If there are defects related to poor quality, impurities, and incorrectly potency of the drug from the manufacturer. Please click here to view an up-to-date list of drug recall notifications. Why are some medicines “high risk” for the elderly? Some medicines can be too strong for a certain group of people and are considered “high risk” for them. This special group may include older people, pregnant women or mothers who are breastfeeding, children, and people with other medical conditions affecting their kidney or liver. For example, certain medicines prescribed for memory issues may have a side-effect that causes dizziness in some seniors who are at “high risk” for falling. In that case, an alternative medicine (or no medicine) for this condition would be better. Where can I find details about medicines that might be harmful for older people? If you are over 65 years old, ask your Doctor or Pharmacist if the medicines you are taking may not be right for you. Please see the short list below of the most common medicines prescribed that may be harmful for older people. Older adults (age 65+): Check with your Doctor first before taking these medicines: Medicine or Medicine Class Potential Risks Sliding scale insulin May make your blood sugar level too low – without improving the condition Glyburide May cause a long period of excessively low blood sugar Muscle relaxants May be poorly tolerated Barbiturates May increase risk of dependence and overdose Benzodiazepines (alprazolam, temazepam, lorazepam) May increase risk of falls and fractures To learn more, visit: https://www.pharmacytoday.org/article/S1042-0991(19)31235-6/fulltext Pharmacy Benefits: Medi-Cal Members IEHP Dual Choice Cal MediConnect Members
Plan Updates - Medicare Beneficiary Identifier (MBI)
d Services (CMS) to remove Social Security Numbers (SSN) from all Medicare cards to address the risk of Medicare beneficiary medical identity theft. CMS will mail out new Medicare Cards to Medicare Beneficiaries starting April 2018 through April 2019. By clicking on the CMS web links below, you will be leaving the IEHP website. For more information regarding the new Medicare cards, please visit https://www.cms.gov/medicare/new-medicare-card/nmc-home.html. For an overview of the new Medicare cards, please visit https://www.cms.gov/medicare/new-medicare-card/nmc-home. New Medicare card resources: New Medicare Card: Information for Partners & Stakeholders (PPT) You're getting a new Medicare card! (PDF) New Card! New Number! (PDF) "10 Things to Know About Your New Medicare Card" (PDF) Your New Medicare Card: Information for People with Medicare (PPT) For additional resources regarding the new Medicare cards, please visit https://www.cms.gov/Medicare/New-Medicare-Card/Partners-and-Employers/Partners-and-Employers.html. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Plan Updates - Regulatory Updates
reventable Conditions. Visit Reporting of Provider Preventable Conditions for DHCS instructions for online reporting. By clicking on these links, you will be leaving the IEHP website. Medicare Outpatient Observation Notice (MOON) In the event any Medicare recipient has been in a status of outpatient observation for greater than 24 hours, Acute Hospitals are required to provide Medicare Members with a Medicare Outpatient Observation Notice (MOON). Medicare recipients must receive the MOON within 36 hours of admission to observation level of care. Please refer to the following website for further details on MOON requirements at https://www.federalregister.gov/articles/2016/08/22/2016-18476/medicare-program-hospital-inpatient-prospective-payment-system-for-acute-care-hospitals-etc. By clicking on this link, you will be leaving the IEHP website. Document Catalog: MOON FAQs (PDF) MOON Instruction Summary (PDF) CMS Manual System 10611_Pub 100-04 Medicare Claims Processing MOON Instructions (PDF) MOON Forms MOON English (PDF) MOON Spanish (PDF) MOON Correspondence (PDF) You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Pharmacy Services - Academic Detailing
