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Medi-Cal 加州醫療保險規定
居住在我們服務區域的民眾 (加州河濱郡與聖貝納迪諾郡的大部分居民)
成人 (無論是否撫養子女)、未成年人、老年人及殘障人士
符合收入標準和其他計劃要求者
50 歲以上的無證成年人
我要負擔多少費用?
成人無須就 Medi-Cal 保險繳交任何月保險費。依據 Children’s Health Insurance Program (CHIP) 享有 Medi-Cal 保險的未成年人,僅須繳交少量月保險費。
我透過 IEHP 可以獲得 Medi-Cal 的哪些照護?
您的計劃承保範圍包括:
門診 (非住院) 服務*
急診服務
跨性別服務*
臨終關懷與安寧照護*
住院治療*
產婦與新生兒照護
心理健康服務
處方藥
康復與復健服務及設備*
實驗室與放射線服務,如 X 光*
預防與健康服務以及慢性疾病管理
敏感性服務
物質使用障礙治療服務
兒科服務
視力服務*
非緊急醫療交通 (Non-Emergency Medical Transportation, NEMT)
非醫療交通 (Non-Medical Transportation, NMT)
長期服務與援助
(Long-Term Services and Supports, LTSS)
遠程醫療服務
上述部分服務僅於預先取得 IEHP 或您的 IPA 核准之情況下方適用。標示星號 (*) 的是可能需預先取得IEHP、您的IPA或醫療組的核准后,計劃所承保的服務。
如何申請 Medi-Cal:
請於週一至週五上午 8 點至下午 5 點致電 (866) 294-4347,與 IEHP 投保顧問聯繫。TTY 使用者請撥 (800) 720-4347。
您也可以致電 1-800-430-4263 與 Health Care Options 聯繫,或上網 www.healthcareoptions.dhcs.ca.gov。TTY 使用者請撥 1-800-430-7077。
IEHP Medi-Cal 會員重要注意事項
Medi-Cal 會員手冊 (PDF) - 說明如何取得 IEHP 照護及計劃承保的福利。
IEHP 會員手冊 Medi-Cal 福利指南 (PDF) - 本指南可協助您在IEHP會員手冊找到各項福利與服務的重要資訊。
Medi-Cal 提供者目錄 (PDF):條列我們不斷壯大的醫療網絡,以及可快速取得所需照護的選項 – 全天無休。
您需使用 Adobe Acrobat Reader 6.0 或更高版本,才能閲讀PDF 文檔。點選 Adobe Acrobat Reader 下載免費版本。
MediCal Open Access Program - Open Access Program
題通常未獲得處理。Open Access Program 可透過加快獲得醫師看診的過程,讓您的子女更容易獲得持續醫療照護。無論您居住在加州內陸帝國的任何地方,您的子女都能夠約診網路內的任何 醫師。 此外,我們的計畫還能為您的子女提供一般 Medi-Cal 系統無法提供的許多服務。
Open Access 計畫如何使您的子女更容易獲得健康照護:
您的子女可預約我們龐大醫師網路內的任何 PCP 。
您可以隨時因任何原因更換醫師。IEHP 將協助您找到合適的醫師。請致電 1-800-440-IEHP (4347)/TTY 使用者請撥 (800) 718-4347。
此計畫會將您子女的健康記錄 (疫苗注射、用藥、檢查) 提供給醫師,以使其在看診時不須猜測。
若您忘了帶 IEHP 會員 ID 卡或保險受益人身份卡 (Beneficiary Identification Card, BIC),Open Access 醫師可上網快速確認您子女的資格。
您與您的子女可免費獲取額外服務:
免費為您的子女提供 哮喘或糖尿病等健康項目。
讓您的子女保持安全與健康,並可享有父母專屬的額外福利,例如嬰兒汽車安全座椅、 兒童維他命及自行車安全帽。
我們設有專屬團隊,可協助您照護患有慢性疾病的子女。我們與您子女的醫師合作,致電給 您,確保您的子女獲得適當的照護。如果醫師看診、實驗室檢測或藥品配製工作塞車時,我們也可伸出援手。
重要資源
Open Access 提供者目錄 (PDF)
如欲深入瞭解 Open Access Program,請於週一至週五上午 8 點至下午 5 點致電 (800) 706-4347,與 IEHP 寄養照護專科醫師聯繫。
您需使用 Adobe Acrobat Reader 6.0 或更高版本,才能檢視 PDF 檔案。免費下載版本。點選 Adobe Acrobat Reader。
IEHP DualChoice - 如何獲得照護
通常是您暫時身處本計畫服務區域外)、區域外透析服務,以及 IEHP DualChoice (HMO D-SNP) 授權使用網絡外提供者的情況。
何謂網路內提供者?
