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ion Officer. In this role, Vinil will provide leadership for the overall information technology architecture, as well as the design, development, implementation, and support of IEHP’s systems. Vinil joins IEHP most recently from Health New England, where he served as the Chief Information and Technology Officer and was responsible for managing a unique portfolio and elevating the role of technology from a supportive function to a strategic partner that played a major part in the growth of the organization.  Vinil also developed and executed an end-to-end operational roadmap for sales, underwriting and accounting. In addition, he rearchitected and streamlined production support and application development operations to bring stability, predictability, and optimizations to the organization. Prior to his role at Health New England, Vinil served as vice president, digital transformation officer at AIG in New York. While in this role, he led a $50M global digital transformation initiative, which included migration and consolidation of digital properties from 140 countries around the world. Vinil holds a Master of Business Administration degree from Bay Path University in Longmeadow, Massachusetts and is eager to join IEHP, “I look forward to joining the team and helping fulfill the IEHP mission through collaboration, innovation, and strategic support.  There are no limits to what we can achieve for the members, providers, employees, and community when we work together”. “Vinil will make an excellent addition to the team and we are so excited to bring him on board,” said IEHP Chief Executive Officer Jarrod McNaughton. “Vinil’s experience and expertise in the field will support our efforts to enhance the effectiveness of the remarkable work IEHP does every day in an effort to heal and inspire the human spirit.”

h plan as its first chief health equity officer.    In this role, Chandler will serve the Inland Empire by further developing and implementing policies, procedures and programs aimed at improving health equity.   This will include using race/ethnicity, language, gender identity/sexual orientation, and geographic data to identify disparities in access to care and health outcomes. IEHP will then work with community partners to improve the provision of culturally appropriate services and develop new initiatives to address these disparities.  “Lorena has a heart for the communities we serve and is deeply committed to ensuring access to optimal care and vibrant health for everyone in the Inland Empire,” said Dr. Takashi Wada, IEHP’s chief medical officer. “We look forward to working with Lorena and learning from the vast experience she brings to IEHP.”  Chandler joins IEHP with a strong background in Medicaid, Medicare, non-profit and government sponsored health programs. Prior to IEHP, she served as Blue Shield of California’s director of Medicare Growth Strategy and associate vice president of Strategic Planning and Performance and was responsible for the development of a Medicare Advantage Plan for Latino Seniors in Los Angeles County. She was also a lead in the integration of Care 1st Health Plan Medi-Cal line of business into Blue Shield of CA, giving her a broad and deep knowledge of health plan operations.   In addition, Chandler brings experience from her work with Molina Healthcare Inc. as an associate vice president of Business Process Improvement and Member Engagement and LA Care Health Plan, where she worked closely with Latino and African American communities to launch and develop their inaugural community resource centers and programs.   She has also worked for the country’s largest Hispanic civil rights organization, Unidos US, as their director for the Center for Latino Community Health, leading and evaluating their community health worker programs, and as a senior project manager for United Healthcare where she developed their Latino Health Solutions Initiative.   Chandler graduated from California State University, Long Beach with a Bachelor of Science degree in Health Care Administration and the University of California, Los Angeles, where she earned a master’s in Public Health with an emphasis in Community Health Sciences.    “Lorena’s experience and passion for health equity will help IEHP excel in its mission and will truly make the Inland Empire a healthier place for all,” said Jarrod McNaughton, IEHP chief executive officer.  

f the not-for-profit’s mission with the appointment of a new chief people officer: Supriya Sood. In her new role, Sood will lead the organization’s human resources department through the development of best practices and strategies focused on maintaining a skilled, engaged and diverse workforce, explained IEHP’s Chief Executive Officer Jarrod McNaughton. “Supriya brings a wealth of experience to the executive leadership team and believes in the profound impact our team members have on driving our mission to improve the health of our communities,” he said. “She has a passion for serving in mission-based companies with over 15 years in the health care industry.” Sood has served in various human resources leadership roles for Elevance Health (formerly Anthem, Inc.) and Molina Healthcare. She holds a master’s degree in business administration from University of California, Irvine, and is a member of the Society for Human Resources Management (SHRM) and Professional Human Resources Association (PIHRA).  Most recently, Sood served as chief people officer for Orange County-based Alignment Healthcare, where she was responsible for evolving the organization, including the clinical, consumer, technology and market areas in support of growth, scalability and diversification of business. Sood switching gears to IEHP lands at an exciting time for the organization with the announcement of several projects and initiatives in the works, such as joining the Covered California exchange – pending state approval – and the addition of programs dedicated to addressing the lack of health care access in marginalized communities, like IEHP’s Community Health Worker Residency Program. For IEHP, some of Sood’s responsibilities will include supporting people programs, including talent acquisition, compensation administration and benefits. She will also oversee all human resources operations and learning and development opportunities for IEHP team members. Sood looks forward to working for an organization with such strong ties to the people it serves. “IEHP is a shining example of what makes the Inland Empire special, and I’m excited to become part of this hard-working team whose efforts have transformed the lives of so many,” she said.  “My hope is to continue to create avenues for these team members to shine as they strive to make a difference in the community through IEHP’s mission of healing and inspiring the human spirit.”

A resource for health providers, IPAs and others interested in the Americans with Disabilities Act, California law as it related to accessibility and Universal Design. In partnership with our Provider Network, IEHP strives to break down barriers to medical care and promote health and wellness for Members with disabilities. With accessibility issues often cited as an obstacle to care, we publish this site to help all stakeholders in the health care system understand the barriers and in some cases the solutions. We invite you to browse these topics: Information on the Americans with Disabilities Act (ADA) Accessibility of Doctor's offices, clinics, and other health care providers is essential in providing medical care to people with Disabilities. Find out more by following the link to the ADA's Access Guide (PDF). The Federal Americans with Disabilities Act (ADA) of 1990 prohibits discrimination on the basis of disability and sets national standards for accessibility. Each page in this section gives you a summary of ADA related documents and a link to the actual Federal resource.  By clicking on this link, you will be leaving the IEHP website. View the full text of the law at the ADA Website.  Enforcement Lawsuits for ADA Violations U.S. Department of Justice (DOJ) 1994 Status reports, briefs, and settlement information will help you stay up-to-date on precedent-setting ADA litigation. Unsuccessful negotiations or mediation may lead to federal lawsuits. Courts can order compensatory damages, back pay, or civil penalties up to $55,000 for the first violation and $110,000 for any subsequent one.  Read more about DOJ Litigation Alternative to Litigation U.S. Department of Justice (DOJ) Mediation Program Established: 1994 Mediation, which is confidential and voluntary, can resolve some ADA disputes quickly and satisfactorily – without the expense and delay of formal investigation and litigation.  Read more about DOJ Mediation Facts and Information Diagnosing & Treating Members with Auditory Disability Communicating with People Who Are Deaf or Hard of Hearing in Hospital Settings U.S. Department of Justice (DOJ) Disability Rights Section, Civil Rights Division Published 2003 Interactive doctor-patient discussions with individuals who are deaf or hard-of-hearing may require an interpreter to ensure proper diagnosis and treatment. DOJ’s brief outlines the types of interpreter services including sign language, oral interpretation, cued speech, and Computer Assisted Real-time Transcription (CART). Read the Full Article: HTM PDF Phone Calls & Auditory/Speech Disabilities Phone Calls & Auditory/Speech Disabilities - Technology Breaks Communication Barriers Created by IEHP, 2006 Learn about FREE options for effective telephone communication with individuals who have auditory and/or speech disabilities: National Telecommunication Relay Service (TRS) – two-way translation between individuals using a TTY and a standard telephone Speech-to-Speech (STS) Relay Service – assistance for individuals with speech disabilities by repeating their message verbatim. Read the Full Article  Fact Sheet - PDF Fact Sheet - TXT Dispelling ADA Myths Just the Facts on the ADA Adapted from 1995 DOJ fact sheet IEHP, 2006 Get the facts on common ADA misconceptions. ADA Myths & Facts  PDF Text Accessibility Pays Off at Tax Time Tax Incentives for ADA Compliance Take advantage tax incentives that help eligible businesses comply with the Americans with Disabilities Act.  The Federal and California state governments offer Tax Credits and/or Deductions for improving accessibility and/or employing persons with disabilities. Attorney General’s ADA Tax Incentives Packet Your practice/health care facility may be eligible for tax credits and/or deductions to help offset the costs of improving accessibility for patients and employees with disabilities. The Attorney General’s packet includes a fact sheet and Internal Revenue Service (IRS) form and instructions. Download IEHP's Fact Sheet PDF Text  Download the Attorney General's information packet: Website Legal Obligations Standards for Accessible Design ADA Accessibility Guidelines U.S. Department of Justice (DOJ) 1991 The ADA Accessibility Guidelines (ADAAG) include stringent criteria for health care Providers as well as additional requirements based on building use (special application 6 – Medical Care Facilities). The Standards for Accessible Design apply to the architecture and construction of new buildings/facilities as well as alterations to existing structures. Download the Standards Standards - PDF Standards - HTM Download Special Application 6 (Health Care Facilities) Access to Medical Care for Individuals with Mobility Disabilities (PDF) Access to Medical Care for Individuals with Mobility Disabilities (HTM) Removing Existing Barriers Checklist for Readily Achievable Barrier Removal Adaptive Environments Center, Inc. and Barrier Free Environments, Inc. 1995 Identify accessibility problems and solutions for eliminating physical/architectural and communication barriers. Use this informal checklist as a guide to meet your obligations under the ADA (for existing facilities only, not new construction or alterations). Download the checklist for readily achievable barrier removal Checklist - PDF Checklist - HTM ADA Regulations for Health Care Providers Nondiscrimination on the Basis of Disability U.S. Department of Justice (DOJ) 1991 Federal regulations for accessibility at Health care facilities include standards for the architecture of buildings, alterations, and new construction (ADA, Title III).  DOJ article - PDF DOJ article - HTM Basic ADA Requirements for Health Care Providers ADA Title III Highlights U.S. Department of Justice (DOJ) Disability Rights Section, Civil Rights Division Published 1990 This functional outline of the ADA’s Title III (section covering health care providers) helps you become familiar with key requirements that impact you and your patients. DOJ’s overview provides details in bullet format for quick reference. See the Full DOJ Article Practical Guidance for ADA Compliance Title III Technical Assistance Manual  U.S. Department of Justice (DOJ) 1993 and 1994 This manual (with supplement) outlines ADA requirements for businesses to ensure access to goods, services, and facilities. The reader-friendly format offers: Lay terms and practical examples (limited legalese) Focused, systematic description of requirements Questions/answers and illustrations  Read the full Manual Read the Supplement Technical Assistance DOJ ADA Information and Technical Assistance on the Americans with Disabilities Act  The official ADA website of the U.S. Department of Justice (DOJ) offers the most up-to-date information and practical guidance on design, construction, and operation:  Regulations and standards impacting Providers and Members  Accessibility and reasonable accommodations guidelines  Solutions for ensuring access within your budget  Tax credits and incentives  Technical assistance and materials/publications Visit DOJ's ADA Homepage Avoid Costly Building Mistakes Common ADA Errors and Omissions in New Construction and Alterations  U.S. Department of Justice (DOJ) Disability Rights Section, Civil Rights Division Published 1997 Incorporating ADA Standards into initial building/alteration plans helps ensure patient safety as well as cost-effectiveness. Review some of the most common accessibility errors/omissions identified through DOJ’s ongoing enforcement efforts. Following each error/omission, you’ll find an explanation of its significance and reference to the appropriate requirement under the ADA Standards for Accessible Design.   Online ADA Course Reaching Out to Customers with Disabilities U.S. Department of Justice (DOJ) with Representatives of Business and Disability Communities 2005 Learn about ADA compliance in an online course with 10 short lessons. Policies, Practices, and Procedures Communicating with Customers Who Have Disabilities New Buildings, Additions, and Remodeling Removing Barriers in Buildings That Are Not Being Remodeled Providing Access When Removing Barriers Is Not Readily Achievable Maintaining Accessibility Transporting Customers ADA Compliance Costs and Tax Incentives Enforcement of the ADA Information Sources Take the ADA online course Pacific Region ADA Technical Assistance Disability Business Technical Assistance Center (DBTAC) Region IX  National Institute on Disability and Rehabilitation Research U.S. Department of Education 1995 Get information on your compliance obligations, problem-solving assistance, and referrals from ADA experts – without the high cost of a consultant. The 10 regional ADA & IT Technical Assistance Centers serve strictly as educational entities to help you understand your rights and responsibilities and have no enforcement or advocacy responsibilities. Federal Region IX, Pacific, serves: Arizona, California, Hawaii, Nevada, and the Pacific Basin. Visit Pacific ADA Center Visit DBTAC Homepage Visit NIDRR Community Based Adult Services (CBAS) Reminder: Community-Based Adult Center (PDF) SPD Awareness Training  By clicking on these links, you may be leaving the IEHP website. By making your facilities accessible you convey a sense of welcome for people with disabilities. Most of all, you comply with the requirements set by the Americans with Disabilities Act (ADA) of 1990. This is a civil rights law that prohibits discrimination against persons with disabilities on the basis of their disability in programs and services that receive federal financial assistance. Please see the resources below for more detailed information. Office Accessibility How to Make Your Medical Office More Accessible (PDF) Guidebook: How to Safely Transfer Patients with Disabilities to an Exam Table (PDF) Video #1: How to Safely Transfer Patients with Disabilities to an Exam Table Video #2: Using an Accessible Scale to Weigh Patients with Disabilities Accessibility Checklist (PDF) Community Resources Community Resources Guide (PDF) Disability Competency and Sensitive Training Disability Etiquette Guide (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.