treach program for our providers and pharmacies. We perform phone and one-on-one outreaches with physicians, nurse practitioners, physician assistants, and pharmacy staff. Our goal is to transform the prescriber and pharmacy practice and enhance the provider, pharmacist and member experience. Clinical Drug Education Clinical Drug Education provides materials that focus on a specific drug, drug class, and/or disease state. These materials contain pharmacological and clinical practice information to assist providers and pharmacies in their practice. As new drug information is available, it is important to stay up to date on clinical research findings to assist with member care and medication-use decisions. Practice Development Practice development education provides materials that focus on enhancing provider and member experience. The materials contain guidance on Formulary Utilization and PA submissions as well as insights regarding electronic prescribing and electronic health records. It is our commitment to provider practice optimization tools and resources to enhance member care. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. Click here to download a free copy by clicking Adobe Acrobat Reader. By clicking on this link, you will be leaving the IEHP website. Biosimilars A growing trend in healthcare is the use of biosimilar drugs. The following information will assist you and your practice on prescribing biosimilars. What is a Biosimilar? (PDF) Biosimilars: Are They the Same Quality? (PDF) Biological Product Definitions (PDF) Prescribing Biosimilar Products (PDF) Prescribing Interchangeable Products (PDF) Opioid and Chronic Pain Management In collaboration with Riverside University Health System (RUHS) and Centers for Disease Control and Prevention (CDC), IEHP would like to provide the following information to assist you and your practice on prescribing opioids for chronic pain management. CURES CURES FAQ (PDF) CURES 2.0 User Guide (PDF) CURES tips and tricks (PDF) Naloxone Naxolone Drug facts (PDF) Naxolone instructions for use (PDF) First Responder Naxolone administration fact sheet (PDF) Opioid Prescribing Guidelines Medication Assisted Treatment (MAT) and Opioid Treatment Program (OTP) FAQ (PDF) CDC Guideline Infographic (PDF) CDC Guidelines Factsheet (PDF) TurnTheTide Pocket Guide for Prescribing Opioids for Chronic Pain (PDF) CDC Guideline at a Glance Opioid Tapering Clinical Pocket Guide to Tapering (PDF) Tapering Resource-AAFP (PDF) Opioid Tapering Resource pack (PDF) Pharmacy Medication Assisted Treatment (MAT) for Substance Abuse (PDF) Urine Drug Testing CDC Clinical Practice Guideline for Prescribing Opioids for Pain UDT for monitoring opioid therapy-AAFP (PDF) X-Waiver X-Waiver resources Removal of DATA Waiver (X-Waiver) Requirement https://www.samhsa.gov/medications-substance-use-disorders/removal-data-waiver-requirement All prescriptions for buprenorphine will now only require a standard DEA registration number. For additional information on the removal of the DATA-Waiver requirement, see the Removal of DATA Waiver (X-Waiver) Requirement. Practice Optimization Electronic Prescribing (e-Rx) Electronic prescribing is a growing standard in the healthcare industry. Most electronic health record systems offer electronic prescription capabilities. The information below will provide insight to the practice of e-prescribing. Benefits of e-Rx brochure (PDF) Formulary Utilization The IEHP Formulary offers a variety of drugs based on safety and efficacy for any condition. The information below will help you find out how to access and interpret the formulary Medicare FAQ (PDF) The process of submitting a prior authorization may be cumbersome for your practice. The information below will help you understand this process and assist with receiving a proper decision in a timely manner. For any questions regarding Pharmacy Academic Detailing Training please contact: PharmacyAcademicDetailing@iehp.org You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. Click here to download a free copy by clicking Adobe Acrobat Reader. By clicking on this link, you will be leaving the IEHP website. Information on this page is current as of January 1. 2022
