Search Results For : " DIPLOMA IN ENVIRONMENTAL SCIE "
Clinical Information - Medication Therapy Management
MTM is a term to describe a broad range of services offered by Pharmacists on our health care team. The IEHP Clinical Pharmacy Team reviews the Members’ medicines, making sure they’re taking the right ones for their health conditions. If you are a Provider for IEHP Members who qualify for the MTM Program, you can let them know to look out for a letter from us. They will be enrolled automatically—unless they opt-out. MTM is offered to Members at no additional cost. IEHP's MTM services include these core elements: Medication therapy reviews Medication education Disease management A team of Pharmacists and Doctors developed these MTM services to help provide better prescription drug coverage for our Members. For example, MTM also helps identify possible medication errors. Medicare MTM Program This is a free program under Medicare Part D for IEHP DualChoice Members who have multiple medical conditions, take many prescription drugs, and have high drug costs to assist with better medication management and overall health. IEHP DualChoice Members’ enrollment includes a yearly comprehensive medication review (CMR) and regular targeted medication review (TMR) services throughout the year. MTM services include: Comprehensive Medication Review (CMR) An IEHP Clinical Pharmacist will provide an annual comprehensive review of the IEHP DualChoice Member’s medications over the phone. The Pharmacist will review IEHP DualChoice Member’s medications and make clinical recommendations to IEHP DualChoice Members and Providers. Targeted Medication Review (TMR) The IEHP Clinical Pharmacy Team will also offer TMRs through the year by reviewing issues with the participating IEHP DualChoice Member’s medicines. The team will perform TMRs for all enrolled beneficiaries every three months. The beneficiary may get TMR recommendations by mail and their Primary Care Provider may receive recommendations by fax—if the IEHP Clinical Pharmacy Team deems it necessary. For more information, IEHP DualChoice Members eligible for CMR or TMR services can call 1-877-273-IEHP (4347), 8am-5pm (PST), 7 days a week, including holidays. TTY users should call 1-800-718-4347. Click here for a blank personal medication list. Medicare MTM Program services may have limited eligibility criteria. They are available for the following conditions: 1. The IEHP DualChoice Member has a minimum of three (3) disease states: Bone Disease-Arthritis-Osteoporosis Bone Disease-Arthritis-Rheumatoid Arthritis Chronic Heart Failure (CHF) Diabetes Dyslipidemia End-Stage Renal Disease (ESRD) Hypertension Mental Health Chronic/ Disabling Mental Health Conditions Respiratory Disease – Asthma Respiratory Disease – Chronic Obstructive Pulmonary Disease (COPD) 2. The IEHP DualChoice Member is prescribed a minimum of five (5) different medications to treat those disease states: ACE-Inhibitors Angiotensin II Receptor Blockers (ARBs) Antidepressants Antihyperlipidemic Antihypertensives Antipsychotics Beta Blockers Bronchodilators Calcium Channel Blockers Disease-Modifying Anti-Rheumatic Drugs (DMARDs) Diuretics Insulins Oral Hypoglycemics Selective Serotonin Reuptake Inhibitors (SSRIs) Tumor Necrosis Factors (TNFs) Inhaled Corticosteroids Calcimimetic Cardiac Glycoside Colony Stimulating Factors Glucagon-Like Peptide-1 Glucocorticosteroids Neprilysin Inhibitor NSAIDs Phosphate Binders Vitamin D Analogs 3. Drug costs of $1,233.75 (one-fourth of $4,935) for the previous three months are likely to be incurred. To learn more about MTM, call IEHP DualChoice (HMO-DSNP) at 1-877-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. TTY users should call 1-800-718-4347. For answers to frequently asked questions, please download the FAQ document below: MTM FAQs (PDF) For details, contact the IEHP Pharmaceutical Services Department at (909) 890-2049, Monday-Friday, 8am-5pm. IEHP DualChoice (HMO-D-SNP) [Medicare-Medicaid Plan] is a Health Plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. Information on this page is current as of March 2023. H5355_CMC_20_1900233_Accepted
Latest News - Statewide Initiative Supports Behavioral Health of I.E. Youth
h Molina Healthcare, County Behavioral Health, the Offices of Education in Riverside and San Bernardino counties, and select local school districts and charter schools to implement the Student Behavioral Health Incentive Program (SBHIP). The three-year program is in accordance with the California Department of Health Care Services’ (DHCS) goal to expand prevention and early intervention behavioral health services in schools and provides financial incentives to partnering school districts and charter schools. A total of $389 million has been allocated for California. Between both IEHP and Molina Healthcare, up to $50,845,334 can be utilized to support this program. According to the American Psychological Association, one in five young women and one in ten young men experience a major depressive episode before the age of 25. The COVID Collaborative also notes one in 330 California children have lost either a parent or caregiver in the last two years, adding significant stress and trauma to the lives of California’s youth, along with stay-at-home orders and remote learning. “If the past few years have taught us anything, it’s that we need to be proactive in addressing mental health and wellness needs early on, before