網路內提供者係指與我們簽訂合約,且接受我們的付款 為全額付款之醫師與其他健康照護專家、醫療團體、醫院與其他健康照護機構。我們安排這些提供者為本計畫會員提供給付的服務。
所有參與本計畫的提供者還會與我們簽訂合約,提供給付的 Medi-Cal 福利。
尋找醫師
請使用下列 IEHP DualChoice 提供者與藥局目錄,尋找網路內提供者:
2023 年 IEHP DualChoice 提供者與藥局目錄 (PDF)
初級照護提供者 (PCP) 是誰?他們在您的計畫中扮演什麼角色?
PCP 是指您的初級照護提供者。您的大部分例行性健康照護需求,都必須先找您的 PCP 看診。您的 PCP 也會協助您安排或協調您身為本計畫會員所享有的其他給付服務。「協調」您的服務包括與其他計畫提供者確認或諮詢您的照護內容與狀況。包括:
X 光
實驗室檢測、治療
專科醫師提供的照護
醫院住院及後續照護
初級照護提供者 (PCP) 通常與特定醫院有所關聯。您在選擇 PCP 時,請記住下列事項:
您必須從提供者與藥局目錄選擇您的 PCP。若您在選擇或更換 PCP 時需要任何協助,請致電 IEHP DualChoice 會員服務中心。
選擇距離您的住家 10 英哩或 15 分鐘車程內的 PCP。
您所選擇的 PCP 只能夠為您辦理入住特定醫院。請儘量選擇距離您的住家 30 英哩或 45 分鐘車程內,且能夠讓您入住欲就診醫院的 PCP。
部分醫院設有「住院專科醫師」,負責於病患住院期間提供照護。若您入住任何此等醫院,「住院專科醫師」可能會在您入住期間擔任您的照護提供者。當您出院後,您的健康照護需求將恢復由您的 PCP 負責。
若您因任何原因需要變更 PCP,您的醫院與專科醫師也可能會變動。您的 PCP 應能夠講您的語言。然而,您的 PCP 也可在必要時隨時撥打語言專線服務,取得口譯人員的協助。
若您在加入 IEHP DualChoice 時未選擇 PCP,我們將為您選擇。我們會將您的 ID 卡與您的 PCP 資訊寄送給您。請記住,您可以隨時變更 PCP。
您可以基於任何原因更換您的 醫師 (及醫院) (每個月一次)。若 IEHP 在當月 25 日之前收到您的變更申請,則變更將從次月一日開始生效;若 IEHP 在當月 25 日之後收到您的變更申請,則變更將從下下個月一日開始生效 (部分提供者可能要求您提供 PCP 的轉介)。
如何取得專科醫師的照護
對於您的大部分例行性健康照護需求,如身體檢查、免疫接種等,通常需要先找您的初級照護提供者 (PCP) 看診。若 PCP 認為您需要專科治療或藥品,他/她將需要向您的計畫及/或醫療小組取得事先授權 (亦即:事先核准)。這稱為轉介。您的 PCP 會發送轉介資料給您的計畫或醫療小組。 最重要的是,您必須在前往計畫專科醫師或特定其他提供者看診前,向您的 PCP 取得轉介 (事先核准)。若您未在向專科醫師取得服務之前取得轉介 (事先核准),您可能需要自行支付服務費用。
需要急症所需照護時,若您身處本計畫服務區域外該怎麼辦?