Pharmacy Services - DHCS Medi-Cal Rx
e January 1, 2022, the Medi-Cal pharmacy benefits and services are administered by DHCS in the Fee-For-Service (FFS) delivery system, known as "Medi-Cal Rx." Magellan Medicaid Administration, Inc. (MMA) assumes operations for Medi-Cal Rx on behalf of the State of California Department of Health Care Services (DHCS). How to Register for the User Administration Console (UAC) (PDF) User Administration Console (UAC) Quick Start Guide (PDF) Medi-Cal Rx 101 Webinar Presentation (PDF) IEHP and DHCS strongly recommends our Providers to visit the new Medi-Cal Rx website (https://medi-calrx.dhcs.ca.gov) to register for the Magellan Medi-Cal Rx portal, review schedule of trainings available on the new Medi-Cal Rx Portal, and review general information about the transition. Communication from DHCS Please refer to the DHCS Medi-Cal Rx: Transition and DHCS Medi-Cal Provider Pharmacy News Bulletins pages for additional information. Communication from IEHP While you can always refer to Pharmacy Communication and Provider Correspondence pages, the below list is provided for your convenience. January 02, 2023 - IEHP DualChoice (HMO D-SNP): PBM Update and Medicare Part B Coinsurance (PDF) December 22, 2022 - Cal MediConnect (CMC) to Medi-Cal Rx/HMO D-SNP Transition (PDF) October 28, 2022 - Cal MediConnect to Medi-Cal RX Transition (D-SNP) (PDF) July 29, 2022 - NEW DATE: Medi-Cal RX Gradual Reinstatement of Prior Auths (PAs) – Phase 1 – September 16, 2022 (PDF) July 13, 2022 - DHCS Medi-Cal Rx Update: Postponement of Implementation of NCPDP Reject Code 80 (PDF) July 11, 2022 - Medi-Cal Rx Gradual Reinstatement of PAs - Phase 1 (PDF) June 03, 2022 - Medi-Cal RX Transition: Blood Pressure Monitors and Cuffs (PDF) June 03, 2022 - Medi-Cal RX Billing Policy for Physician Administered Drugs (PADs) (PDF) February 17, 2022 - RETRACTION - Medi-Cal Rx Transition - Continuous Glucose Monitors (CGM - PCP) (PDF) February 17, 2022 - RETRACTION - Medi-Cal Rx Transition - Continuous Glucose Monitors (CGM - IPA) (PDF) February 14, 2022 - Medi-Cal Rx Transition Survey - Your Response is Important! (PDF) February 11, 2022 - Updated - Medi-Cal Rx Transition - Implantable and Injectable Contraceptives FAQs (PDF) February 09, 2022 - Medi-Cal Rx Transition - Hyaluronic Acid Knee Injections (PDF) February 07, 2022 - Medi-Cal Rx UPDATE: Revised Prior Auth Policy for Prescribers and Emergency Fill Quantity Limit (PDF) February 07, 2022 - Medi-Cal Rx Transition - How To Assist IEHP Members (PDF) January 18, 2022 - Medi-Cal Rx Transition - Implantable and Injectable Contraceptives (PDF) January 18, 2022 - Medi-Cal Rx (Magellan) Customer Service (PDF) January 18, 2022 - Medi-Cal Rx Transition - Continuous Glucose Monitors (CGM) (PDF) January 04, 2022 - CORRECTION! Medi-Cal Rx: Mail Order for Blood Pressure Monitors and Nebulizers (PDF) You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Special Programs - Tobacco Cessation Services
