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Plan Updates - Vaccine Resources

2-2023 influenza season continues to coincide with circulation of COVID-19 virus (SARS-CoV-2). As of August 2022, approximately 94.2 million cases of COVID-19 had been reported in the United States. Influenza vaccination remains an important tool for the prevention of potentially severe respiratory illness, which helps decrease the stress on the U.S. health care system. IEHP DualChoice members who are 18 years of age or older may obtain flu vaccines through the IEHP Pharmacy Vaccine Network. Vaccine Notice: Access to Pharmacy Vaccine Network (PDF) Frequently Asked Influenza (Flu) Questions: 2022-2023 Season (CDC Recommendations) What’s New for 2022-2023  By clicking on these links, you will be leaving the IEHP website. The composition of flu vaccines has been updated. For the 2022-2023 flu season, there are three flu vaccines that are preferentially recommended for people 65 years and older. These are Fluzone High-Dose Quadrivalent vaccine, Flublok Quadrivalent recombinant flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine. The recommended timing of vaccination is similar to last season. For most people who need only one dose for the season, September and October are generally good times to get vaccinated. Vaccination in July and August is not recommended for most adults but can be considered for some groups. While ideally it’s recommended to get vaccinated by the end of October, it’s important to know that vaccination after October can still provide protection during the peak of flu season. The age indication for the cell culture-based inactivated flu vaccine, Flucelvax Quadrivalent (ccIIV4), changed from 2 years and older to 6 months and older. Pre-filled Afluria Quadrivalent flu shots for children are not expected to be available this season. However, children can receive this vaccine from a multidose vial at the recommended dose.   Mpox Information Mpox Vaccination Locations San Bernardino County: Monkeypox (mpox) – Department of Public Health Riverside County: Mpox Vaccine Locations – Riverside University Health System Please advise members to call before going in for a vaccination as some locations are only available with appointments. Members may make appointments for the JYNNEOS vaccine at https://myturn.ca.gov/. Mpox Testing As of December 8, 2022, no commercial testing is available for the diagnosis of Mpox. Providers may contact CDC in the diagnosis, management of patients with suspected Mpox, and for any additional information regarding Mpox connect with the CDC Emergency Operations Center. Phone: 1-770-488-7100, Monday through Friday, 8:00 AM to 4:30 PM EST After Hours Phone: 1-404-639-2888 Treatment Mpox patients usually recover fully within 2-4 weeks without the need for medical treatment. While there are no treatments specifically for Mpox, the virus that causes Mpox is similar to the smallpox virus and therefore antiviral drugs developed to protect against smallpox may be used. The antiviral drug, tecovirimat (TPOXX), has been approved by the FDA to treat smallpox in adults and children. If you prescribe tecovirimat to treat members with Mpox the member must sign a consent form stating tecovirimat is an investigational drug that has not yet been approved by the FDA for treatment of Mpox. More information about tecovirimat visit https://www.cdc.gov/poxvirus/monkeypox/if-sick/treatment.html.   Preventive Services Information Immunizations  By clicking on these links, you will be leaving the IEHP website. CDC ACIP Vaccine Recommendations and Guidelines: https://www.cdc.gov/vaccines/hcp/acip-recs/index.html CDC ACIP Immunization Schedule for Children: https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html CDC ACIP Immunization Schedule for Adults: https://www.cdc.gov/vaccines/schedules/hcp/adult.html USPSTF Task Force's Immunization Recommendations: https://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=immunization California Immunization Registry Portal (CAIR): https://cair.cdph.ca.gov/CAPRD/portalInfoManager.do Immunization Timing 2022 (PDF)   Medicare-Medicaid (MMP) Quality Withhold Measures California Specific Quality Withhold Technical Notes for DY 2 to 8 (PDF) Core Quality Withhold Technical Notes for DY 2 to 10 (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.

Medi-Cal Renewal Process - Medi-Cal Renewal Process

s the Medi-Cal Renewal process, is currently underway across our state. This initiative is the biggest challenge facing the Medi-Cal program in its history. Up to 400,000 IEHP Members could potentially lose their Medi-Cal coverage if they don't complete the necessary renewal paperwork on time. The impact on Providers across the entire healthcare system will be significant, potentially resulting in: Increased use of the emergency department for primary care Decreased capacity of bed availability Delays in hospital discharges while awaiting coverage Increased length of stay for patients with delayed preventative or chronic care Increased cost of care Interruptions of ongoing care However, with every challenge comes opportunities to help our collective health care mission and partnership grow even stronger. IEHP takes this challenge seriously and we are committed to helping Members keep their Medi-Cal coverage and Providers keep their assigned Members without interruption. Resources to Help with the Medi-Cal Renewal Process The following resources for Providers offer more information about the Medi-Cal Renewal process and tools to help your office proactively engage and encourage Members to renew their Medi-Cal coverage on time. Medi-Cal Renewal Flyers and Provider Information IEHP Medi-Cal Renewal Flyer for Members PDF – (English, Spanish, Chinese, Vietnamese) Annual Eligibility Renewal (AER) FAQs Medi-Cal Redetermination PowerPoint presentation - (Providers and IPAs) Department of Health Care Services (DHCS) Toolkits – Medi-Cal Continuous Coverage Requirement IEHP Eligibility Renewal Support Team IEHP’s Eligibility Renewal Support team is here to answer calls from Members needing more one-on-one support during the Medical-Renewal process! We support: Application print outs Online submissions via BenefitsCal.com Assistance in connecting with the appropriate county department Serving as a centralized eligibility hub for all eligibility-related issues (on hold, disenrolled, out of area, etc.) Helping Members update contact information (national change of address, undeliverable address, etc.) Please let your patients and our Members know that additional application support is just a phone call away. IEHP Eligibility Renewal Support Team Hotline Phone and Hours of Operation: 1-888-860-1296, Monday-Friday, 8 am - 5 pm (PST) Additional information for IEHP Members Additional Communication from IEHP IEHP’s Medi-Cal Renewal specific Provider Communication is provided here for your convenience as well as here on our Correspondence page: June 15, 2023 - Medi-Cal Renewal Date Does NOT Override Member's Eligibility Status (PDF) June 09, 2023 - URGENT: What can I do to help patients keep their Medi-Cal (PDF) May 04, 2023 - New: Annual Medi-Cal Eligibility Renewal (AER) Roster Now Available to Download Under CSV! (PDF) April 17, 2023 - Now Live! Annual Medi-Cal Eligibility Renewal (AER) Alerts and Roster! (PDF) April 06, 2023 - Phone Number CORRECTION: IEHP Eligibility Renewal Support Team First Round of Yellow Medi-Cal Renewal Packets Mailed to Members! (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.