假設您身處本計畫服務區域外,但仍在美國境內。若您需要急症所需照護,您可能無法找到或取得本計畫網路內的提供者。在此等情況下 (當您身處服務區域外且無法取得網路內提供者提供的照護時),本計畫會給付任何提供者為您提供的急症所需照護。
若您在美國以外地區接受照護,本計畫將無法給付該等急症所需服務或任何其他照護。
變更您的初級照護提供者 (PCP)
您可以隨時基於任何原因變更 PCP。此外,您的 PCP 可能會退出本計畫的提供者網路,屆時您必須尋找新的 PCP。在此等情況下,您將必須更換為本計畫網路內的另一個提供者。若您的 PCP 退出本計畫,我們將會通知並協助您選擇其他 PCP,以便您持續享有給付的服務。IEHP DualChoice 會員服務中心可協助您找尋與選擇其他提供者。您可以致電 IEHP DualChoice 會員服務中心更換您的醫師。請於 (太平洋標準時間) 每天上午 8 點至晚上 8 點致電 (877) 273-IEHP (4347) 聯繫 IEHP DualChoice 會員服務中心,假日亦提供服務。TTY 使用者請撥 (800) 718-4347。
如需進一步瞭解網路內提供者的相關資訊,請參閱 IEHP DualChoice 會員手冊第 1 章。
IEHP DualChoice (HMO D-SNP) 是與 Medicare 簽約的 HMO 計畫。投保 IEHP DualChoice (HMO D-SNP) 取決於合約續訂。此清單並非完整清單。
您需使用 Adobe Acrobat Reader 6.0 或更高版本,才能檢視 PDF 檔案。點選 Adobe Acrobat Reader 下載免費版本。
此頁面資訊為截至 2022 年 10 月 1 日的最新資訊
H8894_DSNP_23_3241532_M Pending Accepted
管理委員會 - Karen Spiegel
s 和 Highgrove 等非建制社區,以及 Corona、Eastvale、Jurupa Valley、Norco 等城市和河濱市的西半部。2019 年 2 月,她獲指派至 IEHP 管理委員會並於 2020 年擔任副主席,然後在 2021 年 1 月擔任主席職務。 1996 年,Karen Spiegel 當選 Corona 市財政局長,展開了她的政治生涯。在擔任財政局長 6 年後,她參加了 2002 年的 Corona 市議會選舉,並在長達 16 年的市議會生涯中擔任四屆市長。她的行動力不言自明,她對於服務展現出的過人熱忱讓她成為獨樹一格的政治人物。她鼓勵社區參與市和郡政府事務並推出許多新的計畫。Karen 也因為在區域交通問題、協同合作和區域夥伴關係方面的傑出表現而獲得推崇。 除了轄區內的服務以外,Karen 還代表河濱郡參與許多地區和州層級的組織並擔任領導者的角色。她是社區中相當活躍的成員,而她「捲起袖子」的做事態度更讓她能夠完全投入許多民間、商務和社區活動中。在過去幾年中,她的熱心服務讓她榮獲了許多獎項及肯定。
管理委員會 - Jeff Hewitt
和超過 25 個非建制社區,居民總數超過 240 萬。他在 2020 年 1 月獲指派至 IEHP 管理委員會,並在 2022 年 1 月獲任命為副主席。 Hewitt 監事的公職生涯是從擔任 Calimesa 計畫委員會的委員開始,然後再擔任主席職務。他隨後於 2010 年獲選為 Calimesa 市議會議員並連續三屆擔任市長職務。在此期間,他提出了一個大膽的計畫,亦即將消防部門從郡級轉至市級單位,不但在前兩年就為 Calimesa 節省了近 300 萬美元的經費,同時在每次出勤都能夠使隊員人數翻一番。最重要的是,他能夠在不增稅或收費的情況下達到此目標。 Supervisor Hewitt 出身於內陸帝國地區,致力於提升該地區所有居民的生活品質。
管理委員會 - Curt Hagman
月,他獲指派至 IEHP 管理委員會並於 2017 年 2 月擔任副主席,隨後於 2018 至 2020 年擔任主席職務。Hagman 監事在 2021 年 1 月擔任副主席職務。 Hagman 監事在擔任州政府的公職之前在公共服務領域擁有非常豐富的資歷。他的地方政府資歷是從擔任 Chino Hills 的公園/遊憩部門主管開始,同時激發了他投身公共服務領域的熱情。Hagman 監事在 2004 年當選市議會議員,並於 2008 年擔任市長職務。在此期間他曾在多個地區委員會工作,這讓他有許多機會能夠直接瞭解選民面臨的許多問題。2011 年初,他獲市議會議長派任至州撥款委員會 (State Allocation Board),並與公立學校工程辦公室 (Office of Public School Construction) 合作進行轄下學區的資金分配,以確保學校工程的適當運作。
Special Programs - Community Supports
e alternatives that MCPs may offer in place of services or settings covered under the California Medicaid State Plan.
Beginning January 1, 2022, IEHP will be offering 11 of the 14 DHCS Preapproved Community Supports services. Please click on the service for additional details.
Asthma Remediation
Environmental Asthma Trigger Remediations are physical modifications to a home environment that are necessary to ensure the health, welfare, and safety of the individual, or enable the individual to function in the home and without which acute asthma episodes could result in the need for emergency services and hospitalization.
Community Transition Services/Nursing Facility Transition to a Home