acco Cessation Services Provider Education Resources Smoking Cessation Resources - Help your patients quit Tobacco The CDC's Brief Tobacco Intervention ASK In a caring manner, at each visit, ...if your patients use tobacco If they do not, congratulate them If they do, proceed to next step ADVISE Patients who use tobacco to consider quitting. Tobacco products can lead to health problems such as... Heart and Lung Disease Diabetes Stroke Ongoing infections and colds Cancer People exposed to secondhand smoke can also experience these health problems REFER If the patient is interested in quitting, connect them to KICK IT CA and any other local resource (below) Prescribe medications (if appropriate) Congratulate your patient on the decision to quit If patient is not ready to quit, user personalized motivational messages to encourage quitting. Let them know you are here when they are ready. Kick it CA How it works: Patient will receive services from a Coach that has undergone rigorous training & apprenticeships, participates in weekly monitoring and case reviews, and attend continuing education courses on cultural competency. To enroll, patients can call, chat, or complete an online web form. The patient will then receive a Kick-Off call to collect their basic information and find out what they are trying to quit. Right after kick-off, coaching begins. The patient will receive clinically sound motivational interviewing. The coach will help patient put together a quit plan and set a quit date. The patient will then receive check-ins at times they are most susceptible to relapse. The coach will see if their quit-plan is working and help them modify as needed. Phone Number: English - 1 (800) 300-8086 Spanish - 1 (800) 600-8191 Website: KICKITCA.ORG Text: For English: Text "Quit Smoking" or "Quit Vaping" to 66819 For Spanish: Mande "Dejar de Fumar" o "No Vapear" to 66819 Other Smoking Cessation Resources: Link to Resources on Member page: https://iehp.org/en/members/healthy-living?target=smoking-cessation Resources in the Inland Empire: Connect IE Information and Training for Providers: http://www.CAquits.com https://www.cdc.gov/tobacco/ Local Tobacco Control Projects: Tobacco Free San Bernardino County: https://healthcollaborative.org/SBCTobaccoControl/ Tobacco Free Riverside County: https://www.rivcotcp.org/ (Back to Tobacco Cessation Services Menu) Tobacco Cessation Services By clicking on these links, you may be leaving the IEHP website. Training: Comprehensive Tobacco Cessation Services for Medi-Cal Members (PDF) The Smoking Cessation Leadership Center's (SCLC): Recordings Available for CME/CE Credit Kick it CA Education, Training and Technical Assistance: https://kickitca.org/health-professionals 5 Major Steps to Intervention: http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/5steps.html Tobacco Cessation CPT Codes for Identification ACA Facts Sheets and Resources (American Lung Association): https://www.lung.org/policy-advocacy/healthcare-lung-disease/healthcare-policy/affordable-care-act-tobacco Helpline: https://kickitca.org/ (also available in Spanish, Chinese, Korean, and Vietnamese) https://kickitca.org/health-professionals https://kickitca.myshopify.com/collections/all Continuing Medical Education California courses offered through UC Schools of Medicine: https://cmecalifornia.com/Education.aspx Tip: Use key word in search: Tobacco Cessation Centers for Disease Control Coverage for Tobacco Use Cessation Treatments: https://www.cdc.gov/tobacco/quit_smoking/cessation/coverage/ Patients Not Ready to Make a Quit Attempt Now (The “5 R’s”): http://www.ahrq.gov/sites/default/files/wysiwyg/professionals/clinicians-providers/guidelines-recommendations/tobacco/5rs.pdf Smokefree.gov: https://smokefree.gov/help-others-quit/health-professionals University of California San Francisco’s Smoking Cessation Leadership Center’s Tools and Resources: https://smokingcessationleadership.ucsf.edu/ USPSTF-Tobacco Smoking Cessation in Adults, Including Pregnant Women: Behavioral and Pharmacotherapy Interventions: https://www.uspreventiveservicestaskforce.org/uspstf/index.php/recommendation/tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions USPSTF-Tobacco Use in Children and Adolescents: Primary Care Interventions: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/tobacco-and-nicotine-use-prevention-in-children-and-adolescents-primary-care-interventions (Back to Tobacco Cessation Services 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.