Provider Resources - Educational Opportunities

isciplinary Care Team (ICT) DualChoice Medicare CM IPA Training Alzheimer's and Dementia Care Specialty Mental Health Care Coordination National LGBT Health Education Webinars Online Cultural Competency Training   Interdisciplinary Care Team (ICT) Fact Sheet (PDF) Healthcare Provider Toolkit: Assisting Patients with Requests for Workplace Accommodations or Leaves of Absence (PDF) DualChoice Medicare CM IPA Training 2021 Care Management Delegation Oversight Medi-Cal IPA Training (MP4 Video) - December 08, 2021 Discussion Topics: Health Risk Assessments (HRA) Individual Care Plans (ICP) Interdisciplinary Care Team (ICT) Coordination of Care Delegated IPA Reporting Requirements   2021 Care Management Delegation Oversight Medi-Cal IPA Training (MP4 Video) - February 16, 2021 Alzheimer's and Dementia Care Project ECHO Opportunities from the Alzheimer's Association for Inland Empire Primary Care Clinics Alzheimer’s Association / UCSF Memory and Aging Center Alzheimer’s and Dementia Care ECHO Faculty Partners: UCSF Memory and Aging Center faculty When: Thursdays beginning February 16, 2023 until July 20, 2023 from 12:00 pm - 1:00 pm PT via Zoom Who can be involved: All California based Primary care practice teams (including MD/DO, NP, PA, social work, MA) UCSF/Inland Empire ECHO 2023 Flyer (PDF) To register, please contact Kelsey Burnham at kburnham@alz.org  UCLA ADC ECHO Faculty Partners: UCLA Alzheimer’s and Dementia Care (ADC) program faculty When: Wednesdays beginning March 29, 2023 until September 6, 2023 from 11:00 am - 12:00 pm PT via Zoom Who can be involved: Nationwide teams interested in adding to their own knowledge and skills and those interested in learning about or implementing the highly effective UCLA ADC program ADC ECHO 2023 Flyer (PDF) To register, please contact Rachel Goldberger at rbgoldberger@alz.org Specialty Mental Health Care Coordination The Centers for Medicare and Medicaid Services (CMS) is requiring IEHP and its IPAs to document and report the efforts made to coordinate the care of IEHP DualChoice (HMO D-SNP)  Members receiving specialty mental health services through the County Mental Health Plans.   As of June 1, 2018, IEHP has put policies and procedures in place to comply with these process and reporting requirements: On the first (1st) of each month, IEHP will provide IPAs and County MH Clinics a list of IEHP DualChoice (HMO D-SNP) Members known to be receiving specialty mental health services through the County MH Plans. IPAs are expected to outreach to these Members and their County MH Clinic Provider, as well as, document their outreach attempts and outcomes as outlined in Policy 25C2, “Care Management Requirements – Delegated IPA Responsibilities.” IPAs are required to provide data elements specific to this measure, as outlined in Policy 25F1, “Encounter Data Reporting - Medicare MMP Reporting Requirements – IEHP DualChoice (HMO D-SNP)" and Attachment, “Medicare Provider Reporting Requirements Schedule” in Section 25. IEHP, through its Delegation Oversight process, will monitor the IPAs’ compliance with documentation and reporting requirements, as outlined in Policy 25A2, “Delegation Oversight Audit.” To access the On-Site training material presented to IPAs and County Mental Health Clinics, click here (PDF). National LGBT Health Education Webinars IEHP has put together a list of webinars, provided by a third party, to provide educational programs, resources, and consultation to health care organizations with the goal of optimizing quality, cost-effective health care for lesbian, gay, bisexual, transgender, and all sexual and gender minority (LGBT) people. The National LGBT Health Education Center is part of the Division of Education and Training at The Fenway Institute, Fenway Health. The Fenway Institute (TFI) is an interdisciplinary center for research, training, education, and policy development that works to ensure access to quality, culturally affirming medical and mental health care for traditionally underserved communities, including LGBTQIA+ people and those affected by HIV/AIDS. The mission of Fenway Health is to enhance the wellbeing of the LGBTQIA+ community as well as people in our neighborhoods and beyond through access to the highest quality health care, education, research, and advocacy. Fenway Health is one of the largest providers of LGBTQIA+ health care and HIV primary care in the country; as such, it is a leader in the field of LGBTQIA+ health and informs much of the promising practices and innovative models that the Education Center disseminates to health centers nationwide. By clicking on these links, you will be leaving the IEHP website. The National LGBT Health Education Center Webinars  Courses Include:  HIV Prevention/PrEP at Health Centers: An Overview and Current Best Practices What’s new in PrEP and STIs? Cases From a Sexual Health Clinic Insurance Considerations for Navigating Gender-affirming Care Building Your Family: LGBTQ Reproductive Options Behavioral Health Assessments and Referral for Gender-Affirming Surgery Navigating Gender Affirming Care Collecting Sexual Orientation and Gender Identity (SO/GI) Data In Electronic Health Records Providing Mental Health Assessments for Gender Affirming Surgery Referral Letters Online Cultural Competency Training AHRQ Health Literacy Modules Available for Continuing Education (CE) and Maintenance of Certification (MOC) Credit  Physicians and nurses can earn CE credits while learning about the challenges in caring for patients with low health literacy as well as strategies to improve overall patient communication and care. OptumHealth Education is issuing continuing education credit for taking the AHRQ-developed Health Literacy Knowledge Self-Assessment. No fees are charged for the two CE activities: By clicking on these links, you will be leaving the IEHP website. 1. An Updated Overview of Health Literacy Link (optumhealtheducation.com) 2. Improving Health Literacy by Improving Communication Skills Link (optumhealtheducation.com) Pediatricians and family physicians can earn credit for re-certification (MOC Part 2) as well as CE by taking the Health Literacy Knowledge Self-Assessment through the American Board of Pediatrics and the American Academy of Family Physicians, respectively. To learn about AHRQ’s tools to address health literacy, visit Health Literacy Topics at:  https://www.ahrq.gov/health-literacy/index.html To find out about other free AHRQ continuing education opportunities, go to: https://www.ahrq.gov/patient-safety/education/continuing-ed/index.html To contact AHRQ, visit https://www.ahrq.gov/contact/index.html   Office of Minority Health: https://cccm.thinkculturalhealth.hhs.gov/ CDC: www.cdc.gov U.S. Department of Health and Human Service, Health Resources and Services Administration: www.hrsa.gov 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 - IPA