ay have. To ensure that our Members receive the best care, we need them to report any issues. Issues can be, witnessing any type of fraud, or if a Member feels that their personal and private information has been misused. How Do I Report an Issue? To report fraud the following resources are available: waste or abuse, privacy issues, and other compliance issues. Compliance Hotline: (866) 355-9038 Fax: (909) 477-8536 E-mail: compliance@iehp.org Mail: IEHP Compliance Officer P.O. Box 1800 Rancho Cucamonga, CA 91729-1800 Click Report a Compliance Issue to report online. What is the Privacy Incident/Breach? IEHP has established a HIPAA Privacy Program to ensure that Member’s health information is properly protected, while allowing the flow of health information needed to provide and promote high-quality health care. What is a privacy breach? An unauthorized acquisition, access, use, or disclosure of protected health information (PHI) which puts at risk the security or privacy of such information.  PHI is health information that relates to a Member’s past, present or future physical or mental health or condition. This includes the services of his/her health care, or payment for that care and contains personally identifiable information (PII) such as name, SSN, DOB, Member ID, address, or any other unique identifier related to the Member.  This generally means that a breach occurs when PHI is accessed, used, or disclosed to an individual or entity that does not have a business reason to know that information.  The law does allow information to be accessed, used, or disclosed when it is related to treatment, payment, or healthcare operations directly associated with the work that we do at IEHP on behalf of our Members. Click Report a Privacy Incident/Breach to report online. What is the Fraud, Waste, and Abuse (FWA) Program? IEHP has established a fraud, waste, and abuse program to detect, correct, and prevent fraud, waste, and abuse on part of IEHP Employees, IEHP Members, Providers, Vendors, delegated entities and any other entity doing business with IEHP. What is Fraud?  Fraud is knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program, or to obtain, by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any health care benefit program. Examples include: The use of someone else's identification or insurance card to obtain services. Falsifying income or location to obtain insurance. Selling of prescription medication or medical equipment obtained through IEHP. What is Waste? Waste includes overuse of services, or other practices that, directly or indirectly, result in unnecessary costs.  Waste is generally not considered to be caused by actions of criminal neglect but rather by the misuse of resources. Examples include: Frequent visits to the ER or Urgent care for standard doctor visits. Visiting multiple doctors or hospitals to obtain controlled medications. What is Abuse? Abuse includes actions that may, directly or indirectly, result in unnecessary costs and improper payment or services. Abuse involves payment for items or services when there is no legal entitlement to that payment and the provider has not knowingly and/or intentionally misrepresented facts to obtain payment.  Examples include: Use of transportation benefits for non-medical purposes. Click Report Fraud/Waste/Abuse to report online.