Special Programs - Major Organ Transplant (MOT)
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
Special Programs - Total Fracture Care
ticipating Orthopedist for global fracture care without a prior authorization. This Program ensures that Members in need of fracture care by an Orthopedist, as determined by an Emergency Department Physician, Urgent Care Physician or Primary Care Provider, will receive timely access to care. Policy Reference: 10 - Medical Care Standards Total Fracture Care Providers Arrowhead Orthopaedics For more information and locations, please visit: https://www.arrowheadortho.com/ Newport Care Medical Group For more information please call: (951) 363-5064 You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Enroll with IEHP DualChoice
5bab; border: 4px solid #FFD400; margin: 1.25em 0; padding: 1em 3em; font-size: 1.8vh; border-radius: 20px; cursor: pointer; } Trust your heart when it comes to your health-enroll with IEHP DualChoice (HMO D-SNP) If you have both Medi-Cal and Medicare, you may be eligible to enroll in the IEHP DualChoice (HMO D-SNP) plan. Our IEHP DualChoice plan helps you get the care you need to achieve your best possible health. Get covered benefits for $0 including: Doctor visits such as routine checkups and sick visits Prescriptions from the IEHP DualChoice formulary Hospital care such as emergency room and urgently needed servicesAre currently eligible for Medi-Cal, and Specialist case PLUS extra benefits like: Vision care: Up to $350 limit every twelve months for eyeglasses (frames). Lenses are separately reimbursable based on prior approval and medical necessity. Contact Lenses are covered up to $350 every twelve months in lieu of eyeglasses (Lenses and Frames). Utilities allowance of $40 for covered utilities. You must qualify for this benefit. Who is eligible for IEHP DualChoice (HMO D-SNP)? IEHP DualChoice is for people with both Medicare (Part A and B) and Medi-Cal. The following information explains who qualifies for IEHP DualChoice (HMO D-SNP). Included Population: With mandatory enrollment for Medi-Cal benefits, including Long-Term Services and Supports (LTSS) benefits and Medicare benefits. You are eligible for our Plan as long as you: Live in our service area (incarcerated individuals are not considered living in the geographic service area even if they are physically located in it.), and Are age 21 and older at the time of enrollment, and Have both Medicare Part A and Medicare Part B, and Are currently eligible for Medi-Cal, and Are a full-benefit dual eligible beneficiary and enroll in IEHP DualChoice for your Medicare benefits and Inland Empire Health Plan (IEHP) for your Medi-Cal benefits. This is known as “Exclusively Aligned Enrollment”, and Are a United States citizen or are lawfully present in the United States For questions or to enroll over the phone, please call the IEHP DualChoice Medicare Team at 1-800-741-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. TTY users should call 1-800-718-4347. Enroll in IEHP DualChoice Today! IEHP DualChoice Enrollment Form (PDF) IEHP DualChoice (HMO D-SNP) is a HMO Plan with a Medicare contract. Enrollment in IEHP DualChoice (HMO D-SNP) depends on contact renewal. Information on this page is current as of October 01, 2022. H8894_DSNP_23_3241532_M Pending Accepted
Member Testimonials - Our Members
group of students from the Inland Empire. More than 30 recipient students grew up in the Inland Empire and more than 50% are first generation medical students and grew up in low-income households. Through the scholarship fund, aspiring healthcare professionals will be guided through the system and connected to the health plan’s provider network. This allows students to pursue successful careers in healthcare immediately after graduation to help support the region’s growing population. Loma Linda University School of Medicine Inland Empire Medical Community Service Awardees Class of 2022 Ye Jin Jeon Ye Jin's Why: “I applied for the Inland Empire Medical Community Service Award because the goal and priority to expand access to care and healthcare provider options for the Southern California region aligns with my calling. As a child growing up in the San Bernardino County, I saw the economic disproportion within my own neighborhood, and this compelled me…God has led me pursue my medical career” Class of 2024 Edwin Choque Edwin's Why: “Simply put, my heart lies in the Inland Empire. This community of individuals have fostered me and loved me since I was a child and all I can hope is to pay that love and care forward. . . . My dream is to be on the front lines as a representative for these individuals who frequently become marginalized…” University of California, Riverside Dean's Mission Recipients Four Year Award Elizabeth Celaya-Ojeda Elizabeth's Why: “I want to work particularly with the underserved in this area because I truly believe that being a physician is a privilege and with that there is a responsibility to be an advocate for those who are facing health disparities. I am particularly interested in providing care to underserved Native American and Hispanic communities. Not many healthcare providers are aware of the disparities these two communities face and I want to be an advocate for them, especially in the Inland Empire.” Alfonso Parocua Alfonso's Why: “Growing up, my family lacked meaningful access to healthcare and relied on a local free clinic as our only means of interacting with a physician. Through my personal experience with the free clinic, I developed a passion for service to the underserved communities who lack meaningful access to basic healthcare amenities due to low