Assist members to live in the community and avoid further institutionalization. These services are non-recurring set-up expenses for individuals who are transitioning from a licensed facility to a living arrangement in a private residence where the person is directly responsible for his or her own living expenses.
Environmental Accessibility Adaptations (Home Modifications)
Environmental Accessibility Adaptations (EAAs also known as Home Modifications) are physical adaptations to a home that are necessary to ensure the health, welfare, and safety of the individual, or enable the individual to function with greater independence in the home: without which the Member would require institutionalization.
Housing Deposits
Housing Deposits assist with identifying, coordinating, securing, or funding one-time services and modifications necessary to enable a person to establish a basic household that do not constitute room and board.
Housing Tenancy & Sustaining Services
This service provides tenancy and sustaining services, with a goal of maintaining safe and stable tenancy once housing is secured.
Housing Transition Navigation Services
Housing transition services assist Members with obtaining housing.
Medically Supportive Food/Meals/Medically Tailored Meals
Malnutrition and poor nutrition can lead to devastating health outcomes, higher utilization, and increased costs, particularly among Members with chronic conditions. Meals help individuals achieve their nutrition goals at critical times to help them regain and maintain their health. Results include improved Member health outcomes, lower hospital readmission rates, a well-maintained nutritional health status, and increased Member satisfaction.
Nursing Facility Transition/Diversion to Assisted Living Facilities
Nursing Facility Transition/Diversion services assist individuals to live in the community and/or avoid institutionalization when possible. The goal is to both facilitate nursing facility transition back into a home-like, community setting and/or prevent skilled nursing admissions for Members with an imminent need for nursing facility level of care (LOC). Individuals have a choice of residing in an assisted living setting as an alternative to long-term placement in a nursing facility when they meet eligibility requirements.
Recuperative Care (Medical Respite)
Recuperative care, also referred to as medical respite care, is short-term residential care for individuals who no longer require hospitalization, but still need to heal from an injury or illness (including behavioral health conditions) and whose condition would be exacerbated by an unstable living environment. An extended stay in a recovery care setting allows individuals to continue their recovery and receive post-discharge treatment while obtaining access to primary care, behavioral health services, case management and other supportive social services, such as transportation, food, and housing.