of Phase 1A of its vaccination roadmap, vaccines will be distributed to caregivers with In-Home Support Services (IHSS), intermediate care centers, and public and community health centers, including facilities for mental health. Click here to learn more. 1/12/21: San Bernardino County introduces a coronavirus quarantine and isolation calculator. This tool allows people to determine how long they should self-isolate after testing positive for COVID-19, being sick with COVID-19, or being exposed to someone with COVID-19. Click here for more info. 12/7/20: The governor announced a stay at home order for Southern California regions, including Riverside and San Bernardino County, for a minimum of three weeks. This order is in response to a rapid growth in COVID-19 cases and a substantial increase in hospitalizations and ICU admissions. Click here to learn more.  9/11/20: To continue to help slow the spread of COVID-19, Riverside County is urging residents to get tested. In addition, increased testing will help the county move into the next level of the state’s reopening plan. For testing locations, visit gettested.ruhealth.org.   8/21/20: Health officials urge Riverside County residents to get tested for COVID-19, whether or not they are experiencing symptoms. For testing locations, visit gettested.ruhealth.org.  8/21/20: To stop the spread of COVID-19, San Bernardino County Public Health Director urges all residents to get tested. Watch this video to learn more.  7/24/20: Fraud reports have increased due to uncertainty surrounding COVID-19, leaving many San Bernardino residents unsure how to avoid scams or report them to authorities. Scams include fake at-home COVID-19 testing kits or vaccinations, IRS impersonators, illegal robocalls and fake charities. For more information visit the San Bernardino County Public Website. 6/29/20: San Bernardino County is encouraging all residents, including those who have not experienced symptoms of COVID-19, to be testing for the Coronavirus. Click here for testing locations.  6/19/20: Governor Newsom requires California residents to wear face coverings while in public. Click here to learn more. For information on how to wear a proper face covering, watch this short video. 6/12/20: A COVID-19 testing site returns to Blythe. Testing started on June 10th and will continue for two weeks. In addition, a testing site opens at the Edgemont Women’s Club in Moreno Valley and will operate June 17 through June 19th. Click here for more information.  5/29/20: Cooling Centers open throughout Riverside County, offering residents an escape from extreme heat and are open to the public at no cost. The centers will be available through October. Click here for more information.  5/29/20: New COVID-19 testing sites open in San Bernardino County. They are scheduled to run through June with appointment registrations opening weekly. For a complete list of testing locations click here: Click here for a complete list of testing locations.  5/27/20: A drive up COVID-19 testing site will be opened at the old Sears parking lot in Riverside, replacing the testing location at Harvest Christian Fellowship that is closing. Click here for a complete list of testing.   5/22/20: Riverside County added three new COVID-19 testing sites in Corona, San Jacinto and Temecula. Click here for a complete list of testing locations.  4/30/20: Riverside County’s Public Health Officer is extending his order requiring residents to wear face coverings when outside and to continue practicing social distancing through June 19. Residents are still required to remain in their primary residence under Governor Newsom’s existing “stay at home” order unless they are engaged in an essential business or activity, such as grocery shopping or visiting the doctor.  Click here for more information. 4/28/20: San Bernardino County opens up criteria for COVID-19 testing. Beginning April 30th, residents 65 and older, healthcare workers, emergency responders, and law enforcement can get tested without displaying symptoms of COVID-19. For testing information, visit the San Bernardino County website.  4/24/20: In response to an increasing number of requests for resources, Riverside County released an online map to connect residents to local food resources. Resources include senior meal sites, school district meal sites and food pantries. Click here to find food resources.  4/20/20: Testing for COVID-19 has been expanded to all Riverside County residents, including those who do not have any COVID-19 symptoms.  In addition, a fifth COVID-19 testing site will be established at the Blythe Fairgrounds on April 22nd. All residents interested in testing must call 800-945-6171 for an appointment. Click here for more information. 4/13/20: A fourth drive-up COVID-19 testing site opens in Riverside County on Tuesday, April 14th. The site has been established at the Perris Fairgrounds, located at 18700 Lake Perris Drive. Perris, California. Residents who want to get tested must have symptoms to make an appointment, symptoms include fever, cough, sore throat, runny nose or cough. Residents must call 800-945-6171 to make an appointment. For more information on testing locations, visit the Riverside County Public Health website.  4/13/20: San Bernardino County Public Health will conduct a community drive-through event for COVID-19 testing in Montclair on Tuesday, April 14. This event is open to San Bernardino County residents by appointment only. Residents can make an appointment online at http://wp.sbcounty.gov/dph/coronavirus/ at 2 p.m. on Monday, April 13 or by calling (909) 387-3911. Additional community drive-through events are scheduled throughout this month in Yucaipa, Big Bear Lake, Joshua Tree, and Rancho Cucamonga, California. For more information visit the San Bernardino County website.  4/8/20: Arrowhead Regional Medical Center will begin a COVID-19 drive-thru testing site on Thursday, April 9th. Appointments are required. To make an appointment call 855-422-8029. For more information visit Arrowhead Regional Medical Center.   4/7/20: CalWORKs and CalFresh renewals and SAR 7 status reports do not need to be submitted for March, April or May. This does not apply to Transitional CalFresh or Transitional Nutrition benefits. To access your benefits, visit: c4youself.com or call 877-410-8829 (San Bernardino County) 877-410-8827 (Riverside County).  4/7/20: The San Bernardino County’s Acting Health Officer ordered everyone in San Bernardino County to wear face coverings when leaving home and interacting with other people. Face coverings may include homemade cloth ear loop covers, bandannas and handkerchiefs, and neck gaiters. Also, orders all religious services to be done electronically, including upcoming Easter celebrations.Click here for more information. 4/4/20: The Riverside County Public Health Officer orders the public to stay home and cover their face when leaving and interacting with other people, including essential workers. Face coverings can be bandanas, scarves, neck gaiters or other clothing that does not have visible holes. Click here to learn more. 4/4/20: The Small Business Association (SBA) is offering forgivable loans that help businesses keep their workforce employed during the Coronavirus (COVID-19) crisis. The Paycheck Protection Program is a loan designed to provide a direct incentive for small businesses to keep their workers on the payroll. The loan application period opens on Friday, April 3, 2020. For more information visit the SBA website.   3/31/20: San Bernardino County will conduct a drive-thru sample collection event for COVID-19 in the High Desert on April 2nd. This event is open to San Bernardino County residents only. Residents can request an appointment online at sbcovid19.com or by calling (909) 387-3911. For more information on this event visit: http://www.sbcounty.gov/main/default.aspx 3/30/20 – A third drive-up COVID-19 testing site opens in Riverside County on April 1st. The site has been established at Harvest Christian Fellowship church in Riverside.  Residents must have symptoms to make an appointment, which include fever, cough, sore throat, runny nose or cough.  Residents must call 800-945-6171 to make an appointment. For more information on testing locations, visit the Riverside County Public Health website. 3/30/20 – A COVID-19 testing site in Indian Wells will be relocated to the Riverside County Fairgrounds in Indio. The first day of testing at the fairgrounds is Tuesday (March 31). Residents must have symptoms to make an appointment, which include fever, cough, sore throat, runny nose or cough. Appointments must be scheduled by calling 800-945-6171. For more information on testing locations, visit the Riverside County Public Health website. 3/27/20: San Bernardino County Public Health will conduct a drive-thru specimen collection for COVID-19 on Friday, March 27. The specimen collection for COVID-19 testing will be available for the public by appointment only. Appointment sign-up and details will be available on the county website. 3/25/20: COVID-19 testing for IEHP Members is now available at SAC Health Systems in San Bernardino. IEHP Members must call (909) 771-2911 to schedule a telephone appointment with a Doctor. The Doctor will evaluate the Member and determine if they need COVID-19 testing and will provide details on how to obtain testing. 3/20/2020: Gov Gavin Newsom announces a California statewide order for residents to “stay at home,” excluding essential entities which include grocery stores, take-out and delivery and health care organizations. IEHP is an essential entity and will continue operations to support our Members and Providers through telephonic contact only. OUR BUILDINGS ARE CLOSED TO NON-EMPLOYEES. We highly encourage you (our Members and Providers) to call us if you need any services or have any questions. Continue to visit our website for frequent updates and news from Gov Gavin Newsom. 3/19/2020: IEHP Chief Medical Officer, Dr. Hansberger, has an important message for our Members in the Coachella Valley region about the COVID-19 situation and ways for them to protect their health. Click here.  3/18/2020: To help our IEHP Members stay home and avoid public places, we encourage Members to use mail order delivery service for both new and refill prescriptions. By using this service, Members can get medicines mailed to their home at no cost by using standard shipping. 3/13/2020: We are requesting when you (including Members, Providers, Community Partners, Vendors, and all Visitors) need IEHP services, please call IEHP or your IEHP contact directly to get the help you need. If you must visit IEHP in person, please ensure that you do not have a fever, cough or breathing problem. 3/13/2020: All classes and events at IEHP’s Community Resource Centers are canceled until further notice for the protection and safety of our community during the Coronavirus (COVID-19) situation. We apologize for any inconvenience and expect to resume classes as soon as possible.

p Fund is the health plan’s partnership with local academic institutions to help remove the barrier of debt for medical students and develop a growing workforce for healthcare professionals to care for the Inland Empire’s growing Medi-Cal population. Why is the Healthcare Scholarship Fund needed? According to the California Healthcare Foundation, the Inland Empire has one of the lowest ratios of Primary Care Physicians (PCPs) and specialty physicians per 100,000 people in California. In addition, the Inland Empire lacks adequate Specialty and Behavioral Health practitioner capacity to serve the current growing population. With the average cost of a four-year medical degree standing firm at $276,800, pursuing a career in the medical field is out of reach for more and more each year. The HSF will aid students by helping to remove the financial burden of medical school that often restricts the choices of many aspiring healthcare professionals and allow recipients to immediately pursue careers in healthcare. I am a student and am interested in becoming a Doctor, what should I do? Students interested in the IEHP Healthcare Scholarship Fund are encouraged to contact the academic institutions below for more information on how apply. While each institution may have differing eligibility requirements, all Healthcare Scholarship Fund scholarships require students commit to practicing in the Inland Empire for 5 years after graduation. Participating schools and programs include: Loma Linda University Medical School University of California Riverside California University of Science and Medicine

l care, like: Routine checkups Sick visits, such as colds, flu and fever Chronic illnesses, like asthma and diabetes Order medical tests Your Doctor also handles your preventive care, such as vaccines, shots, health screenings and other tests.  Preventive care is about preventing disease. Regular checkups, even when you are not sick, can help your Doctor spot a health problem early, and treat it before it gets worse. 2. Getting care from a Specialist When you need specialty care, your Doctor will refer you to a Specialist. This is how referrals work:  When the request is received by IEHP, a decision will be made within 5 business days for a regular referral. For an urgent referral, this is done within 72 business hours. For a regular referral, expect a letter from your medical group or IEHP within 2 days after a decision has been made. When the request is approved, call your Specialist to make an appointment. If the request is denied, talk to your Doctor or call IEHP Member Services at (800) 440-4347 or (800) 718-4347 (TTY) to learn more. 3. Getting your medicine You can fill your prescription at any IEHP contracted pharmacy. There are more than 760 pharmacies in our network. From major chains, like Walgreens, CVS, Rite Aid, Walmart and many others. To find one close to you, check your IEHP Doctor Directory or click the Provider Search link. Helpful tips to help your treatment: Be sure to call the pharmacy five days before you run out of medicine. Take your medicine the way your Doctor tells you to.   4. Find a Doctor To find more information on Primary Care Physician's (PCPs), Specialists, Pharmacies, etc., click here to visit the Doctor search.  5. Getting help from Member Services If you need help, 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. The call is toll free. If you reach IEHP Member Services after hours, you will be able to leave a secure voice message. Calls will be returned the next working day. If you call after midnight and leave a secure voice message, we will return your call the same working day. Resources Barriers to Care: We all have our own cultural, religious or health beliefs. This document includes some common beliefs that may keep you from getting the care you need—along with some facts to help you make informed decisions about your health.