socioeconomic status. I sought opportunities that would allow me to pay my gratitude forward by becoming part of the solution to healthcare disparities in Inland Southern California. Through my volunteer efforts in free clinics and other community involvement programs, I witnessed the passion and dedication that health care providers and volunteers in the area have towards the underserved community. This realization deepened my connection to Inland Southern California because I was reminded so much of the health care professionals that helped my family when they couldn't help themselves.” Two Year Award Cesar Fortuna Cesar's Why: “A San Bernardino native, I have had the opportunity to volunteer in my community as a Spanish language translator for free clinics. Most patients I have spoken with fell into the category of uninsured, underinsured, or undocumented. It became clear the extent of need in this region when I would translate to the providers that this was the first-time dozens of our patients had ever seen a medical professional; however, this wasn’t uncommon. To these patients and their stories, I thank them because they inspire me to pursue Emergency Medicine where I can become a valuable player in providing care, providing resources, or providing comfort.” Lavinia Mitroi Lavinia's Why: “My goal of pursuing a career at the intersection of medicine and public health is driven by a desire to put patients and communities at the center of our health care system in the U.S. This desire was sparked most poignantly by my own experiences as an IEHP patient growing up in the Inland Empire. As I prepare for a future career as a pediatrician in this region, I hope to serve as an advocate for children and families, providing direct health services but also creating systems change.” Armando Navarro Armando's Why: “The earliest memory of my grandfather is him telling me, “Mijo, tienes que aprender Español para ayudar tu comunidad, you have to learn how to speak Spanish to help your community”. These words were often repeated to me by my grandfather who lamented the fact that he only spoke Spanish. I witnessed the health disparities affecting my community; doctors who did not speak Spanish, parents who could not afford a trip to the doctors’ office, and a healthcare system that was not inclusive of my community’s culture. I have a duty to give back to a school, a community, that has given me so much.” Christ Ordookhanian Christ's Why: “I see the medical profession through the lens of an individual who had lived through challenging times and witnessed how one individual provider can make such and impact when their heart is in the right place. My dedication to our underserved community stems from that of a lifelong mission I have set for myself which is to ensure I give back to a community that I am deeply associated with, they are my founding roots in the United States, and I vow to be at the forefront of the next generation of physicians that care and give the underserved hope.” University of California, Riverside Dean's Mission Recipients Daphne Du Daphne's Why: “I spent most of my life in underprivileged areas and saw firsthand how difficult healthcare access could be through inadequate financial resources, transportation, or translation services. Thanks to this investment in my studies, there is less stress in my life. I can focus on my studies and eventually give back to the community by becoming a physician who will advocate for patients without meaningful access to health care.” Judith Gonzales Judith's Why: “As a first-generation college student, there have always been many barriers in my path to higher education. I am the eldest daughter of an immigrant family, and it is truly an honor to be able to reach this point in my education and in my career, and to give back to my parents who have sacrificed so much for me and my sisters. Growing up in an underserved community showed me the long-lasting impacts of health inequities and strengthened my resolve to pursue a career in medicine. Working in the Inland Empire, I hope to not only address, but actively work towards combating the health inequity present in our communities.” Jordan Hough Jordan's Why: “Despite disadvantages encountered when living in a low-income community, I am grateful for the privilege I had in meeting physicians dedicated to their practice and willing to share that love through mentorship. These individuals have served as exemplary medical professionals and have encouraged me to follow in their footsteps. As a future physician, I aspire to empathetically care for patients by allowing my past experiences to enhance my understanding of their needs. I also plan to incorporate teaching into patient care by presenting opportunities for students to shadow and be mentored for a career in medicine.” Diana Martinez Diana's Why: “I am the daughter of Mexican Immigrants and grew up in Compton, California where I unfortunately was quickly desensitized to violence and was able to tell the difference between a firework and a gun shot. My mother had to travel a significant distance to ensure we had adequate healthcare. Despite these conditions, my parents always stressed education and did their best to give me what I needed. These life circumstances ignited my passion to serve those in disadvantaged communities, which I interacted with throughout my educational career. The Inland Empire Health Program Scholarship means I can achieve my dream –by practicing medicine in a community that deserves adequate, equitable, and accessible healthcare. I will serve as a bilingual physician in the Inland Empire that can serve families like my own and many more.”