Short-Term Post-Hospitalization Housing
Short-Term Post-Hospitalization housing provides Members who do not have a residence and who have high medical or behavioral health needs with the opportunity to continue their medical/psychiatric/substance use disorder recovery immediately after exiting an inpatient hospital (either acute or psychiatric or Chemical Dependency and Recovery hospital), residential substance use disorder treatment or recovery facility, residential mental health treatment facility, correctional facility, nursing facility, or recuperative care and avoid further utilization of State plan services.
Sobering Centers (Riverside County)
Sobering centers are alternative destinations for individuals who are found to be publicly intoxicated (due to alcohol and/or other drugs) and would otherwise be transported to the emergency department or jail. Sobering centers provide these individuals, primarily those who are homeless or those with unstable living situations, with a safe, supportive environment to become sober.
IEHP Direct and Delegated Providers can submit referrals for Community Supports via the Provider Portal. For questions on how to submit a referral or more information relating to the above services, Providers can call the Provider Call Center at (909) 890-2054 or (866) 223-4347.
Please continue to direct IEHP Members needing additional information on Community Supports Services to IEHP Member Services at (800) 440-4347, Monday - Friday, 8am - 5pm. TTY users should call (800) 718-4347.
If you have programmatic questions, please email DGCommunitySupportTeam@iehp.org
Community Supports Provider Brochure - English (PDF) | Spanish (PDF) | Chinese (PDF) | Vietnamese (PDF)
Community Supports FAQs (PDF)
Medi-Cal Community Supports or In Lieu of Services (ILOS) Policy 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.
Provider Resources - POLST Registry
fornia Physician Orders for Life Sustaining Treatment (POLST) Registry (CPR) to connect a digital POLST network throughout the Inland Empire Healthcare System which includes independent physicians, hospitals, skilled nursing facilities, and the Health Information Exchange (HIE). The goal of this initiative is to provide a more effective means of documenting, communicating, and ensuring Member desired Treatment at the end of life is being honored.
By clicking on these links, you will be leaving the IEHP website.
To login, visit Working Toward a Statewide POLST Registry in California | POLST (capolst.org)
To sign up, simply go to POLST for Healthcare Providers | POLST (capolst.org)
CPR Correspondence (PDF)
CPR FAQ (PDF)
For any questions, please contact Care Directives at (888) 621-4383 or email support@caredirectives.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.
Plan Updates - Updates
l Notes for DY 2 to 8 (PDF)
Core Quality Withhold Technical Notes for DY 2 to 10 (PDF)
Riverside University Health System - Health Advisory
Public Health Advisory - Respiratory Viruses (PDF)
A Message From IEHP Medical Director, Dr. Takashi Wada
The 2022-2023 influenza season continues to coincide with circulation of COVID-19 virus (SARS-CoV-2). As of August 2022, approximately 94.2 million cases of COVID-19 had been reported in the United States. Influenza vaccination remains an important tool for the prevention of potentially severe respiratory illness, which helps decrease the stress on the U.S. health care system. IEHP DualChoice members who are 18 years of age or older may obtain flu vaccines through the IEHP Pharmacy Vaccine Network.
Vaccine Notice: Access to Pharmacy Vaccine Network (PDF)
Mpox Vaccination Locations
San Bernardino County: Monkeypox (mpox) – Department of Public Health
Riverside County: Mpox Vaccine Locations – Riverside University Health System
Please advise members to call before going in for a vaccination as some locations are only available with appointments. Members may make appointments for the JYNNEOS vaccine at https://myturn.ca.gov/.
Mpox Testing
As of December 8, 2022, no commercial testing is available for the diagnosis of Mpox. Providers may contact CDC in the diagnosis, management of patients with suspected Mpox, and for any additional information regarding Mpox connect with the CDC Emergency Operations Center.