ence and access to care for the low-income working residents of the Inland Empire. These recognitions honor our steadfast commitment to improving access to quality, wellness-based healthcare services when and where members need it. NCQA Accreditation IEHP was the first Medicaid-only health plan in California to earn accreditation from the National Committee for Quality Assurance (NCQA) for its Medi-Cal health plan, in 2000. We have retained NCQA accreditation every year since. Innovation Awards from DHCS In November 2021, IEHP received the “Innovation Award - Runner Up 2021” for the Medi-Cal PCP Auto Assignment Redesign, which focused on directing Members to Providers with higher quality scores. In November 2020, IEHP was awarded the prestigious California Department of Healthcare Services (DHCS) Innovation Award. The award was based on IEHP’s groundbreaking work using location intelligence to reach high-risk members and providers in geographic areas affected by power outages, wildfires, and other natural disasters. This is the fourth time the health plan has received this honor. In 2018, IEHP received the Innovation Award from Department of Health Care Services (DHCS), for its Housing Initiative, which provides permanent supportive housing and intensive case management services to homeless, high utilizing Members. In October 2017 IEHP won a California Department of Health Care Services (DHCS) Innovation Award for improving the health of low-income members through a program that coordinates their complex physical and behavioral health care needs across the healthcare system in Riverside and San Bernardino counties. In 2015 IEHP won the first annual Innovation Award from DHCS for its Transitional Care Program, which strives to reduce emergency room usage and curtails the re-admission rates of members recently discharged from the hospital IEHP Receives the CORE Certification Seal  In April 2022, IEHP received the CORE Certification Seal for the Eligibility & Benefits, Claim Status, and Payment & Remittance CAQH CORE Operating Rule Sets. As a CAQH CORE-certified entity, IEHP has demonstrated that they follow a set of national operating rules and standards which improve business processes in healthcare — going above and beyond what is federally required.  The CORE Seal is widely recognized as the industry gold standard. IEHP Receives Rancho Cucamonga Fire District’s Business Partner of the Year Award In September 2021, IEHP was awarded Business Partner of the Year by the Rancho Cucamonga Fire District at the City’s Fire and Police Recognition. The distinguished award recognizes the health plan’s partnership with the City and County of San Bernardino to host an ongoing super vaccine clinic at the health plan’s headquarters. IEHP Receives Health Equity Award for Engaging Communication In 2020, IEHP received the Health Equity Award for their ability to engage and connect with members via text message during Governor Newsom’s social isolation order. The award was given by mPulse Mobile, a leader in conversational AI solutions for healthcare, during their annual Activate Awards. Click here to learn more. IEHP DualChoice Cal MediConnect Plan Earns Top Customer Satisfaction Score in the Nation The IEHP DualChoice Cal MediConnect Plan had the third-highest score in the country in the 2016 MMP CAHPS survey from the Centers for Medicare and Medicaid Services (CMS), which assesses the experiences patients have with their health plans. In 2016 there were 40 Medicare-Medicaid Plans (MMP) in the nation (called Cal MediConnect plans in California). Annual Excellence Award In 2016, IEHP received the Excellence Award from the Pharmacy Benefit Management Institute (PBMI) for its Pharmacy Pay for Performance Program, which leverages IEHP network pharmacies to offer clinical education to its members. Top Physician Satisfaction  Doctors and other medical providers ranked IEHP at or above the 90th percentile in most areas on a 2016 satisfaction survey administered by an independent survey vendor. They ranked IEHP at the:  99th percentile for “IEHP Compared to All Other Health Plans” 98th percentile for “Overall Satisfaction with Call Center Staff” 98th percentile for “Overall Satisfaction with Financial Services”   97th percentile for “Recommend IEHP to Other Physicians’ Practices” IEHP Receives Workplace of the Year Award from Advisory Board in March 2018 Inland Empire Health Plan (IEHP) has been awarded the Advisory Board 2018 Workplace of the Year Award. The annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. IEHP is one of only 20 organizations nationwide to receive the award. Favorite Employer IEHP was voted “Favorite Overall Company to Work For,” “Favorite Training Program” and “Favorite Workplace Culture” by Los Angeles News Group Readers in the 2014 Winning Workplaces survey. “Access to Caring” Award IEHP was recognized for making a difference in advancing health care access and availability to people with disabilities by the Western University of Health Sciences, in 2014. Energy Star Award for Superior Energy Performance IEHP’s corporate headquarters (“The Atrium”) in Rancho Cucamonga, Calif. earned the U.S. Environmental Protection Agency’s ENERGY STAR® certification for superior energy performance in 2017, demonstrating IEHP’s commitment to continued energy savings and environmental responsibility. “Gold Standard” Certification for Electronic Payments and Claims Processing In 2016 IEHP achieved Phase III certification for accurate and efficient electronic provider payments and claims reconciliation from the Council for Affordable Quality Healthcare (CAQH) and the Committee on Operating Rules for Information Exchange (CORE). The voluntary certification is widely viewed as the industry “gold standard” for provider payments and claims processing.

contracted provider. Prior to extending a contract, we must receive the following documents.  PLEASE NOTE, IEHP is only accepting Vision Providers who meet the following exceptions through October 31, 2022: Providers practicing in any of the CalAIM service area expansion territories effective January 1, 2022 (including formerly voluntary and excluded zip codes) Providers filling positions that have been vacated in an existing practice Providers transitioning from an existing group agreement to their own individual agreement Providers being added to existing Vision groups Please completely fill out all required documents and submit to contract@iehp.org. Any delay in receiving the below stated documents will affect the effective date of the contract that will be mailed to you.  1. Vision Provider Network Participation Form (PDF) 2. Letter of Interest that outlines the following: What Specialty/Services you are interested in contracting for Facility locations(s) National Provider Identifier (NPI) for each facility Medi-Cal Provider information number (PIN) 3. W-9 Form (PDF) A current Taxpayer Identification Number and Certification Form 4. California Participating Physician Application (PDF) 5. Liability Insurance Certificate Professional general liability in the minimum amount of One Million Dollars ($1,000,000) per occurrance; and Three Million Dollars ($3,000,000) aggregate per year for professional liability 6. Facility Business License - Faculty 7. Ownership Information (PDF) Name, Title, and Percent of Ownership Contracts Maintenance Request Form can be found here (PDF). All documents should be e-mailed to contract@iehp.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.

tions in compliance with ethical standards, contractual obligations under State and Federal programs, laws, and regulations applicable to Medi-Cal and IEHP DualChoice. This commitment extends to our business associates and delegated entities that support IEHP’s mission to improve the delivery of quality, accessible, and wellness based healthcare services for our community.  Our Compliance Program is designed to: Ensure we comply with applicable laws, rules, and regulations Reduce or eliminate Fraud, Waste, and Abuse (FWA) Prevent, detect, and correct non-compliance Reinforce our commitment to culture of compliance for which we strive Establish and implement our shared commitment to honesty, integrity, transparency, and accountability FDR Information What is an FDR? A First Tier, Downstream or Related Entity (FDR) is a delegated entity subcontracted on behalf of IEHP to provide health plan related services.  FDR Requirements FDRs are required* to follow IEHP’s policies and procedures, Code of Business Conduct and Ethics, and other contractual requirements.   FDR Resources First Tier and Downstream Entities/Compliance Program Requirements Manual – This manual doesn’t pertain to IPA’s IEHP Vendor FDR Manual Policy_Compliance Program Requirements_2021 IEHP Vendor FDR Manual Policy_FWA Requirements_2021 IEHP Vendor FDR Manual Policy_HIPAA Requirements  IEHP Code of Business Conduct and Ethics  Non Retaliation Policy FDR Compliance Program Attestation CMS Compliance, FWA, and HIPAA training material ICE FWA Training ICE General Compliance Training *For IPA requirements, visit the Provider Resources page.  Code of Business Conduct and Ethics Inland Empire Health Plan (IEHP) expects Team Members and business entities doing business with IEHP to conduct business activities in an ethical and professional manner that promotes public trust and confidence in the integrity of IEHP. The Code provides guidance about the compliance culture at IEHP and the role that each Team Member, including Senior Management, Chief Officers, the Governing Board, and our business partners, play in building and preserving that culture. IEHP Code of Business Conduct and Ethics Compliance, Fraud, Waste, and Abuse (FWA), and Privacy Program Training The IEHP Compliance, FWA, and Privacy Training Program focuses on to the elements of an effective Compliance Program, conduct & ethics, and the Fraud, Waste and Abuse and Privacy Programs. IEHP requires delegated entities to provide Compliance Training to  their employees, Providers, downstream entities, Board of Directors, and Contractors within 90 days of hire/start date. IEHP is committed to a culture of compliance, ethics, and integrity, the goal of Compliance Training is to provide all associated parties the ability to demonstrate awareness of IEHP’s requirements, including regulations and policies & procedures associated with Compliance as it relates to daily work. If you have questions or additional suggestions, please e-mail The IEHP Compliance Department at compliance@iehp.org General Compliance Training Compliance Fraud, Waste and Abuse (FWA) HIPAA Privacy and Security (PDF) Reporting Information IEHP has the following resources available for reporting fraud, waste or abuse, Privacy issues, and other compliance issues: Compliance Hotline: (866) 355-9038 Fax: (909) 477-8536 E-mail: compliance@iehp.org Mail: IEHP Compliance Officer P.O. Box 1800 Rancho Cucamonga, CA 91729-1800 Online: Report a Compliance Issue