Special Programs - Alcohol & Drug (SABIRT)
ant to the Department of Health Care Services (DHCS) APL 21-014 (PDF), “Alcohol and Drug SABIRT,” IEHP has updated its requirements for alcohol and substance use screening in the primary care setting. Helpful resources: Correspondence - June 2022 - Alcohol and Drug SABIRT Training Guide (PDF) Screening Tools Alcohol Use Disorders Identification Test (AUDIT-C) Brief Addiction Monitor (BAM) (PDF) Cut Down-Annoyed-Guilty-Eye-Opener Adapted to Include Drugs (CAGE-AID) (PDF) Tobacco Alcohol, Prescription Medications and other Substances (TAPS) (PDF) National Institute on Drug Abuse (NIDA) Quick Screen for Adults (PDF) Drug Abuse Screening Test (DAST-10) (PDF) Parents, Partner, Past, and Present (4Ps) for pregnant women and adolescents (PDF) Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) for non-pregnant adolescents (PDF) Michigan Alcoholism Screening Test Geriatric (MAST-G) alcohol screening for geriatric population (PDF) Assessment Tools Alcohol Use Disorders Identification Test (AUDIT) (PDF) Brief Addiction Monitor (BAM) (PDF) NIDA-Modified Alcohol, Smoking and Substance Involvement Screening Test (NM-ASSIST) (PDF) Drug Abuse Screening Test (DAST-20) (PDF) Pamphlets Riverside Brochure (English) (PDF) Riverside Brochure (Spanish) (PDF) San Bernardino Brochure (English) (PDF) San Bernardino Brochure (Spanish) (PDF) You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Join Our Network - Hospitals
CA 92324 (909) 580-1000 (909) 580-6308 Barstow Community Hospital 820 E Mountain View Barstow, CA 92311 (760) 256-1761 (760) 957-3397 Bear Valley Community Healthcare District 41870 Garstin Drive Big Bear Lake, CA 92315 (909) 866-6501 (909) 878-8282 Chino Valley Medical Center 5451 Walnut Ave. Chino, CA 91710 (909) 464-8600 (909) 464-8882 Colorado River Medical Center 1401 Baily Ave. Needles, Ca. 92363 (909) 326-7100 (909) 326-7292 Community Hospital of San Bernardino 1805 Medical Center Dr #201 San Bernardino, CA 92411 (909) 887-6333 (909) 806-1044 Corona Regional Medical Center 800 S Main St. Corona, CA 92882 (951) 737-4343 (951) 736-6310 Desert Regional Medical Center 1150 N Indian Canyon Dr. Palm Springs, CA 92262 (760) 323-6511 (760) 323-6330 Desert Valley Hospital 16850 Bear Valley Rd. Victorville, CA 92395 (760) 241-8000 (760) 951-2034 Eisenhower Medical Center 39800 Bob Hope Dr. Rancho Mirage, CA 92270 (760) 340-3911 (760) 773-1532 Hemet Global Medical Center 1117 E Devonshire Ave. Hemet, CA 92543 (951) 652-2811 (951) 765-4745 Hi-Desert Medical Center 6601 White Feather Rd. Joshua Tree, CA 92252 (760) 366-3711 (760) 365-9309 Inland Valley Regional Medical Center 36485 Inland Valley Dr., Wildomar, CA 92595 (951) 677-1111 (951) 698-7721 John F. Kennedy Memorial Hospital 47111 Monroe St. Indio, CA 92201 (760) 347-6191 (760) 775-8014 Loma Linda University Children's