p 1668 S. Garfield 2nd Fl. Alhambra, CA 91801 (877) 282-8272 (626) 943-6329 Dignity Health Medical Network - Inland Empire 3400 Data Drive, Rancho Cordova, CA 95670 (916) 851-2026 (916) 851-7642 LaSalle Medical Associates 1855 W. Redlands Blvd. 2nd Floor, Redlands, CA 92373 (888) 554-4562 (626) 943-6369 Optum Care Network - Inland Faculty MG 1860 Colorado Blvd. Ste 200, Los Angeles, CA 90041 (800) 371-7547 (323) 257-7329 Physicians Health Network P.O. Box 11429, San Bernardino, CA 92423 (909) 300-5030 (909) 332-5555 Horizon Valley Medical Group 18564 US Highway 18 Ste 105, Apple Valley, CA 92307 (760) 813-6950 (760) 813-6947 DualChoice CalMediConnect CPN - Horizon Valley Medical Group 18564 US Highway 18 Ste. 105, Apple Valley, CA 92307 (760) 242-7777 (760) 242-0487 Dignity Health Medical Network - Inland Empire 3400 Data Drive, Rancho Cordova, CA 95670 (916) 851-2026 (916) 851-7642 EPIC Health Plan 1615 Orange Tree Lane, Redlands, CA 92374 (909) 799-1818 (909) 786-0816 Alliance Desert Physicians, Inc.       Optum, formerly Beaver MG       Chaffey Medical Group       FENIX Medical Group       Optum, formerly Pinnacle MG       Redlands - Yucaipa Medical Group       TriValley Medical Group       Heritage Provider Network 8510 Balboa Blvd. Ste 275, Northridge, CA 91325 (818) 654-3461   Desert Oasis Healthcare 275 N El Cielo Rd., Palm Springs, CA 92262 (760) 320-8814   Regal Medical Group 621 E Carnegie Dr. Ste 140, San Bernardino, CA 92408 (818) 654-3400   Optum, formerly PrimeCare 3990 Concourse St., Ontario, CA 91764 (909) 605-8000   Optum Care Network - Citrus Valley 9130 Anaheim Place Ste 130, Rancho Cucamonga, CA 91730 (909) 466-8000 (909) 484-6825 Optum Care Network - Corona 2275 Sampson Ave. Ste 111, Corona, CA 92879 (951) 371-8440 (951) 371-3910 Optum Care Network -  Inland Valley 9130 Anaheim Pl. Ste 130, Rancho Cucamonga, CA 91730 (909) 466-8000 (909) 484-6825 Optum Care Network -  Moreno Valley 1467 Ford St. Ste 103, Redlands, CA 92373 (909) 798-7766 (909) 792-8627 Optum Care Network - Redlands 1520 Barton Rd., Redlands, CA 92373 (909) 798-7766 (909) 792-8627 Optum Care Network - Riverside 2275 Sampson Ave. Ste 111, Corona, CA 92879 (951) 371-8440 (951) 371-3910 Optum Care Network - San Bernardino 1467 Ford St. Ste 103, Redlands, CA 92373 (909) 798-7766 (909) 792-8627 Optum Care Network - Southwestern Valleys 41391 Kalmia St. Ste 310, Murrieta, CA 92562 (951) 461-0762 (951) 698-5194 Riverside Medical Clinic 3660 Arlington Ave., Riverside, CA 92506    