Phone: 1-770-488-7100, Monday through Friday, 8:00 AM to 4:30 PM EST
After Hours Phone: 1-404-639-2888
Treatment
Mpox patients usually recover fully within 2-4 weeks without the need for medical treatment. While there are no treatments specifically for Mpox, the virus that causes Mpox is similar to the smallpox virus and therefore antiviral drugs developed to protect against smallpox may be used. The antiviral drug, tecovirimat (TPOXX), has been approved by the FDA to treat smallpox in adults and children.
If you prescribe tecovirimat to treat members with Mpox the member must sign a consent form stating tecovirimat is an investigational drug that has not yet been approved by the FDA for treatment of Mpox.
More information about tecovirimat visit https://www.cdc.gov/poxvirus/monkeypox/if-sick/treatment.html.
Frequently Asked Influenza (Flu) Questions: 2022-2023 Season (CDC Recommendations)
What’s New for 2022-2023
By clicking on these links, you will be leaving the IEHP website.
The composition of flu vaccines has been updated.
For the 2022-2023 flu season, there are three flu vaccines that are preferentially recommended for people 65 years and older. These are Fluzone High-Dose Quadrivalent vaccine, Flublok Quadrivalent recombinant flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine.
The recommended timing of vaccination is similar to last season. For most people who need only one dose for the season, September and October are generally good times to get vaccinated. Vaccination in July and August is not recommended for most adults but can be considered for some groups. While ideally it’s recommended to get vaccinated by the end of October, it’s important to know that vaccination after October can still provide protection during the peak of flu season.
The age indication for the cell culture-based inactivated flu vaccine, Flucelvax Quadrivalent (ccIIV4), changed from 2 years and older to 6 months and older.
Pre-filled Afluria Quadrivalent flu shots for children are not expected to be available this season. However, children can receive this vaccine from a multidose vial at the recommended dose.
Preventive Services
Immunizations
By clicking on these links, you will be leaving the IEHP website.
CDC ACIP Vaccine Recommendations and Guidelines: https://www.cdc.gov/vaccines/hcp/acip-recs/index.html
CDC ACIP Immunization Schedule for Children: https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html
CDC ACIP Immunization Schedule for Adults: https://www.cdc.gov/vaccines/schedules/hcp/adult.html
USPSTF Task Force's Immunization Recommendations: https://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=immunization
California Immunization Registry Portal (CAIR): https://cair.cdph.ca.gov/CAPRD/portalInfoManager.do
Immunization Timing 2022 (PDF)
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
有用資訊與資源 - 人身傷害與意外
mecast.com/s/Xe1jCJ6xqQCBo4gtnovWOE?domain=dhcs.ca.gov。
營業時間:週一至週五上午 8 點至中午 12 點,下午 1 點至下午 5 點。週末與假日不營業。
郵寄地址:
Department of Health Care Services
Third Party Liability and Recovery Division
Casualty Insurance Section – MS 4720
P.O.Box 997425
Sacramento, CA 95899-7425
IEHP DualChoice (HMO D-SNP) Medicare-Medicaid 計畫 會員
如果您是 Medicare 會員並且想要報告可能的債務清償、判決、裁定或是您收到的其他款項,或要求取得您的「受保護健康資訊」,請按一下此處以下載揭露授權書 (PDF)。
Provider Resources - Educational Opportunities
isciplinary Care Team (ICT)
Dual Choice Medicare CM IPA Training
Alzheimer's and Dementia Care
Specialty Mental Health Care Coordination
Staying Healthy Assessment (SHA) Training
National LGBT Health Education Webinars
Online Cultural Competency Training
Interdisciplinary Care Team (ICT) Fact Sheet (PDF)
Healthcare Provider Toolkit: Assisting Patients with Requests for Workplace Accommodations or Leaves of Absence (PDF)
Dual Choice Medicare CM IPA Training
2021 Care Management Delegation Oversight Medi-Cal IPA Training (MP4 Video) - December 08, 2021
Discussion Topics:
Health Risk Assessments (HRA)
Individual Care Plans (ICP)
Interdisciplinary Care Team (ICT)
Coordination of Care