traumas have a chance to manifest later in life,” said Amrita Rai, IEHP’s clinical director of community behavioral health. Through SBHIP efforts, existing mental health initiatives will be bolstered, and coordination between schools, managed care plans, county behavioral health and community partners aim to address the equity gap and improve access to mental health prevention and treatment for students. Resources will be directed to fill gaps in these areas throughout the participating schools and their respective communities. Services will be limited to schools who are participating in SBHIP and who receive funding. “We are well into a crisis when it comes to the mental health and wellness of our youth. Now is the time to be bold and work tirelessly for our children because what we do now will affect generations to come,” said Rai. “Why not focus our resources, our passion, and our commitment back into the community and schools? Our children spend most of their lives in school, which makes this multi-organizational partnership so worthwhile.” Partnerships with local education agencies and school sites include San Bernardino County Superintendent of Schools (SBCSS); Riverside County of Education; Palm Springs Unified School District; Hemet Unified School District; San Bernardino City Unified School District; Rialto Unified School District; Victor Valley Union High School; Ontario-Montclair School District; Leadership Military Academy; Nuview Union School District; Provisional Accelerated Learning Academy; and Riverside County Office of Education Alternative Education Program. While the initiative will begin at these partner sites, it is anticipated that learnings would benefit other schools and districts interested in implementing similar programs in the future. “San Bernardino County Superintendent of Schools recognizes the growing mental health crisis among our youth and supports this joint effort to address this critical issue,” said County Superintendent Ted Alejandre. “SBCSS seeks to build capacity within countywide systems and increase access to much needed support to ensure every child receives the services they need when they need them.” “Educators at the Riverside County Office of Education and within all Local Educational Agencies (LEA) in Riverside County, are vitally interested in addressing the needs of the whole student beyond the classroom. Linking arms with partners across the county via the Student Behavioral Health Incentive Program (SBHIP) will equitably provide mental health services to those who might not otherwise have access to this level of support,” said Riverside County Superintendent of Schools, Dr. Edwin Gomez. Selection of school districts and charter schools was dependent on DHCS guidelines and considered specific criteria, such as the number of students who received Medi-Cal, were foster youth or English learners, received free or reduced priced meals, were interested in participating in the program and other factors. “It’s the right thing to do. This program gives us a great opportunity to extend both heart and hand to children in our community,” said Dr. Takashi Wada, IEHP’s chief medical officer. “Working together, we can equip them with necessary skills, habits and care they can use today and through adulthood, setting them up for a healthier and happier tomorrow.” “The COVID-19 pandemic has exacerbated and elevated behavioral health needs in our communities, including in young people. Mental and emotional wellbeing make up a significant portion of overall health and healthy youth lead to improved community wellness. We are proud to partner with IEHP, local offices of education and mental health professionals to address the youth behavioral health crisis in tangible, preventative ways.” said Dr. Sayeed Khan, chief medical officer at Molina Healthcare. Program preparation began this year and will support a January 2023 launch at all 10 participating local education agencies. Through careful planning and implementation, the program will aim to build and support a sustainable system beyond the life of the program, which will end in December 2024. alt=" "="" src="-/media/7c6d40e217094fb1be8ec6cec9473878.ashx?h=233&w=350" class="" />
Latest News - Celebrity Chef Provides Healthy Cooking Demos to I.E. Residents
althy cooking to the Inland Empire (I.E.) by showing Members and community residents how to cook delicious, traditional meals with a healthy and spicy twist at the health plan’s Victorville Community Resource Center. A 2018 MasterChef Latino judge, Chef Mario is a Boyle Heights native and has expertise elevating the culinary experience of residents in and around the Los Angeles area. Chef Mario’s demonstrations highlight cooking with both new and familiar ingredients that are proven to address common health issues in the region, including diabetes and hypertension. “Healthy eating doesn’t need to mean bland or boring food and Chef Mario knows how to make that possible,” said IEHP’s Community Health Senior Director Cesar Armendariz. “We’re thrilled to connect Chef Mario to our Members and communities to learn how to better utilize spices and well-known ingredients to better manage our health and wellness in a vibrant, delicious manner.” Chef Mario’s cooking demonstrations are open to the community and take place in July every Tuesday from 12:30 p.m. - 1:30 p.m. Classes in August will be every Thursday from 10:30 a.m. - 11:30 a.m. at the health