CalAIM - Pay for Performance (P4P)

th Care Services (DHCS), California Advancing and Innovating Medi‐Cal (CalAIM) is a long‐term commitment to transform and strengthen Medi‐Cal, offering Californians a more equitable, coordinated, and person‐centered approach to maximizing their health and life trajectory.1 DHCS Goals For CalAIM 2 Identify and manage comprehensive needs through whole person care approaches and social drivers of health. Improve quality outcomes, reduce health disparities, and transform the delivery system through value-based initiatives, modernization, and payment reform. Make Medi‐Cal a more consistent and seamless system for enrollees to navigate by reducing complexity and increasing flexibility. Resource Links DHCS CalAIM page DHCS CalAIM Transformation Infographic (PDF) DHCS Medi-Cal Alignment Primer (PDF) IEHP Enhanced Care Management IEHP Enhanced Care Management (Member Page) IEHP Community Support Services IEHP Community Support Services (Member Page)   1,2https://dhcs.ca.gov/calaim You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.  

Renew your Medi-Cal coverage - Medi-Cal FAQs

to act now! During the COVID-19 Public Health Emergency (PHE), your Medi-Cal was renewed automatically – even if you had changes in your household. But now Medi-Cal members like you must again renew coverage each year to keep your health care benefits. Your county will mail you a letter or yellow envelope about your Medi-Cal eligibility. The letter will tell you if your Medi-Cal coverage was renewed automatically. If the county could not auto-renew, then you’ll need to complete the packet and return it right away by mail or in-person to your Medi-Cal office. Or fill it out online at www.BenefitsCal.com. Always make sure your contact information is updated with your local county office. What if I’m not sure of my Medi-Cal renewal date? You can contact your local Medi-Cal county office, call IEHP’s Eligibility team at 1-888-860-1296 or visit www.BenefitsCal.com. (You can set up an online account if you don’t have one yet.) How do I update my contact information? Call IEHP’s Eligibility team at 1-888-860-1296, Monday-Friday, 8am-5pm, or Create and update your online account at www.BenefitsCal.com, or Call or visit your county office: Riverside County: 1-877-410-8827, Monday - Friday, 8am-5pm San Bernardino County: 1-877-410-8829, Monday - Friday, 8am-5pm How do I report a change if I have SSI? If you get SSI, Social Security will process your Medi-Cal renewal. If you have questions: Call 1-800-772-1213 (TTY: 1-800-325-0778, Monday through Friday, 8am – 7pm, or Contact your local Social Security office via their online locator. What if I am no longer eligible for Medi-Cal? You may be able to get health coverage through Covered California. The county office will send you information about how to sign up. Who do I contact if I have additional questions? If you need more help, call IEHP’s Eligibility team at 1-888-860-1296, Monday-Friday, 8am-5pm. Or contact your county Medi-Cal office: Riverside County: 1-877-410-8827, Monday-Friday, 8am-5pm San Bernardino County: 1-877-410-8829, Monday-Friday, 7am-5pm

RFPs and Bids - Procurement

Procurement department is continuously looking for suppliers of the varied goods and services it procures.  IEHP procures goods and services through the solicitation process, and in the case of repetitively purchased items, establishes long-term contracts. With the exception of Public Works (construction type bids) and a few specialty bids, most bids for goods and services procured are completed using a third-party solicitation website called Bonfire. Vendors have the option to view IEHP’s open solicitations on the Bonfire website. IEHP invites all vendors to register with Bonfire and participate in IEHP’s fair and open solicitation process for goods and services. Mission Statement The Procurement department is committed to supporting the mission of IEHP, which is “to organize and improve the delivery of quality, accessible and wellness based healthcare services for our community”. As a community-developed health plan, we are accountable to the public. IEHP’s Procurement professionals possess the necessary skill set, knowledge base, and negotiating skills to assist IEHP with the acquisition of materials, equipment and contractual services. Utilizing this expertise, our best procurement practices, and the highest standards of professional ethics and integrity, we ensure that procurement decisions made are in the best interest of IEHP and in compliance with all applicable laws, regulations and policies. Compliance with Economic Sanctions Imposed in Response to Russia’s Actions in Ukraine On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (EO) regarding sanctions in response to Russian aggression in Ukraine. The EO is located at https://www.gov.ca.gov/wp-content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-Order.pdf. This serves as a notice under the EO that as a vendor, contractor or grantee, compliance with the economic sanctions imposed in response to Russia’s actions in Ukraine is required, including with respect to, but not limited to, the federal executive orders identified in the EO and the sanctions identified on the U.S. Department of the Treasury website (https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-and-country-information/ukraine-russia-related-sanctions). Failure to comply may result in the termination of contracts or grants, as applicable. For general inquiries, please email procurement@iehp.org. Code of Ethics Policy Click to Download Our Code of Ethics Policy