Hospital 11234 Anderson St. Loma Linda, CA 92354 (909) 558-8000 (909) 558-3278 Loma Linda University Medical Center 11234 Anderson St. Loma Linda, CA 92354 (909) 651-1702 (909) 478-3202 Loma Linda University Medical Center - Murrieta 28062 Baxter Rd. Murrieta, CA 92563 (951) 290-4000 (951) 290-4092 Menifee Global Medical Center 28400 McCall Blvd. Sun City, CA 92585 (951) 679-8888 (951) 766-6470 Montclair Hospital Medical Center 5000 San Bernardino St. Montclair, CA 91763 (909) 625-5411 (909) 626-4777 Mountains Community Hospital 29101 Hospital Rd. Lake Arrowhead, CA 92352 (909) 336-3651 (909) 336-4730 Palo Verde Hospital 250 N 1st St. Blythe, Ca 92225 (760) 922-4115 (760) 921-5263 Parkview Community Hospital Medical Center 3865 Jackson St. Riverside, CA 92503 (951) 688-2211 (951) 352-5363 Pomona Valley Hospital Medical Center 1798 N. Garey Ave. Pomona, CA 91767 (909) 865-9500 (909) 865-2104 Rancho Springs Medical Center 25500 Medical Center Dr. Murrieta, CA 92562 (951) 696-6000 (619) 627-5949 Redlands Community Hospital 350 Terracina Blvd. Redlands, CA 92373 (909) 335-5500 (909) 335-6497 Riverside Community Hospital 4445 Magnolia Ave. Riverside, CA 92501 (951) 788-3000 (951) 788-3201 Riverside University Health Care System 26520 Cactus Ave. Moreno Valley, CA 92555 (951) 486-4000 (951) 486-4475 San Antonio Regional Hospital 999 San Bernardino Rd. Upland, CA 91786 (909) 985-2811 (909) 920-6357 San Gorgonio Memorial Hospital 600 N Highland Springs Ave., Banning, CA 92220 (951) 845-1121 (951) 845-2836 St. Bernardine Medical Center 2101 N Waterman Ave., San Bernardino, CA 92404 (909) 883-8711 (909) 881-4337 St. Mary Medical Center 18300 US Highway 18 Apple Valley, CA 92307-2206 (760) 242-2311 (760) 946-8714 Temecula Valley Hospital 31700 Temecula Pkwy Temecula, CA 92592 (951) 331-2200 (951) 331-2211 Victor Valley Global Medical Center 15248 Eleventh St. Victorville, CA 92395 (760) 245-8691 (760) 245-6996
Provider Resources - POLST Registry
fornia Physician Orders for Life Sustaining Treatment (POLST) Registry (CPR) to connect a digital POLST network throughout the Inland Empire Healthcare System which includes independent physicians, hospitals, skilled nursing facilities, and the Health Information Exchange (HIE). The goal of this initiative is to provide a more effective means of documenting, communicating, and ensuring Member desired Treatment at the end of life is being honored. By clicking on these links, you will be leaving the IEHP website. To login, visit Working Toward a Statewide POLST Registry in California | POLST (capolst.org) To sign up, simply go to POLST for Healthcare Providers | POLST (capolst.org) CPR Correspondence (PDF) CPR FAQ (PDF) For any questions, please contact Care Directives at (888) 621-4383 or email firstname.lastname@example.org. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.