plan’s Victorville center, located at 12353 Mariposa Road, Suites C-2 & C-3. IEHP also plans to record demonstrations for public use in the coming months. “This partnership means so much to me on a personal level. A healthy way of life should be available to all – it’s such an important component of health care that is often ignored,” said Chef Mario. “Food is the connection to everything, from our physical well-being to our mental well-being. There has been no greater time than now to embrace healthy eating but not sacrifice the flavor. I'm so excited to partner with IEHP and have so many fun demos, recipes and other surprises coming.” In addition, IEHP will connect Chef Mario to community partners for additional cooking demonstrations and civic events. “IEHP is proud to provide education and resources to Members and community residents who want to learn how to better manage their health through cooking. We’re excited to have Chef Mario’s help as we continue to look for ways to serve our community,” said IEHP Chief Executive Officer Jarrod McNaughton. To learn more about IEHP’s Community Resource Centers or to find a nutrition class, visit the community resource page. alt=" "="" src="-/media/dc4dca59a6f446009bdb09836af76cc9.ashx?h=400&w=300" class="" />
Latest News - SAC Health Receives IEHP’s Mission INSPIRE AWARD
C), received Inland Empire Health Plan’s (IEHP) Mission INSPIRE Award this month at the health plan’s second Annual Mission Conference. The award recognized SAC Health’s ongoing support and service to residents in Riverside and San Bernardino counties. SAC Health’s roots reach back as far as the 1960s, which have led to 35 specialties offered today at 10 locations, including a mobile unit that supports more than 144,000 patient visits each year. SAC Health is also one of IEHP’s most prominent partners, providing care to more than 50,000 of the Inland Empire’s most vulnerable residents and educating future physicians in the region. In collaboration with SAC Health, new health care clinics were developed in brand new service areas, supporting thousands of residents in Blythe and Barstow. “You can’t do this kind of work and truly impact the community and those that need the care without really strong partnerships. It takes a whole community to do that,” said Dr. Jason Lohr, CEO of SAC Health. “We are overwhelmed with gratitude and humility to be honored with this award.” SAC Health is one of the first recipients of the IEHP Mission INSPIRE Award. The award honors providers, community organizations and partners for their commitment to the health plan’s mission to “heal and inspire the human spirit.” “We are thrilled to honor SAC Health’s dedication and determination to consistently do the right thing for our communities and Members,” said Jarrod McNaughton, IEHP Chief Executive Officer. To learn more about the IEHP Mission Conference and how the health plan is charting a collaborative path forward, visit iehp.org.
Latest News - Student Health Reimagined at 2023 SBHIP Event
he Student Behavioral Health Incentive Program (SBHIP) event held Feb. 27 at Inland Empire Health Plan’s (IEHP) headquarters. IEHP, Molina Healthcare of California, Riverside University Health System Behavioral Health, San Bernardino Department of Behavioral Health, the Offices of Education in Riverside and San Bernardino Counties, local school districts and charter schools gathered to acknowledge their collaboration and planning efforts over the last year. These efforts are in response to the California Department of Health Care Services' (DHCS) goal to expand prevention and early intervention behavioral health services in and around schools. The initiative provides financial incentives to partnering school districts and charter schools. To move beyond planning and gear up for the implementation phase of the initiative, the group shared experiences and insight and raised awareness about their plans. Event speakers included Dr. Amy Young-Snodgrass, chief of the division of forensic pediatrics at LLU Children’s Hospital, Dr. Edwin Gomez, Riverside County Office of Education superintendent, Ted Alejandre, San Bernardino County Office of Education superintendent, Jarrod McNaughton, IEHP chief executive officer, Abbie Totten, plan president of Molina Healthcare of California and others. “Molina Healthcare of California is committed to improving access to behavioral health care services in our local schools,” said Totten. “We are grateful for the opportunity to collaborate with organizations that share in this mission as we move forward to implement innovative solutions addressing this critical issue.” The initiative’s implementation phase will include key interventions that focus on behavioral health wellness programs, care teams, expansion of the behavioral health workforce, substance use disorders and culturally appropriate and targeted populations. In addition, IEHP will be supporting SBHIP interventions through their Health Plan Navigators, stationed on local school campuses. “The relationships, processes and infrastructure we build together will redefine how we care for our children, and have a positive impact for generations to come,” said Amrita Rai, IEHP’s clinical director of community behavioral health. “Having the opportunity to reimagine our systems of care takes intention and it takes work. I’m so thankful for organizations that share that vision and are willing to make that future a reality.”