Healthy Living - Coronavirus

how eating right and being active are the secrets to a long, healthy life. These are important. But there’s more you can do to stop disease. Finding health problems early gives you more treatment choices or a cure. That’s where health screenings come in.  Health screenings are vital for all people, from newborns to seniors. These tests are designed to look for signs that you may be at risk for certain conditions. They help spot health problems at an early stage, even if you do not have symptoms.  Types of cancer screenings Breast Cancer A mammogram is a breast X-ray. It can spot breast cancer early when it’s most treatable and when your chance of a cure is much higher. Both women and men can get breast cancer and should get screened every two years, starting at age 50. Those who are at high risk or would like to start screening at an earlier age can talk to their Doctor about starting screening at age 40. Cervical Cancer (Pap Smear)  The Pap test also known as a pap smear, can detect not normal cells on your cervix early enough so they can be treated before cancer has a chance to grow. The screening is recommended for woman ages 21-65 every 3-5 years, depending on the risk and type of screening. To schedule a screening, talk to your Doctor.  Colorectal Cancer Colorectal cancer affects the colon and the rectum. Screening can find and remove growths in these areas before they turn into cancer. Everyone ages 45-75 should get screened for colorectal cancer every 1-10 years, depending on risk and type of test used. Talk with your Doctor about which test is the best for you. Lung Cancer Screening for lung cancer with imaging (CT scan) in people who smoke or who have quit within the past 15 years, can help find cancer at an early stage. Catching it early keeps you healthy. A yearly screening is recommended for anyone ages 50-80 who smokes cigarettes or has quit smoking in the last 15 years.  If you’re due for a screening, call your Doctor today to schedule your appointment. Don’t wait. Take charge of your health! For help, call IEHP Member Services at 1-800-440-4347, Monday – Friday, 7 a.m. – 7 p.m., and Saturday-Sunday, 8 a.m. – 5 p.m.  

Community Supports - Flexible Care Choices: Community Supports

e options. These may be offered (instead of state plan-covered services) to qualified Members at medium to high levels of risk. Community Supports can help you remain healthy, reduce complications from illnesses, and avoid unnecessary stays in the hospital, nursing facilities, and emergency departments You may find that Community Supports with IEHP can help during a transition in housing or care. If you need help managing your health, IEHP’s Community Supports might be the right choice. When you need extra care IEHP’s Community Supports are open to any Medi-Cal or IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan) Member who needs supportive care. Community Supports may nurture your whole health—to care for your body and mind. Members who could benefit from Community Supports may be: Facing times without housing Struggling to get food for their loved ones Having asthma issues and need changes to their living space How your Care Team can help you If you can be helped by Community Supports, you may get a care team that can assist in identifying your needs. Then, they will coordinate no-cost services. This includes finding resources for housing, care after leaving the hospital, and dealing with asthma at home. Who may be on your care team: Nurse Care Manager Behavioral Health Care Manager Care Coordinator Community Health Worker Support when you need it Your care team can assist you by phone or in person, and they can even meet you at your location. You are not alone with IEHP’s Community Supports. What community supports are offered? Asthma Remediation: Environmental Asthma Trigger Remediations are physical modifications to a home environment that are necessary to ensure the health, welfare, and safety of the individual, or enable the individual to function in the home and without which acute asthma episodes could result in the need for emergency services and hospitalization. Community Transition Services/Nursing Facility Transition to a Home: Assist members to live in the community and avoid further institutionalization.These services are non-recurring set-up expenses for individuals who are transitioning from a licensed facility to a living arrangement in a private residence where the person is directly responsible for his or her own living expenses. Environmental Accessibility Adaptations (Home Modifications): Environmental Accessibility Adaptations (EAAs also known as Home Modifications) are physical adaptations to a home that are necessary to ensure the health, welfare, and safety of the individual, or enable the individual to function with greater independence in the home: without which the Member would require institutionalization. Housing Deposits: Housing Deposits assist with identifying, coordinating, securing, or funding one-time services and modifications necessary to enable a person to establish a basic household that do not constitute room and board. Housing Tenancy & Sustaining Services: This service provides tenancy and sustaining services, with a goal of maintaining safe and stable tenancy once housing is secured. Housing Transition Navigation Services: Housing transition services assist Members with obtaining housing. Medically Supportive Food/Meals/Medically Tailored Meals: Malnutrition and poor nutrition can lead to devastating health outcomes, higher utilization, and increased costs, particularly among Members with chronic conditions. Meals help individuals achieve their nutrition goals at critical times to help them regain and maintain their health. Results include improved Member health outcomes, lower hospital readmission rates, a well-maintained nutritional health status, and increased Member satisfaction. Nursing Facility Transition/Diversion to Assisted Living Facilities: Nursing Facility Transition/Diversion services assist individuals to live in the community and/or avoid institutionalization when possible. The goal is to both facilitate nursing facility transition back into a home-like, community setting and/or prevent skilled nursing admissions for Members with an imminent need for nursing facility level of care (LOC). Individuals have a choice of residing in an assisted living setting as an alternative to long-term placement in a nursing facility when they meet eligibility requirements. Recuperative Care (Medical Respite): Recuperative care, also referred to as medical respite care, is short-term residential care for individuals who no longer require hospitalization, but still need to heal from an injury or illness (including behavioral health conditions) and whose condition would be exacerbated by an unstable living environment. An extended stay in a recovery care setting allows individuals to continue their recovery and receive post-discharge treatment while obtaining access to primary care, behavioral health services, case management and other supportive social services, such as transportation, food, and housing. Short-Term Post-Hospitalization Housing: Short-Term Post-Hospitalization housing provides Members who do not have a residence and who have high medical or behavioral health needs with the opportunity to continue their medical/psychiatric/substance use disorder recovery immediately after exiting an inpatient hospital (either acute or psychiatric or Chemical Dependency and Recovery hospital), residential substance use disorder treatment or recovery facility, residential mental health treatment facility, correctional facility, nursing facility, or recuperative care and avoid further utilization of State plan services. Sobering Centers: Sobering centers are alternative destinations for individuals who are found to be publicly intoxicated (due to alcohol and/or other drugs) and would otherwise be transported to the emergency department or jail. Sobering centers provide these individuals, primarily those who are homeless or those with unstable living situations, with a safe, supportive environment to become sober. Day Habilitation Programs: Day Habilitation Programs are provided in a participant’s home or an out-of-home, non-facility setting. The programs are designed to assist the participant in acquiring, retaining, and improving self-help, socialization, and adaptive skills necessary to reside successfully in the person’s natural environment. Respite Services These are provided to caregivers of participants who require intermittent temporary supervision. The services are provided on a short-term basis because of the absence or need for relief of those persons who normally care for and/or supervise them and are non-medical in nature. Personal Care and Homemaker Services This service is provided for individuals who need assistance with Activities of Daily Living (ADL), such as bathing, dressing, toileting, ambulation, or feeding. Personal Care Services can also include assistance with Instrumental Activities of Daily Living (IADL), such as meal preparation, grocery shopping, and money management. To learn more about Community Supports, 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.