IEHP GOVERNING YOUR USE OF THE DEVELOPER PORTAL AND THE IEHP APIS (DEFINED BELOW). BY CLICKING “I AGREE” OR ACCESSING THE DEVELOPER PORTAL OR USING IEHPS APIS YOU ARE AGREEING TO BE BOUND BY THE TERMS OF THIS DEVELOPER AGREEMENT AND ANY OTHER APPLICABLE TERMS AND CONDITIONS POSTED ON IEHPS WEBSITE LOCATED AT WWW.IEHP.ORG/EN/ABOUT/PRIVACY-POLICY. IF YOU DO NOT AGREE TO THE TERMS OF THIS AGREEMENT, YOU MAY NOT ACCESS THE DEVELOPER PORTAL OR USE THE IEHP APIs. By entering into this Agreement, you affirm that you are at least 13 years old and of legal age to enter into this Agreement and are authorized to enter into this Agreement on behalf of your Company. No legal partnership or agency relationship is created between IEHP and you or your Company by virtue of this Agreement. We may update this Agreement by posting the updated version(s) on this Website. Updated versions of the Agreement will apply to your use of the IEHP APIs occurring on or after the date of the last update. The "Last Updated" legend above indicates when this Agreement was last changed. You should periodically review this page to determine if this Agreement has been updated. Your continued use of the IEHP APIs following any updates to this Agreement shall constitute notice and acceptance of any such updates. PERMISSIBLE USE OF IEHP APIS We provide access to Our application programming interfaces (“APIs”), including Our Patient Access API, Provider Directory API and Promoting Interoperability API, and their associated documentation and sandbox (collectively, the “IEHP APIs”) on the Developer Portal. We may update, change, discontinue or add IEHP APIs or functionality or features to the IEHP APIs in Our discretion with or without providing notice to you. Subject to the terms of this Agreement, IEHP grants you a limited, non-sublicensable, non-assignable, non- transferable, royalty-free, non-exclusive license only to use: (a) the Patient Access API to retrieve certain health plan information maintained by Inland Empire Health Plan, a local public entity of the State of California, and its subsidiary health plans with the approval and at the direction of the applicable member or their personal representative consistent with applicable law; (b) the Provider Directory API to retrieve certain provider and pharmacy directory information; and (c) the Promoting Interoperability API to retrieve certain health care information with the consent of the applicable patient or their personal representative consistent with applicable law. You may only access the Patient Access API and Promoting Interoperability API by means of an application that has been registered with IEHP to access them. You agree to comply with all applicable laws, regulations, and governmental issuances. RESTRICTIONS You may not: (a) decompile, disassemble, reverse engineer, or otherwise attempt to derive, reconstruct, identify, or discover any source code, underlying ideas, or algorithms of the IEHP APIs by any means, except to the extent that the foregoing restriction is prohibited by applicable law; (b) remove any proprietary notices, labels, or marks from the IEHP APIs; (c) interrupt or attempt to interrupt the operation of the IEHP APIs in any way, including, without limitation, by restricting, inhibiting, or interfering with the ability of any other user to use the IEHP APIs (including by means of hacking or defacing any portion of the IEHP APIs, or by engaging in spamming, flooding, or other disruptive activities); (d) disrupt, interfere with, modify, bypass, or otherwise circumvent IEHP APIs functionality or features, limitations, security measures, technical processes, availability, integrity, or performance (or attempt the same); (e) transmit or attempt to transmit data over a IEHP APIs unless such transmission is authorized and formatted in accordance with applicable specifications in the IEHP APIs implementation guide; (f) transmit or otherwise make available through or in connection with the IEHP APIs any malicious, harmful or invasive code; (g) attempt to exceed IEHP APIs rate limits; (h) conduct security research on or testing against IEHP APIs, services, applications, systems, devices, or networks without prior written approval from IEHP; or (i) use the IEHP APIs (1) for any unlawful purpose or in any manner not authorized or intended in the IEHP APIs implementation guide, (2) in any way that could pose a threat to, disrupt, interfere with, harm, or impair the IEHP APIs, IEHP or other IEHP services, applications, systems, devices, or networks, or Inland Empire Health Plan members’, patients’, customers’, or other users’ use of IEHP APIs, (3) in any manner that, in IEHP’s reasonable determination, constitutes excessive or abusive usage, (4) to gain unauthorized access to any IEHP service, application, system, device, or network, or (5) to transmit malicious code or exploit security flaws, vulnerabilities, or deficiencies. MONITORING Your use of this Website and the IEHP APIs may be monitored by IEHP to ensure compliance with this Agreement. You consent to such monitoring. REPORTING SECURITY ISSUES You agree to promptly report to IEHP any security flaws, vulnerabilities, or deficiencies identified through normal use of IEHP APIs by calling the Inland Empire Compliance Hotline at 1-866-355-9038. You may not publicly disclose security flaws, vulnerabilities, or deficiencies in the IEHP APIs or other IEHP applications, systems, devices, or networks of which you become aware. ACCOUNTS/REGISTRATION You agree to promptly report to IEHP any security flaws, vulnerabilities, or deficiencies identified through normal use of IEHP APIs by calling the Inland Empire Health Plan Compliance Hotline at 1-866-355-9038. You may not publicly disclose security flaws, vulnerabilities, or deficiencies in the IEHP APIs or other IEHP applications, systems, devices, or networks of which you become aware. PROPRIETARY RIGHTS IEHP or its licensors own the IEHP APIs and the content on this Website and all intellectual property rights therein. You may not use any Inland Empire Health Plan entity’s name, trademarks, service marks, tradenames, logos or other distinctive brand features except as necessary to comply with your obligation, above, and agree not to remove any proprietary notices, labels, or marks from the IEHP APIs, and, in any case, you may not use those notices, labels or marks to imply affiliation with or endorsement by Inland Empire Health Plan. You have only those rights to access and use the IEHP APIs as are expressly granted by IEHP under this Agreement and all other rights in the IEHP APIs are reserved to IEHP or its licensors. You acknowledge that these rights are valid and protected in all forms, media, and technologies existing now or hereinafter developed. “Inland Empire Health Plan, a local public entity of the State of California,” means the health care organization doing business as Inland Empire Health Plan including, without limitation, Inland Empire Health Plan, and the subsidiaries, partners, and successors of the foregoing. PUBLIC ENTITY STATUS; BROWN ACT/PUBLIC RECORDS ACT The parties hereby acknowledge and agree that IEHP is a local public entity of the State of California subject to the Brown Act, California Government Code Sections 54950 et seq., and the Public Records Act, California Government Code Sections 6250 et seq. PRIVACY Your submission of information through the Website is governed by our Privacy Policy. RESPONSIBILITY FOR HARDWARE, SOFTWARE, TELECOMMUNICATIONS AND OTHER SERVICES You are responsible for obtaining, maintaining, and paying for all hardware, software, and all telecommunications and other services, needed for you to use the IEHP APIs. DISCLAIMER OF WARRANTY IEHP AND ITS SERVICE PROVIDERS DISCLAIM ALL EXPRESS OR IMPLIED REPRESENTATIONS OR WARRANTIES REGARDING THE IEHP APIS, INFORMATION, CONTENT, SERVICES, FUNCTIONALITY, AND ANY OTHER RESOURCES AVAILABLE ON OR ACCESSIBLE THROUGH THIS WEBSITE, INCLUDING, WITHOUT LIMITATION, ANY IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, OR NON- INFRINGEMENT. ALL SUCH IEHP APIS, INFORMATION, CONTENT, SERVICES, FUNCTIONALITY AND RESOURCES ARE MADE AVAILABLE "AS IS" AND "AS AVAILABLE", AT YOUR SOLE RISK, WITHOUT WARRANTY OF ANY KIND. IEHP DOES NOT WARRANT THAT THE WEBSITE OR IEHP APIS WILL BE ACCURATE OR OPERATE WITHOUT INTERRUPTION OR ERROR. LIMITATION OF LIABILITY TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, IN NO EVENT SHALL IEHP, INLAND EMPRIE HEALTH PLAN OR THEIR SERVICE PROVIDERS, LICENSORS OR RESPECTIVE EMPLOYEES, OFFICERS, DIRECTORS, AGENTS, AFFILIATES, SUPPLIERS, VENDORS, LICENSORS, CO-BRANDERS OR PARTNERS (COLLECTIVELY, THE “INLAND EMPRIE HEALTH PLAN PARTIES") BE LIABLE FOR ANY DIRECT, INDIRECT, SPECIAL, PUNITIVE, INCIDENTAL, EXEMPLARY, OR CONSEQUENTIAL DAMAGES, OR ANY DAMAGES WHATSOEVER RESULTING FROM ANY LOSS OF USE, LOSS OF DATA, LOSS OF PROFITS, BUSINESS INTERRUPTION, LITIGATION, OR ANY OTHER PECUNIARY LOSS, WHETHER BASED ON BREACH OF CONTRACT, TORT (INCLUDING NEGLIGENCE), PRODUCT LIABILITY, OR OTHERWISE ARISING OUT OF OR IN ANY WAY CONNECTED WITH THE USE, OPERATION OR PERFORMANCE OF THE IEHP APIS, WITH THE DELAY OR INABILITY TO USE THE IEHP APIS, ANY DEFECTS IN THE IEHP APIS, OR WITH THE PROVISION OF, OR FAILURE TO MAKE AVAILABLE, ANY INFORMATION, SERVICES, PRODUCTS, MATERIALS, OR OTHER RESOURCES AVAILABLE ON OR ACCESSIBLE THROUGH THE IEHP APIS, EVEN IF ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. You acknowledge and agree that the limitations set forth above are fundamental elements of this Agreement. INDEMNIFICATION You agree to indemnify, defend, and hold the Inland Empire Health Plan Parties harmless from any liability, loss, claim, and expense (including reasonable attorneys' fees) actually or allegedly related to or arising out of your use of the IEHP APIs or this Website, your use or disclosure of information obtained through the IEHP APIs, your violation of this Agreement, and/or your violation of the rights of any other person. TERM, TERMINATION, SUSPENSION AND REVOCATION This Agreement is effective until terminated by either party. If you no longer agree to be bound by this Agreement, you must cease your use of the IEHP APIs. If you breach any provision of this Agreement, then you may no longer use the IEHP APIs. IEHP may suspend or revoke your Credentials or access to the IEHP APIs without prior notice for your failure to comply with this Agreement or if IEHP determines that your access to the IEHP APIs would present an unacceptable level of risk to the security of IEHP’s systems. IEHP may terminate this Agreement if you fail to comply with its terms and, to the extent permitted by law, for any or no reason. If this Agreement is terminated for any reason, then: (a) this Agreement will continue to apply and be binding upon you in respect of your prior use of the IEHP APIs (and any unauthorized further use of the IEHP APIs); and (b) any rights granted to us under this Agreement will survive such termination. GENERAL LEGAL TERMS This Agreement constitutes the entire agreement between you and IEHP with respect to its subject matter IEHP’s failure to exercise or enforce any right or provision of this Agreement shall not constitute a waiver of such right or provision. If a court of competent jurisdiction rules that any provision of the Agreement is invalid, then that provision will be removed from the Agreement without affecting the rest of the Agreement and the remaining provisions will continue to be valid and enforceable. There are no third- party beneficiaries to this Agreement. The rights granted in this Agreement may not be assigned or transferred by You without the prior written approval of IEHP. You may not delegate your responsibilities or obligations under this Agreement without the prior written approval of IEHP. This Agreement shall be governed by the laws of the State of California without regard to its conflict of laws provisions. You agree to submit to the exclusive jurisdiction of the courts located within the county of San Bernardino, California to resolve any legal matter arising from this Agreement. IEHP may, notwithstanding this, seek injunctive remedies in any jurisdiction.