Latest News - IEHP Expands Healthcare Services to Entire Inland Empire
are services for more than 11,000 residents in Needles, Big River, Red Mountain, Blythe, Trona and surrounding areas in California. The expanded coverage, directed through the CalAIM initiative, will transition traditional services to managed care plans like IEHP and provide a new coordinated care service offering supporting all 27,408 miles of the Inland Empire. Prior to the expansion, residents in these rural areas received health coverage through Medi-Cal’s traditional fee-for-service model but did not have access to services like health education programs, telephone advice nurses, and coordinated care support. IEHP is currently in the process of contracting and credentialing available Providers in these areas to ensure Members are assigned to the Primary Care Providers nearest to their areas. “Just like the rest of our Membership, these new Members deserve the best care possible and should have access to a solid network of Providers and community supports,” said Susie White, IEHP Chief Operating Officer. “We’re thrilled some of our trusted Provider partners have made their way into our new service area and opened clinics to welcome our new Members. Teams across our organization continue to work on building a sustainable network for our entire community.” To help new Members become familiar with the health plan and the resources they now have access to, IEHP’s Community Health Teams have attended and hosted various events in the community, with the commitment to continue the support efforts moving forward. Earlier this year, IEHP joined community partners Young Visionaries, the Family & Kids Foundation, and Food Forward, to provide food, toys, household items, fresh produce, and vaccine opportunities for more than 300 residents in Trona. “As an IEHP Member, you can absolutely trust that we will do the right thing for you and your family and get you connected to the care you need,” said Jarrod McNaughton, IEHP Chief Executive Officer. “We are so excited to welcome our neighbors in these rural areas and support them in a way that complements and enhances their quality of life for years to come.”
Latest News - IEHP and Victor Valley College Continue Food Distribution in the High Desert
curity in the high desert. Community residents can receive a free food box at VVC’s Lower Campus every Monday from 11 a.m. to 12:30 p.m. While residents are encouraged to register online at tinyurl.com/vvcfoodboxreg, non-registered walk-ups are welcome at 12:30 p.m., while supplies last. Recipients must be 18 years or older, and boxes are limited to one per household. Prior to partnering with VVC, the health plan hosted weekly food box drive-thru distribution events at their Victorville Community Resource Center (CRC), totaling more than $5M in food from June 2020 to July 2021. “Food insecurity is one of the greatest needs in our region. We knew the distribution efforts had to continue,” said Delia Orosco, IEHP Victorville CRC Manager. “We are so grateful to VVC, a key community partner, for continuing to serve the community so our resource centers can prepare to reopen and serve again in the future.” To support high desert residents, food is ordered weekly through Community Action Partnership of San Bernardino, picked up each Monday morning by High Desert Second Chance, and delivered to VVC. IEHP Team Members, VVC students and faculty, and volunteers from God’s Hand Extended operate the event and work to distribute food directly to residents. “It is truly our pleasure to partner with such amazing organizations like IEHP and God’s Hand Extended. This is a collaborative effort and great example of how education, healthcare, and community organizations can come together with a common goal and purpose to serve,” said Amber Allen, VVC Special Grant Programs Director. “By bringing our community to the college to provide food, we are opening the doors to people who may not be aware of available opportunities at VVC. This effort helps us to meet people where they are, so they have the ability to focus on their goals, beyond just meeting their basic needs.” In addition to food distribution efforts, IEHP and VVC will launch on-campus health and wellness programs to support VVC students. Programs will include personalized wellness support for students, fitness classes and more. “These resources are brought to the community, by the community,” said Jarrod McNaughton, IEHP Chief Executive Officer. “These partnerships place life-changing resources within reach for so many of our most vulnerable residents. Times may be tough, and resources may be sparse, but partnerships and collaborations allow for hope and progress to be continuously made.” VVC hopes to continue the distribution effort for as long as it is needed. To learn more about the food box drive-thru, visit vvc.edu/events/free-weekly-food-box-drive-thru.