Kids and Teens - Immunizations

s, and other diseases that can make them very sick or even cause death.  How do vaccines work? Vaccines train the body to fight germs that cause disease. When exposed to disease, the body will know how to fight and kill the germs before they cause health problems. This is called immunity against disease. Why so many vaccines? Vaccines are needed in all stages of life. Many are given to infants and young children who need them the most to Grow Well. Vaccines protect against diseases such as: Influenza (Flu) Measles, mumps, rubella Polio Tetanus Varicella (chicken pox) Pertussis (whooping cough) For a complete list of shots, see the Recommended Immunization Schedule for Persons Aged 0-18 (PDF) and Immunization Brochure (PDF). Get Vaccinated at No Cost to You With IEHP, you can get vaccinated at no cost. You can also find schedules for your shots and checkups in your IEHP Member Handbook. Ask your Doctor for an Immunization Record Card or print one by logging into your IEHP Health Account and bring it with you to each checkup.

Plan Updates - Public Health Advisory

- Mosquito Borne Disease Update (PDF) March 17, 2023 - Riverside University Health Systems - Increased Enteric Disease Activity - Shigella (PDF) November 11, 2022 - Riverside University Health Systems - Early Respiratory Syncytial Virus (RSV) and Seasonal Influenza Activity (PDF) October 25, 2022 - Riverside University Health Systems - Outbreak of Ebola Virus Disease Due to Sudan Virus in Central Uganda (PDF) October 21, 2022 - Riverside University Health Systems - Influenza (PDF) August 18, 2022 - Updated Monkeypox Guidance (PDF) August 18, 2022 - Riverside University Health System - Monkeypox Home Isolation Instructions (PDF) August 18, 2022 - CDC - Dear Colleague: 2022 Monkeypox Outbreak (PDF) July 19, 2022 - Updated Monkeypox Guidance (PDF) March 14, 2022 - Riverside County Legionnaires' Disease Advisory (PDF) By clicking on the links below, you will be leaving the IEHP website.

Healthy Living - Health Resources

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

Kids and Teens - Teen Health

ol, hang out with friends, play sports and go to dances. But that’s not all! They also make important choices about their future during this transitional time. Many choices teens make will affect their health as they get older. IEHP wants to help ensure teens are making the healthiest choices possible. IEHP wants to make sure teens stay away from risky habits such as: Smoking Using alcohol and other substances Having unprotected sex Missing school IEHP wants to promote healthy habits like: Eating a well-balanced diet Taking care of teens mental health Exercising Getting enough sleep Having regular Doctor visits Looking for information now? Visit the following links for helpful information and tools on teen health topics. By clicking on the links below, you will be leaving the IEHP site. Centers for Disease Control and Prevention (CDC) - Adolescent and School Health  U.S. Department of Health & Human Services: Office of Adolescent Health 