h plan operations in compliance with ethical standards, contractual obligations under State and Federal programs, laws, and regulations applicable to Medi-Cal and IEHP DualChoice. This commitment extends to our business associates and delegated entities that support IEHP’s mission to organize and improve the delivery of quality, accessible, and wellness based healthcare services for our community.   Our Compliance Program is designed to: Ensure we comply with applicable laws, rules, and regulations Reduce or eliminate Fraud, Waste, and Abuse (FWA) Prevent, detect, and correct non-compliance Reinforce our commitment to culture of compliance for which we strive Establish and implement our shared commitment to honesty, integrity, transparency, and accountability Code of Business Conduct and Ethics Inland Empire Health Plan (IEHP) expects Team Members and business entities doing business with IEHP to conduct business activities in an ethical and professional manner that promotes public trust and confidence in the integrity of IEHP. The Code is meant to provide guidance about the compliance culture at IEHP and the role that each Team Member, including management, Chief Officers and the Governing Board, plays in building and preserving that culture. IEHP Code of Business Conduct and Ethics (PDF) Compliance, Fraud, Waste, and Abuse (FWA), and Privacy Program Training The IEHP Compliance, FWA, and Privacy Training Program focuses on the elements of an effective Compliance Program, conduct & ethics, and the Fraud, Waste and Abuse and Privacy Programs. IEHP requires delegated entities to provide Compliance Training to their employees, Providers, downstream entities, Board of Directors, and Contractors within 90 days of hire/start, and annually thereafter. IEHP is committed to a culture of compliance, ethics, and integrity. The goal of Compliance Training is to provide all associated parties the ability to demonstrate awareness of IEHP’s requirements, including regulations and policies & procedures associated with Compliance as it relates to daily work. If you have questions or additional suggestions, please e-mail the IEHP Compliance Department at compliance@iehp.org. Compliance Training FWA HIPAA Privacy and Security (PDF) Eligibility to Participate in Federal and State Health Care Programs Inland Empire Health Plan (IEHP) is prohibited from issuing payment for services provided, ordered, or prescribed by an individual or entity that is excluded, ineligible, or terminated from participation in State and Federal health care programs in accordance with regulatory and contractual requirements. IEHP conducts regular reviews of Federal and State exclusionary databases and lists, including but not limited to: Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE list) GSA Excluded Parties List System (EPLS) DHCS Medi-Cal Suspended and Ineligible Provider List CMS Preclusion List Restricted Provider Database (RPD) Exclusion Screening IEHP has implemented a screening process to identify individuals and entities that appear on the DHHS OIG LEIE, the GSA EPLS, the CMS Preclusion List and the DHCS Medi-Cal Suspended and Ineligible Provider List prior to appointment, contracting, and/or employment and monthly thereafter to ensure that none of these individuals or entities are excluded, ineligible or terminated from participation in State and Federal health care programs. Delegated entities must implement a screening program for employees, Board Members, contractors, and business partners to avoid relationships with individuals and/or entities that tend toward inappropriate conduct. This program includes but is not limited to: Prior to contract and monthly thereafter, review of the GSA System for Award Management (SAM), the Department of Health Care Services Medi-Cal Suspended and Ineligible list, and the Office of Inspector General’s (OIG) List of Excluded Individuals and Entities (LEIE) that are excluded from participation in government health care programs (42 CFR §10011901). A monthly review of the Department of Health Care Services Medi-Cal Suspended and Ineligible list. Criminal record checks when appropriate or as required by law. Review of the National Practitioner Databank (NPDB). Review of professional license status for sanctions and/or adverse actions. Reporting results to Compliance Committee, Governing Body, and IEHP as necessary. Fraud, Waste, and Abuse (FWA) IEHP has established a Fraud, Waste, and Abuse Program to detect, correct, and prevent fraud, waste, and abuse on part of Team Members, IEHP Members, Providers, Vendors, delegated entities and any other entity doing business with IEHP. Fraud Prevention Fraud Prevention, it’s a Team Effort In an effort to prevent fraud and abuse, IEHP encourages Providers and their staff to report any suspicious circumstances when they arise. You may want to ask for another form of identification in addition to the IEHP Member identification card. Identification with both a picture and a signature, such as a valid driver’s license or State identification card, are suggested. We are informing Members of this concern and are requesting that they have additional identification available when they come to you. To obtain more compliance guidelines, the Department of Health and Human Services (HHS) offers assistance (by clicking on this link you will be leaving the IEHP website). Fraud is knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program, or to obtain, by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any health care benefit program. Examples include: Knowingly billing for services or prescriptions not furnished or supplies not provided Knowingly altering claim forms for a higher payment Selling medicine, medical equipment, or other things received through IEHP Waste includes overuse of services, or other practices that, directly or indirectly, result in unnecessary costs. Waste is generally not considered to be caused by criminally negligent actions but rather by the misuse of resources. Examples include: Conducting excessive office visits Writing excessive prescriptions or ordering excessive tests Prescribing more medications than necessary for the treatment of a specific condition Abuse includes actions that may, directly or indirectly, result in unnecessary costs and improper payment or services. Abuse involves payment for items or services when there is no legal entitlement to that payment and the provider has not knowingly and/or intentionally misrepresented facts to obtain payment. Examples include: Billing for unnecessary medical services or medical equipment Billing for brand name drugs when generics are dispensed Misusing codes on a claim, such as upcoding and unbundling codes. Report potential FWA Click Here (By clicking on this link, you will be leaving the IEHP website). Privacy Incident/Breach IEHP has established a HIPAA Privacy Program to ensure that Member’s health information is properly protected while allowing the flow of health information needed to provide and promote high-quality health care. A privacy breach is defined as unauthorized acquisition, access, use, or disclosure of protected health information (PHI) which compromises the security or privacy of such information. PHI is health information that relates to a Member’s past, present or future physical or mental health or condition, including the provision of his/her health care, or payment for that care and contains personally identifiable information (PII) such as name, SSN, DOB, Member ID, address, or any other unique identifier related to the Member. This generally means that a breach occurs when PHI is accessed, used, or disclosed to an individual or entity that does not have a business reason to know that information. The law does allow information to be accessed, used, or disclosed when it is related to treatment, payment, or healthcare operations directly associated with the work that we do at IEHP on behalf of our Members. Report a Privacy Incident/Breach Click Here (By clicking on this link, you will be leaving the IEHP website). Reporting Information IEHP has the following resources available for reporting fraud, waste or abuse, privacy issues, and other compliance issues: Compliance Hotline: (866) 355-9038 Fax: (909) 477-8536 E-mail: compliance@iehp.org. Mail: IEHP Compliance Officer P.O. Box 1800 Rancho Cucamonga, CA 91729-1800 Online: (By clicking on this link, you will be leaving the IEHP website) Report a Compliance Issue: Click Here Report a Privacy Incident/Breach: Click Here Report potential FWA: Click Here Frequently Asked Questions (FAQs) What are some common examples of fraud? Providers Billing for services not rendered Paying a "kickback" in exchange for a referral for medical services or goods Unbundling Overcharging for services or goods  Using false credentials Members Allowing unauthorized individuals to use ID card to obtain benefits Altering prescriptions Falsifying residence information to obtain benefits Drug seeking or doctor shopping to obtain narcotics What do I do if I suspect an IEHP Member is engaging in possible fraud, waste, or abuse? First, document your suspicions. Then, contact IEHP’s Compliance Department at (866) 355-9038 and make a report with one of our Representatives. At times, IEHP may request additional information that is necessary to investigate. IEHP also has the following resources available for reporting fraud, waste or abuse, privacy issues, and other compliance issues: Compliance Hotline: (866) 355-9038 Fax: (909) 477-8536 E-mail: compliance@iehp.org Mail: IEHP Compliance Officer P.O. Box 1800 Rancho Cucamonga, CA 91729-1800 Online: (By clicking on the following links, you will be leaving the IEHP website) Report a Compliance Issue Click Here Report a Privacy Incident/Breach Click Here Report potential FWA Click Here What do I do if my facility has made some billing errors? If you suspect that errors in billing may have occurred, contact your IEHP Provider Services Representative at (909) 890-2054. What are some other things I can do as a Provider? Periodically perform internal audits of billing practices and compare billing records with payments received. Do not leave prescription pads, which include a Provider's identification and license number, out in the open. For example, do not store prescription pads in exam room cabinets or leave on office counters. IEHP DualChoice (HMO D-SNP) Model of Care Training The Centers for Medicare & Medicaid Services (CMS), the Department of Health Care Services (DHCS) and the National Committee for Quality Assurance (NCQA) require that IEHP staff and contracted consultants/vendors, our Medicare IPAs, Hospitals/SNFs, and Providers, receive training on the Plan’s Model of Care for our D-SNP Members: Interdisciplinary Care Team (ICT) Fact Sheet (PDF) IEHP DualChoice (HMO D-SNP) Model of Care Training (PDF) IEHP DualChoice (HMO D-SNP) Model of Care Training (HTML)   *We recommend opening file in: Mozilla Firefox, MS Edge or MS Internet Explorer Contact the OIG The Office of the Inspector General (OIG) is there to assist you and maintains a hotline, which offers a confidential means for reporting vital information. For information on confidentiality, please contact the hotline and ask about their confidential source program. Each caller is encouraged to assist the OIG by providing information on how they can be contacted for additional information but the caller may remain anonymous. Contacting the Office of the Inspector General Phone: (800) HHS-TIPS (447-8477) E-mail: Htips@oc.dhhs.gov Additional Hotlines DHCS Medi-Cal Fraud Hotline Phone: (800) 822-6222 E-mail: fraud@dhcs.ca.gov Web: https://apps.dhcs.ca.gov/stopfraud/Default.aspx  The recorded message may be heard in English and 10 other languages: Spanish, Vietnamese, Cantonese, Armenian, Hmong, Cambodian, Laotian, Farsi, Korean and Russian. The call is free and the caller may remain anonymous.    You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