Innovations and Quality Performance - Quality Performance
rting our providers. We are committed to quality, driving us to create programs and services to meet the needs of our members and providers. In fact, IEHP is one of the top-rated Medicaid plans in California. Determined by both the Healthcare Effectiveness Data and Information Set (HEDIS) and the Consumer Assessment of Healthcare Providers and Systems (CAHPS), NCQA has awarded IEHP an Accreditation status for Medi-Cal. This status is only given to health plans that have clinical and service programs that meet or exceed NCQA standards. Learn more about how IEHP delivers quality services and care below. Quality Report Inside the 2023 Quality Report, we take you through our quality journey by looking at our performance over the past year with critical measures. We show you how that data translates into tangible outcomes for our Members, Providers and Team Members. While there were many areas where we excelled, there were also places where we found opportunities for improvement. The goal of this Quality Report is to be transparent—with you and with ourselves. This journey is ongoing, and we hope to learn from it so we can do better and be better for those who rely on us the most. 2023 Annual Quality Report (PDF) 2022 Annual Quality Report 2020 Annual Quality Report (PDF) Quality Management IEHP supports an active, ongoing, and comprehensive quality management program with the primary goal of continuously monitoring and improving the quality of care, access to care, patient safety, and quality of services delivered to IEHP Members. The Quality Management (QM) Program provides a formal process to systematically monitor and objectively evaluate, track and trend the health plan’s quality, efficiency and effectiveness. Quality Management Evaluation 2021 Quality Management Annual Evaluation (PDF) Quality Management Program Description 2022 Quality Management Program Description (PDF) HEDIS Every year, IEHP assesses the overall quality of health care experienced by IEHP members. To achieve this IEHP uses NCQA, a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and manages the evolution of HEDIS® which provides: a set of standardized performance measures based on statistically valid samples of members the public with information to compare health plan performance HEDIS Rate: 2021 Medi-Cal HEDIS Rates (PDF) 2021 Medicare HEDIS Rates (PDF) Physician Satisfaction IEHP values a strong partnership with our providers. To support them we offer many services from online support to a call center, to a dedicated service representative. That's why doctors think highly of IEHP. In fact, according to the 2022 Provider Satisfaction Survey conducted by SPH Analytics, 98.2% of physicians would recommend IEHP to other physicians. See the full results of the 2022 Provider Satisfaction Survey (PDF). Population Needs Assessment Every year, IEHP sends out a Population Assessment Survey to IEHP Members to learn more about their needs. View the results below. 2020 Population Needs Assessment Results You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. Download Adobe Acrobat Reader.
COVID-19 - Coronavirus
symptoms of COVID-19 People with COVID-19 have had a wide range of symptoms reported, ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. Anyone can have mild to severe symptoms, including: Fever or chills Cough Shortness of breath or difficulty breathing Fatigue Muscle or body aches Headache New loss of taste or smell Sore throat Congestion or runny nose Nausea or vomiting Diarrhea Go to the hospital or seek emergency medical attention right away if you develop severe COVID-19 symptoms, including: Trouble breathing Persistent pain or pressure in the chest New confusion Inability to wake or stay awake Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone What to do if you are feeling sick If you are experiencing any of these symptoms, consider the following actions: Get tested for COVID-19: It is free. IEHP will also pay for members who receive standard COVID-19 testing and doctor-ordered tests, no matter what type of test. Your doctor is required to bill IEHP directly for these tests. Visit your doctor or an urgent care center either in-person or telehealth access within 24 hours of symptoms starting. For IEHP members, if you can’t reach your doctor or if it’s after-hours, you can call IEHP’s 24-Hour Nurse Advice Line at 1-888-244-4347 or 711 for TTY users, 24 hours a day, seven days a week. Our trained nurses offer medical advice and, if needed, will connect you with a doctor via phone or video chat. Facts about COVID-19 treatments Most COVID-19 treatments are pills that you take at home. COVID-19 medications are free in California. You don’t need to have insurance or be a U.S. citizen. COVID-19 medications work best when started as soon as possible, within the first 5-7 days of symptoms. If you think you may have COVID, don’t wait for symptoms to get worse. COVID-19 medications are safe and effective at stopping COVID-19 illness from getting serious. They can lower the risk of serious illness, hospitalization, and death from COVID-19 by half or more. COVID-19 medications may help you test negative sooner and may reduce the risk of long COVID symptoms.