San Bernardino County Medi-Cal

of Americans. About nine percent of San Bernardino County residents under the age of 65 were uninsured based on the last count of the US Census. That is why Inland Empire Health Plan (IEHP) provides coverage to millions of Members in San Bernardino and Riverside counties. Discover the health plan that puts its members at the center of their universe. IEHP will not rest until our communities enjoy optimal care and vibrant health. Keep reading to learn more about IEHP and the benefits offered to Medi-Cal recipients. IEHP Provides Coverage for San Bernardino County Medi-Cal Recipients Medi-Cal is a no-cost or low-cost health coverage program. It provides health, dental and vision coverage to qualified low-income California residents. IEHP is the health plan for Medi-Cal recipients in San Bernardino County. We are dedicated to providing our Members and local communities with optimal care and vibrant health. Top-Class Medi-Cal Services Medi-Cal is a no-cost or low-cost health coverage program. It provides health, dental and vision coverage to qualified low-income California residents. IEHP is the health plan for Medi-Cal recipients in San Bernardino County. We are dedicated to providing our Members and local communities with optimal care and vibrant health. With IEHP and Medi-Cal coverage, Members not only have access to general health care but also advanced and specialized care such as: Transgender services Laboratory services Radiology services Pediatric care Mental health services Addiction rehabilitation care These are just a few examples of how IEHP’s network of Providers gives Members and their families in San Bernardino County a wide range of medical care. To apply for Medi-Cal in San Bernardino County call the IEHP Enrollment Advisors at (866) 294-4347, Monday – Friday, 8am – 5pm. TTY users should call (800) 720-4347. You may also call Health Care Options at 1-800-430-4263 or visit www.healthcareoptions.dhcs.ca.gov. TTY users should call 1-800-430-7077. Vision Services IEHP provides vision coverage and has a wide network of vision specialists. IEHP Members get a free vision exam every 24 months, additional or more frequent eye exams are covered if medically necessary, such as those with diabetes. You also get a pair of eyeglasses, with both frames and lenses every 24 months, when you have a valid prescription. Contact lens testing and contact lenses may be covered if the use of eyeglasses is not possible due to eye disease or condition. Medi-Cal San Bernardino Dental Services Through Medi-Cal, you and your family get professional dental services. This benefit is included with your Medi-Cal coverage at little to no cost to you.  Some of the types of dental care offered include: Diagnostic and preventive dental hygiene (such as examinations, X-rays, and teeth cleanings) Emergency services for pain control Tooth extractions Root canal treatments (anterior/posterior) Scaling and root planning Crowns (prefabricated/laboratory) Orthodontics for children who quality Complete and partial dentures Topical fluoride If you have any questions or need help finding a Medi-Cal dental provider, call the Medi-Cal Dental Customer Service Line at 1-800-322-6384, or visit www.smilecalifornia.org. Medical Trip Transportation Your Medi-Cal benefits include round trip transportation for plan-covered health services and Medi-Cal-covered services, such as mental health, substance abuse and dental, within San Bernardino and Riverside counties. IEHP covers: Visits to your Primary Care Doctor, Specialists and urgent care clinics. Visit for dental, mental health, substance abuse and other services. Click here to learn more about transportation services offered by IEHP. How to Apply for Medi-Cal IEHP’s mission to heal and inspire the human spirit is made possible through its Vision—to not rest until our communities enjoy optimal care and vibrant health. You have many options to apply for Medi-Cal, these include: Call IEHP Call 1-866-294-4347, 8am-5pm Monday-Friday. TTY users should call 1-800-720-4347. You’ll speak to one of IEHP’s friendly bilingual Enrollment Advisors. By Mail You can mail your completed and signed application to:   Covered California P.O. Box 989725 West Sacramento, CA 95798-9725 Or mail it to the Riverside County Medi-Cal Office. Apply in Person Click here to find the Riverside County Medi-Cal Office. Apply Online Click here to apply online. Get Health Coverage Now Become a member of the IEHP family and get access to the top-rated California state medical insurance. For more than 25 years, IEHP has proudly served Inland Empire residents and their families. Join IEHP now and make your health our top priority.  

Super Heroes - Super Nutricia

hood obesity and unhealthy eating habits. The campaign features appearances by Super Nutricia at numerous IEHP supported community events, where children, young adults and families can meet her in person and receive free comic books, posters, brochures and other nutrition education materials.  Super Nutricia has become well known throughout the Inland Empire and is frequently requested to help support healthy eating initiatives for children and young teens. Super Nutricia Video Super Nutricia Comic Book (PDF)

Super Heroes - Mighty Fitnessa

ity for a healthy body and healthy mind. The campaign features appearances by Mighty Fitnessa at numerous IEHP supported community events. Children, young adults and families can meet her in person at these events and receive free comic books, posters, brochures and other fitness related education materials. Mighty Fitnessa Video Mighty Fitnessa Comic Book (PDF)

Super Heroes - Eradicator

lts, ages 5-16, about the health-related dangers of smoking and tobacco usage. Eradicator makes appearances at a variety of community events, including school events, health fairs and other health-related activities. He has connected with thousands of children and young adults throughout the years, autographing posters and comic books. Eradicator Video Eradicator Comic Book (PDF)

Super Heroes - Rad Rider

afety. Rad Rider Bicycle Safety Program, targets children ages of 5 to 14. Rad Rider makes appearances at a variety of community events, including school events, health fairs and other health-related activities. He has connected with thousands of children throughout the years, autographing posters, comic books, and bike helmets. Rad Rider Video Rad Rider Comic Book (PDF)