a logistics support and communications electronics officer for the U.S. Air Force.  Mr. Williams received a Bachelor of Science degree in mathematics from Morehouse College in 1964 and a Master of Science in logistics management, which he earned through the Air Force Institute of Technology in 1970.  

ted to the Moreno Valley City Council in 2013, also serving as a three-term mayor and the city’s first directly elected mayor. Supervisor Gutierrez grew up in Moreno Valley, attending all local public schools. He went on to earn an associate degree from Moreno Valley College, a bachelor’s from California Baptist University, a master’s in education from American InterContinental University and a doctoral degree in special education from Northcentral University. He was appointed to the IEHP Governing Board in January 2023.  

sitors to iehp.org need to be in control of their personal information.  Therefore, the following is IEHP’s Internet Privacy Policy: You do not have to give us personal information to visit our site. If you choose not to provide personal information, you can still visit iehp.org. Cookies What is a cookie? A cookie is a small piece of information that is sent to your browser – along with a Web page – when you access a Web site. There are two kinds of cookies. A session cookie is a line of text that is stored temporarily in your computer's memory. Because a session cookie is never saved, it is destroyed as soon as you close your browser. A persistent cookie is a more permanent line of text that gets saved by your browser to a file on your hard drive. IEHP uses session cookies only. We do not use any persistent cookies. IEHP's Use of Cookies Certain applications on the iehp.org web site require session cookies to function correctly. If you have session cookies disabled, you may not be able to use these applications or features of our site. Where they are used, IEHP's session cookies remember your selection criteria. For example, if you use the "Screen Reader Friendly" version of iehp.org with cookies disabled, you will need to choose this option for every page. If you have cookies enabled, this preference will be remembered for the duration of your visit. You do not need to have session cookies enabled to view static web content on iehp.org. We have set our software so that your browser will only return cookie information to iehp.org. No other site can request it. Note: Regardless of the particular uses for cookies on IEHP website, we will not share any cookie information with any third parties. Linking to other sites From time to time we will provide links to other websites, not owned or controlled by IEHP. We do this because we think this information might be of interest or use to you or where, as a Member, we can provide you with additional information and/or services. While we do our best to ensure your privacy, we cannot be responsible for the privacy practices of other sites. A link to a non-IEHP Web site does not constitute or imply endorsement by IEHP. Additionally, we cannot guarantee the quality or accuracy of information presented on non-IEHP websites. We encourage you to review the privacy practices of any website you visit. The IEHP website clearly displays when a User is leaving the home website and going to a linked site. How will information collected about me be used? We may collect personally identifiable information (name, e-mail address, physical address, and other unique identifiers) only if specifically and knowingly provided by you. Personally identifying information collected, such as information you give us when submitting a grievance, will be used only in connection with iehp.org, or for such purposes as are described at the point of collection. IEHP will protect the personal information that you share with us. IEHP does not disclose, give, sell, or transfer any personal information to third parties. If we share demographic information with third parties, we will give them aggregate information only. Information collected is for statistical purposes. IEHP performs analyses of user behavior in order to measure Member interest in the various areas of our sites.  To change any information that you provided to us online, call IEHP Member Services at 1-800-440-IEHP (4347)/TTY (909) 890-0731. We manage and maintain retained personal health information for six years in compliance with federal and state regulations. Deletion and/or removals are handled in accordance with Grievance Policy and Procedures: Deletions and Removals. Use of Electronic Mail While IEHP will make every attempt to protect the personal information that you share with us, electronic mail is not secure against interception. If your communication is very sensitive, you may want to send it by mail instead. Or call IEHP Member Services at 1-800-440-IEHP (4347)/TTY (909) 890-0731. We want to be very clear: We will not obtain personally identifying information about you when you visit our site, unless you choose to provide such information. E-mail sent to Member Services at memberservices@iehp.org will be responded to within 24 hours. Grievances submitted online will be acknowledged in writing within 5 calendar days. Requesting Policy and Procedures You can view our Policy and Procedures detailing editorial policies, security, accountability, and access online, or request a copy by calling IEHP Member Services at 1-800-440-IEHP (4347)/TTY (909) 890-0731. Changes to Our Web Privacy Statement The foregoing Web Privacy Statement, effective September 1, 2002, was revised on July 8, 2004. IEHP may change this statement from time to time without notice. This statement is not intended to and does not create any contractual or other legal right in or on behalf of any party. Protect yourself against email scams called “phishing” or “spoof” emails. Protecting Member privacy is a priority at IEHP. We also strongly encourage our Members to take every precaution in guarding their personal information against the Email scam known as “phishing.” Spoofing and phishing are two different, but interrelated, techniques employed by scammers to steal your personal information. Spoofing refers to the practice of "impersonating" someone else in an e-mail or on the Web. Phishing attempts to trick users into revealing their private information, usually in tandem with a spoofed e-mail and Web page. What is Email phishing? “Phishing” is designed to steal identities. Through fraudulent Emails masking as emails from legitimate businesses, criminals attempt to con individuals into providing personal information such as credit card numbers, passwords, account data, or other valuable information. How does Email phishing work? The Emails usually display well-known brand names such as your bank, your insurance carrier, or even your wireless provider. These deceptive emails are called "Spoof Emails" because they fake the appearance of a popular website or company in an attempt to commit identity theft. Typically, the Email tries to create a sense of urgency, requesting that the recipient update or confirm their personal information. Links may be provided to a website that may also display the company logo or other well-known elements of the company. What to watch out for: Generic greetings. Instead of using your name, many fraudulent emails begin with a general greeting, such as: "Dear [Company Name] customer”. (IEHP will always send emails that include either your Member ID number or your full name in each email.) A false sense of urgency. The Email will attempt to deceive you with the threat that your account is in jeopardy if you don't update your information as soon as possible.  Fake links. The text in a link may look valid, and then send you to a “spoof” address. Always check where a link is going before you click. Move your mouse over it and look at the URL on your browser or status bar. If it looks suspicious, don’t click on the link. What happens if I receive an Email that is fraudulent or seems to be fraudulent?  We suggest that you do not respond to the Email or the Email address in the body of the message. If you receive a suspicious Email purporting to be from IEHP, please contact IEHP Member Services immediately by calling 1-800-440-IEHP. Practice good general computer security measures. This includes installing and maintaining antivirus and firewall software. Some phishing e-mails include spyware that can track your Internet activity and compromise the security of your system. Note: IEHP does not send Email notices asking for customer payment information, username, or passwords used to manage account. Messages and transactions Comments or questions sent to us using e-mail or secure messaging forms may be shared with IEHP staff and health care professionals who are most able to address your concerns. We will archive your messages once we have made our best effort to provide you with a complete and satisfactory response. All IEHP staff considers Member information confidential. Your Privacy is priority to IEHP.   When you use a service on the secure section of this Web site to interact directly with IEHP health care professionals, some information you provide may be documented in your medical record, and available for use to guide your treatment as a patient. Children  We do not knowingly allow IEHP Members under the age of 18 to create accounts that allow access to the secured features of this site. Opt out  If a user makes a request to receive information in an ongoing manner through this Web site by providing their e-mail address (for example, requesting a subscription to one of our online publications), a user may make a request to discontinue future mailings. Similarly, if you receive information about an IEHP service through e-mail, you may make a request to discontinue receiving similar messages in the future. All such materials sent to you by e-mail will contain information about how to opt out. To stop receiving emails from IEHP, log into your Member account. Click on your “Update Profile” tab and uncheck the box stating, “Email Contact” (do so for each Member in your family). Also, if as a member you register to use protected features on our Web site, you may be given an opportunity to receive e-mails about different types of IEHP products, services, announcements, and updates. You may change your preferences anytime by calling IEHP Member Services at 1-800-440-IEHP. Again, we hope to make your online experience enjoyable and secure. Thank you for taking the time to read this Privacy Statement.   Sharing Your Health Information Privacy guidance when selecting third-party apps We are required to provide you with access to detailed information about your health history through a “Patient Access API.” While you are a current member, you may access this information by downloading an application (app) on your smartphone, tablet, computer, or other similar device. The information available through the Patient Access API includes information we collect about you while you have been enrolled in certain lines of business since January 1, 2016. The information includes the following information for as long as we maintain it in our records: Claims and encounter data concerning your interactions with health care providers Clinical data that we collect in the process of providing case management, care coordination, or other services to you. The information we will disclose may include information about treatment for substance use disorders, mental health treatment, HIV status, or other sensitive information. It is important for you to understand that the app you select will have access to all your information. The app may not be subject to the Health Insurance Portability and Accountability Act (HIPAA) rules and other privacy laws, which generally protect your health information. Instead, the app’s privacy policy describes self-imposed limitations on how the app will use, disclose, and (possibly) sell information about you. It is important for you to know once we send your data to the app, we no longer control how the app uses or shares your information. If you decide to access your information through the Patient Access API, you should carefully review the privacy policy of any app you are considering using to ensure you are comfortable with what the app may do with your information. IEHP asks that any app developer planning to access the IEHP Patient Access API attest that it complies with basic privacy and security standards, but you can consent to sharing your data with the app even if they do not attest. When you access a third-party app and select to share your data, IEHP will provide a warning to you if an app did not attest that it complies with basic privacy and security standards. Things you may wish to consider when selecting an app: Will this app sell my data for any reason? Will this app disclose my data to third parties for purposes such as research or advertising? How will this app use my data? For what purposes? Will the app allow me to limit how it uses, discloses, or sells my data? If I no longer want to use this app, or if I no longer want this app to have access to my health information, can I terminate the app’s access to my data? If so, how difficult will it be to terminate access? What is the app’s policy for deleting my data once I terminate access? Do I have to do more than just delete the app from my device? How will this app inform me of changes in its privacy practices? Will the app collect non-health data from my device, such as my location? What security measures does this app use to protect my data? What impact could sharing my data with this app have on others, such as my family members? Will the app permit me to access my data and correct inaccuracies? (Note that correcting inaccuracies in data collected by the app will not affect inaccuracies in the source of the data.) Does the app have a process for collecting and responding to user complaints? If the app’s privacy policy does not satisfactorily answer these questions, you may wish to reconsider using the app to access your health information. Your health information may include very sensitive information. You should therefore be careful to choose an app with strong privacy and security standards to protect it. Covered entities and HIPAA enforcement The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) enforces the HIPAA Privacy, Security, and Breach Notification Rules. IEHP is subject to HIPAA as are most health plans and health care providers, such as hospitals, doctors, and clinics. You can: Find more information about your rights under HIPAA and who is obligated to comply with HIPAA Learn more about filing a complaint with OCR related to HIPAA requirements File a complaint by calling 1-800-440-4347; or completing the grievance form on our website here: GRIEVANCE FORM. Apps and privacy enforcement An app generally will not be subject to HIPAA. An app that publishes a privacy notice is required to comply with the terms of its notice, but generally is not subject to other privacy laws. The Federal Trade Commission Act protects against deceptive acts (such as an app that discloses personal data in violation of its privacy notice). An app that violates the terms of its privacy notice may be subject to the jurisdiction of the Federal Trade Commission (FTC). The FTC provides information about mobile app privacy and security for consumers. If you believe an app inappropriately used, disclosed, or sold your information, you should contact the FTC and file a complaint.      