* COVID-19 medications are recommended for people 12 years and older who have certain health conditions or other common factors that increase risk. A doctor can tell you if you are eligible to receive COVID-19 medications and which type is best for you. COVID-19 medications are effective whether you are vaccinated or not. If you test positive for COVID-19, have symptoms, and meet the following criteria, you should seek treatment: You are 50 years old or older –OR– You are unvaccinated or not up to date with COVID-19 vaccinations –OR– You have a health condition or other factors that increase risk. These include obesity, asthma, diabetes, lack of physical activity, smoking, mental health conditions such as depression, being of a racial/ethnic minority, and more. Learn more about medical conditions that increase the risk of serious illness from COVID-19. Click here for more information on mental health and mood conditions. * Early evidence suggests that the COVID-19 medication Paxlovid may decrease the risk of developing long COVID symptoms. These symptoms can last for weeks, months or years after a COVID-19 infection. How to get tested for COVID-19 It’s important to know how and when to test for COVID-19. Testing can give you peace of mind, provide you with information to help you make decisions about your health and help slow the spread of the virus in our community. Where to get tested for COVID-19 Visit our link for more information: https://www.iehp.org/en/members/covid-19?target=covid-19-testing-sites What if you test positive for COVID-19 Self-isolate to avoid spreading the virus to others; click here for tips about isolation and precautions for people with COVID-19 Immediately seek treatment options How to get treatment Contact your doctor’s office Contact your pharmacy Visit a test-to-treat location
Helpful Information and Resources - Member Newsletters
n programs, and important reminders to help you live a better life. The Pulse: this newsletter is for adults and families with children and who have Medi-Cal with IEHP. Health Spotlight: this newsletter is for IEHP Members with both Medi-Cal and Medicare (CMC). AccessAbility: this newsletter is for seniors and people with disabilities who have Medi-Cal with IEHP.
Pharmacy Services - IEHP DualChoice (HMO D-SNP)
P DualChoice (HMO D-SNP) is a Health Plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. It is an organization made up of doctors, hospitals, pharmacies, providers of long-term services and supports, behavioral health providers, and other providers. It also has care coordinators and care teams to help you manage all your providers and services. They all work together to provide the care you need. What is the goal of this program? The goal is to improve care by integrating the following healthcare services: Medicare and Medi-Cal benefits Long-term care Behavioral health Home and community-based services (HCBS) such as Community-Based Adult Services (CBAS) and Multipurpose Senior Services Program (MSSP). Who is eligible for IEHP DualChoice (HMO D-SNP)? People who have both Medicare and Medi-Cal. For a complete list of who is included or excluded, visit Who Qualifies? Plans and Benefits IEHP DualChoice (HMO D-SNP) integrates healthcare services to better coordinate care and improve health. How to Enroll To enroll, please call: IEHP DualChoice (HMO D-SNP) Team at 1-800-741-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. TTY/TDD users should call 1-800-718-4347, OR Health Care Options (HCO) at 1-844-580-7272, 8am – 5pm (PST), Monday – Friday. TTY/TDD users should call 1-800-430-7077. For more information, visit the DHCS website. By clicking on this link, you will be leaving the IEHP DualChoice (HMO D-SNP) website. You may also call IEHP DualChoice (HMO D-SNP) for help at 1-877-273-IEHP (4347), 8am – 8pm (PST), 7 days a week, including holidays. TTY/TDD users should call 1-800-718-4347 (4347). Plan Benefits and Cost-Sharing: Find out about plan benefits which are the types of medical care that are covered. Also view information on cost-sharing which is how much you will pay for services or prescription drugs, including monthly plan premium and co-payment. Part D Prescription Drugs: Get information on pharmacy benefits, IEHP network pharmacies, out-of-network coverage, pharmacy transition process, drug utilization management, and prescription mail order. Provider Access Information: Learn about network providers, primary care providers, specialists and how to choose