Join Our Network - Behavioral Health

l Health Forms Behavioral Health  As a local Health Plan, Inland Empire Health Plan (IEHP) is committed to improving behavioral health services for our Members by developing direct relationships with select clinicians.     IEHP now has over 1,000,000 Members. Behavioral Health Clinicians are viewed as "Specialists" that are partners in improving the health status of our Members. IEHP Behavioral Health is an integrated essential partner with primary medical care. IEHP’s Direct Behavioral Health Program will offer our Behavioral Health Specialists: Streamlined Authorization & Claims Submission - via our fast and secure website. Competitive Reimbursement Rates - based on current Medicare rates. Speedy Payments - our track record is payment in less than 3 weeks (in most cases). Personal, Friendly Service - to ensure a successful and long-lasting working relationship. IEHP is committed to develop direct partnerships with Psychiatrists, Psychologists, LCSW's, LMFT's, Psychiatric Nurse Practitioners, Physician Assistants, and most recently, Licensed Professional Clinical Counselors (LPCC) who have met the couples and family qualifications. LPCCs without this qualification will not be considered eligible to join IEHP's Behavioral Health Network. For any questions or concerns, please email Contract@iehp.org. Requirements for this certification can be found here: https://www.bbs.ca.gov/pdf/publications/lpcc_couple-fam_courses.pdf In compliance with APL 17-019 (a DHCS regulation), IEHP now requires Behavioral Health Providers to begin the process of enrolling with Medi-Cal prior to contracting with IEHP. To ensure timely processing of your application, IEHP will accept your application to contract upon receipt of verification of Medi-Cal enrollment submission. Prospective Providers: QASP PLEASE NOTE, IEHP is now accepting new QASP Providers in all services areas.  Behavioral Health Behavioral Health Provider Letter and Application (PDF) Why You Should Contract with IEHP Directly for Behavioral Health (PDF) How IEHP Keeps You Informed and Drive Business to Your Practice (PDF) Medi-Cal Number (Physicians should be enrolled in the State's Medi-Cal Program) Existing Providers: Contracts Maintenance Request Form (PDF) W-9 Form (PDF) (Remittance advice address change) Medi-Cal Number (Physicians should be enrolled in the State's Medi-Cal Program) Frequently Asked Questions (FAQs) What is IEHP? How do I contract with IEHP? What are IEHP's compensation rates? What are IEHP’s minimum requirements to be considered for your BH Network? What if I have additional information about my practice, specialties or experience that is not covered on the survey; where can I send this information? When will I hear back from IEHP after I send my contract in? What services does IEHP offer online? What are the benefits and limitations for Medicare DualChoice Members? I am a Behavioral Health Treatment Provider for one or more of the following services, how do I contract with IEHP? (Services for Individuals (0-21) with Autism, Developmental Disabilities, or Specialized Behavioral needs; utilizing Applied Behavior Analysis and Behavior Modification treatment modalities) What is IEHP? IEHP stands for Inland Empire Health Plan. IEHP is a not-for-profit health plan that serves over 1,000,000 Members in public-sponsored health coverage programs including Medi-Cal and Medicare Special Needs Plan.  How do I contract with IEHP? The first step is to fill out the Behavioral Health Provider Letter and Application (PDF) and email Contract@iehp.org. We will contact you directly once we have evaluated our Member’s needs and are ready to proceed with contracting. What are IEHP compensation Rates? Reimbursement rates for Behavioral Health Services are based on Medicare rates. What are IEHP’s minimum requirements to be considered for your BH Network? A valid California License (LCSW, LMFT, LPCC, Psychologist, Psychiatrist, Nurse Practitioner) $1 million to $3 million Malpractice Insurance Must be enrolled with Medi-Cal Satisfy all IEHP’s standard credentialing requirements What if I have additional information about my practice, specialties or experience that is not covered on the survey; where can I send this information? You can send your information to: Inland Empire Health Plan Attention: Provider Relations P.O. Box 1800 Rancho Cucamonga CA 91729-1800 When will I hear back from IEHP after I send my contract in? Over the next two to three months we will be gathering information and determining our needs and as soon as we have determined what Providers we will need we will send out draft contracts with rate sheets for review. What services does IEHP offer online? Member Eligibility Verification Claims Submission Services Claims Status Authorization Status Medication Search Pharmaceutical Services Information Resources Provider Manuals; Benefit Manuals; EDI manuals  What are the benefits and limitations for Medicare DualChoice Members? Click here.  I am a Behavioral Health Treatment Provider for one or more of the following services, how do I contract with IEHP? (Services for Individuals (0-21) with Autism, Developmental Disabilities, or Specialized Behavioral needs; utilizing Applied Behavior Analysis and Behavior Modification treatment modalities) The first step is to fill out the Behavioral Health Provider Letter and Application (PDF) and email Contract@iehp.org. We will contact you directly once we have evaluated our Member’s needs and are ready to proceed with contracting. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

Contact Us

e questions, call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347. You can also email MemberServices@iehp.org. Medicare/Medi-Cal Members:  If you have questions, call IEHP DualChoice at 1-877-273-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. TTY users should call 1-800-718-4347. You can also email MemberServices@iehp.org. If you are a PROVIDER: If you need information, call the Provider Relations Team at (909) 890-2054, 8am-5pm, Monday-Friday. You can also email ProviderServices@iehp.org. To enroll with IEHP: If you need healthcare coverage, call 1-866-294-4347, 8am-5pm Monday-Friday. TTY users should call 1-800-720-4347. You’ll speak to one of our friendly bilingual Enrollment Advisors. To verify the employment status of an IEHP employee  Please submit your request to the IEHP Human Resources Department:  Email: Human_Resources@iehp.org. Fax: 909-477-8544 Phone: 909-890-2000 (and ask for Human Resources) Our Communities For general inquiries please call (909) 890-2000, 8am-5pm, Monday-Friday. TTY users should call (909) 890-0731. Prospective Vendors  If you are interested in becoming a vendor for IEHP, please visit our Procurement page. For all records processing Please contact the IEHP Legal Department. The Legal Department processes inquiries related to Protected Health Information (“PHI”), Subpoena, Guardianship, Public Records Act (“PRA”), and California Government Claims requests. The Legal Department is also IEHP’s designated Agent for Service of Process. Inland Empire Health Plan Attn: Legal Department 10801 Sixth Street Rancho Cucamonga, CA 91730 E-mail: legal@iehp.org Fax: (909) 477-8578 Authorization of Release (PDF) - This form authorizes IEHP to use and disclose Protected Health Information. If you are a reporter of the Media/Press  Please call our media contact: Kristina Hernandez Media and Public Relations Strategist (909) 552-0509 press@iehp.org Our Location 10801 Sixth Street Rancho Cucamonga, CA 91730  Mailing Address P.O. Box 1800 Rancho Cucamonga, CA 91729-1800 Fax: (909) 890-5877  Claims Mailing Address for IEHP Direct Members Inland Empire Health Plan - Claims P.O. Box 4349 Rancho Cucamonga, CA 91729-4349 Claims Appeals and Disputes Mailing Address for IEHP Direct Members Inland Empire Health Plan - Claims Appeals and Disputes P.O. Box 4319 Rancho Cucamonga, CA 91729-4319