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

s for Contracted and Non-Contracted Providers Emergency and Post-Stabilization Care for IEHP Members IEHP DualChoice (HMO D-SNP) Model of Care Training for Non-Contracted Providers Provider Referral Outside of the IEHP Network Provider Dispute Resolution Process for Contracted and Non-Contracted Providers   Definition of a Provider Dispute A provider dispute is a written notice from the provider to Inland Empire Health Plan (IEHP) that: Challenges, appeals, or appeals, or requests reconsideration of a claim (including a bundled group of similar claims) that has been denied, adjusted, or contested Challenges a request for reimbursement for an overpayment of a claim Seeks resolution of a billing determination or other contractual dispute   What is not Considered to be a Provider Dispute Claims denied for missing or additional documentation requirements such as consent forms, invoices, Explanation of Benefits from primary carrier, or itemized bills are not considered Provider Disputes Corrected Claims Pre-Service Authorization Denials   Provider Dispute Time Frame IEHP accepts disputes from providers if they are submitted within 365 days of receipt of IEHPs decision (for example, IEHPs Remittance Advice (RA) indicating a claim was denied or adjusted).   Submission of Provider Disputes When submitting a provider dispute, a provider should use a Provider Dispute Resolution Request form. If the dispute is for multiple, substantially similar claims, complete the spreadsheet on page 2 of the Provider Dispute Resolution Request Form All Provider Disputes and supporting information must be submitted to: IEHP Claims Appeal Resolution Unit PO BOX 4319 Rancho Cucamonga, CA 91729-4349   Acknowledgement of Provider Dispute IEHP acknowledges receipt of each provider dispute, regardless of whether the dispute is complete, within 15 business days of receipt.   Resolution Timeframe IEHP resolves each provider dispute within 45 business days following receipt of the dispute, and provides the provider with a written determination stating the reasons for determination.   PDR Determination Resulting in Additional Payment If IEHP determines to pay additional monies based on information originally provided and/or available at the time the claim was first presented to IEHP for adjudication, or a result of a processing error IEHP will automatically include the appropriate interest amount if payment is not issued within required regulatory timeframes.   Non-Contracted Provider Disputes Resolution Process for IEHP DualChoice (HMO D-SNP) A non-contracted provider, on his or her own behalf, is permitted to file a standard appeal for a denied claim only if the non-contracted provider completes a waiver of liability statement, which provides that the non-contracted provider will not bill IEHP DualChoice (HMO D-SNP) Plan Members.   Who to Call with Questions on IEHPs PDR Process Contracted providers may visit our online secure provider portal at www.iehp.org for more information. Providers may also call the IEHP Provider Call Center at (909) 890-2054 or (866) 223-4347 Monday-Friday, 8:00 am to 5pm PST.   (Back to Non-Contracted Providers Menu) Emergency and Post-Stabilization Care for IEHP Members   Triage and Advice Systems IEHP provides Members triage, screening, and advice services by telephone 24 hours a day, 7 days a week through its Nurse Advice Line (NAL). By calling the NAL, Members receive assistance with access to urgent or emergency services from an on-call physician, or licensed triage personnel. IEHP Members can reach this 24/7 Nurse Advice Line at (888)-244-IEHP (4347) or 711 (TTY).   Post-Stabilization Care IEHP requires contracted and non-contracted hospitals to obtain prior authorization for post-stabilization care for Members (patients). IEHP requests the patient’s diagnosis as indicated by the treating physician or surgeon and any other information reasonably necessary for the Plan to decide on whether to authorize post-stabilization care or to assume management of the patient’s care by prompt transfer to another facility. The hospital should request prior authorization from IEHP’s Utilization Management (UM) Department by: Phone at (866) 649-6327; or Fax at (909) 477-8553 to send clinical notes for medical necessity review.   IEHP makes every effort to respond to requests for necessary post-stabilization care within thirty (30) minutes of receipt. The services are considered approved if IEHP does not respond within this timeframe. All subsequent hospital day are subject to review for medical necessity. IEHP will inform the provider of the Plan’s decision and will coordinate the transfer of the Member if IEHP denies the request for authorization of post-stabilization care and elects to transfer the Member to another health care provider.   Non-Emergency Services If a Member presents at the emergency department for non-emergency services, please refer the Member to their IEHP Member Handbook, section 3 (How to Get Care), which outlines the process for obtaining a referral.   Claims Reimbursement Complete facility claims for authorized health care services must be sent to: Inland Empire Health Plan Attn: Claims Department – IEHP Direct PO BOX 4349 Rancho Cucamonga, CA 91729-4349 Complete professional claims for authorized health care services must be sent to: For IEHP-Direct Members, please send to address above. For IEHP Members assigned to an IPA, please click for here for more information on how to send to the appropriate IPA.   Billing IEHP Members Providers under the Medi-Cal program must not submit claims to, demand or otherwise collect reimbursement from a Medi-Cal beneficiary, or from other persons on behalf of the beneficiary, for any service included in the Medi-Cal program’s scope of benefits in addition to a claim submitted to the Medi-Cal program for that service.   (Back to Non-Contracted Providers Menu) IEHP DualChoice (HMO D-SNP) Model of Care Training for Non-Contracted Providers   The Centers for Medicare & Medicaid Services (CMS), the Department of Health Care Services (DHCS), and National Committee for Quality Assurance (NCQA) requirement that out-of-network providers routinely seen by IEHP DualChoice (HMO D-SNP) Members, receive training on IEHPs Model of Care for our D-SNP Members:   IEHP DualChoice (HMO D-SNP) Model of Care Training (PDF) IEHP DualChoice (HMO D-SNP) Model of Care Training (HTML)   *We recommend opening file in: Mozilla Firefox, MS Edge, Chrome or MS Internet Explorer 2023 IEHP DualChoice (HMO D-SNP) Model of Care eAOR 2023 IEHP DualChoice (HMO D-SNP) Model of Care Non-Contracted Provider AOR (PDF) Report an Issue To report any issues with this system or process or for any questions, please send an email to DGHospitalRelationsServiceTeam@iehp.org   (Back to Non-Contracted Providers Menu) Provider Referral Outside of the IEHP Network   In cases where an out-of-network provider that has been approved to provide service(s) to an IEHP Member and needs to refer said IEHP Member to another out-of-network provider, the approved out-of-network provider must first contact the Member’s IPA to request the referral. The Member’s IPA will review the request for referral and provide a decision within regulatory timeframes. The Member’s IPA will approve the request if it is deemed medically necessary and if IEHP or the IPA does not have an appropriate alternative provider available within its network. If you have any questions or if you would like to request a referral, please reach out to the Member’s IPA.   (Back to Non-Contracted Providers 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.