a provider in our network. Read about our quality assurance activities and find out what happens if your doctor leaves our plan. Grievances, Coverage Determination and Appeals Process: Find out what to do if you have a problem or complaint about your medical care or Part D. Helpful Information: View your rights and responsibilities upon disenrollment and as a Member of IEHP. You will also find important forms, such as our Privacy Notice, Plan Transition Process and the section of CMS' website regarding Best Available Evidence. Service Area: Only people who live in our service area can join IEHP DualChoice. Our service area includes all of Riverside and San Bernardino counties. IEHP DualChoice (HMO D-SNP) is a Health Plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. Information on this page is current as of April 19, 2023. H5355_CMC_19_1059755 Accepted
P4P - Proposition 56 - GEMT - Proposition 56 & GEMT
2016, now includes proposed supplemental payments for physicians participating in Medi-Cal Fee-For-Service (FFS) and Medi-Cal Managed Care. Proposition 56 FAQs SFY 19/20 (PDF) Published: October 24, 2022 Click on the following links to jump to that specific section: Electronic Payments Ground Emergency Medical Transport (GEMT) Payment Adverse Childhood Experiences Screening (ACES) Services HYDE Developmental Screening Services Proposition 56 and GEMT Payment Schedule Family Planning Services Proposition 56 Payment Dispute Process Electronic Payments With the current public health situation that our country is experiencing, it is necessary for IEHP to take additional precautions to ensure the health and well-being of our community. These precautions are being reviewed, and discussed daily, by our Executive leadership team and will be implemented as deemed necessary. Future COVID-19 precautions may include reduced on-site staffing and prioritization of electronic payments over printed checks. To minimize any disruption or delay in payment, we recommend that you sign up for electronic payments as soon as possible if you have not done so already. Our team is available to assist you with the necessary paperwork required to make this change or to answer any questions you may have. The team can be reached by e-mailing email@example.com or by calling (909) 294-3928 and selecting Option 1. Our priority remains keeping our Members, Providers, Vendors, and Team Members safe while doing what we can to minimize the potential spread of the virus. We will continue to work hard to provide you with the level of service you have come to expect during this uncertain time. (Back to Prop 56 Menu) Adverse Childhood Experiences Screening (ACES) Services Proposition 56 Adverse Childhood Experience Screening (ACES) Services (PDF) Published: May 15, 2020 FAQs on Proposition 56 Payment - Adverse Childhood Experience Screening (ACES) Services (PDF) Published: October 14, 2021 PSA Videos: Do More Ask Resilience (Back to Prop 56 Menu) Developmental Screening Services Proposition 56 Developmental Screening Services (PDF) Published: March 19, 2020 FAQs on Proposition 56 - Developmental Screening Services (PDF) Published: October 14, 2021 (Back to Prop 56 Menu) Family Planning Services Proposition 56 - Family Planning Services (PDF) Published: June 1, 2022 FAQs on Proposition 56 - Family Planning Screening Services (PDF) Published: October 13, 2022 (Back to Prop 56 Menu) Ground Emergency Medical Transport (GEMT) Payment The Department of Health Care Services (DHCS) has established a Ground Emergency Medical Transport (GEMT) Quality Assurance Fee (QAF) program. In accordance with 42 USC Section 1396u-2(b)(2)(D), Title 42 of the Code of Federal Regulations part 438.114(c), and WIC Sections 14129-14129.7, Medi-Cal Managed Care Health Plans must provide increased reimbursement rates for specified GEMT services to non-contracted GEMT providers. SPA 18-004 implements a one-year QAF program and reimbursement add-on for GEMT provided by emergency medical transportation providers effective for State Fiscal Year (SFY) 2018-19 from July 1, 2018, to June 30, 2019. GEMT Program Overview (PDF) FAQs on GEMT (PDF) GEMT Dispute Request Form (PDF) Please email completed forms to Prop56Inquiry@iehp.org or fax to (909) 296-3550. (Back to Prop 56 Menu) HYDE Proposition 56 HYDE Services (PDF) Published: May 15, 2020 FAQs on Proposition 56 - HYDE Services (PDF) Published: October 14, 2021 (Back to Prop 56 Menu) Proposition 56 and GEMT Payment Schedule Proposition 56 and GEMT Supplemental Payment Schedule CY2023 Updated: January 6, 2023 (Back to Prop 56 Menu) Proposition 56 Payment Dispute Process Proposition 56 - Paid Claims Dispute Request Form (PDF) Proposition 56 - Encounter Dispute Request Form (PDF) Please email completed forms to Prop56Inquiry@iehp.org or fax to (909) 296-3550. (Back to Prop 56 Menu) You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.