Delegated IPA Reporting Requirements
2021 Care Management Delegation Oversight Medi-Cal IPA Training (MP4 Video) - February 16, 2021
Alzheimer's and Dementia Care
Project ECHO Opportunities From The Alzheimer's Association For Inland Empire Primary Care Clinics
Alzheimer’s Association / UCSF Memory and Aging Center Alzheimer’s and Dementia Care ECHO
Faculty partners: UCSF Memory and Aging Center faculty
When: Thursdays beginning February 16, 2023 until July 20, 2023 from 12:00 pm - 1:00 pm PT via Zoom
Who can be involved: All California based Primary care practice teams (including MD/DO, NP, PA, social work, MA)
UCSF/Inland Empire ECHO 2023 Flyer (PDF)
To register, please contact Kelsey Burnham at kburnham@alz.org
UCLA ADC ECHO
Faculty partners: UCLA Alzheimer’s and Dementia Care (ADC) program faculty
When: Wednesdays beginning March 29, 2023 until September 6, 2023 from 11:00 am - 12:00 pm PT via Zoom
Who can be involved: Nationwide teams interested in adding to their own knowledge and skills and those interested in learning about or implementing the highly effective UCLA ADC program
ADC ECHO 2023 Flyer (PDF)
To register, please contact Rachel Goldberger at rbgoldberger@alz.org
Specialty Mental Health Care Coordination
The Centers for Medicare and Medicaid Services (CMS) is requiring IEHP and its IPAs to document and report the efforts made to coordinate the care of IEHP DualChoice (HMO D-SNP) Members receiving specialty mental health services through the County Mental Health Plans. As of June 1, 2018, IEHP has put policies and procedures in place to comply with these process and reporting requirements:
On the first (1st) of each month, IEHP will provide IPAs and County MH Clinics a list of IEHP DualChoice (HMO D-SNP) Members known to be receiving specialty mental health services through the County MH Plans.
IPAs are expected to outreach to these Members and their County MH Clinic Provider, as well as, document their outreach attempts and outcomes as outlined in Policy 25C2, “Care Management Requirements – Delegated IPA Responsibilities.”
IPAs are required to provide data elements specific to this measure, as outlined in Policy 25F1, “Encounter Data Reporting - Medicare MMP Reporting Requirements – IEHP DualChoice (HMO D-SNP)" and Attachment, “Medicare Provider Reporting Requirements Schedule” in Section 25.
IEHP, through its Delegation Oversight process, will monitor the IPAs’ compliance with documentation and reporting requirements, as outlined in Policy 25A2, “Delegation Oversight Audit.”
To access the On-Site training material presented to IPAs and County Mental Health Clinics, click here (PDF).
National LGBT Health Education Webinars
IEHP has put together a list of webinars, provided by a third party, to provide educational programs, resources, and consultation to health care organizations with the goal of optimizing quality, cost-effective health care for lesbian, gay, bisexual, transgender, and all sexual and gender minority (LGBT) people.
The National LGBT Health Education Center is part of the Division of Education and Training at The Fenway Institute, Fenway Health. The Fenway Institute (TFI) is an interdisciplinary center for research, training, education, and policy development that works to ensure access to quality, culturally affirming medical and mental health care for traditionally underserved communities, including LGBTQIA+ people and those affected by HIV/AIDS.
The mission of Fenway Health is to enhance the wellbeing of the LGBTQIA+ community as well as people in our neighborhoods and beyond through access to the highest quality health care, education, research, and advocacy. Fenway Health is one of the largest providers of LGBTQIA+ health care and HIV primary care in the country; as such, it is a leader in the field of LGBTQIA+ health and informs much of the promising practices and innovative models that the Education Center disseminates to health centers nationwide.
By clicking on these links, you will be leaving the IEHP website.
The National LGBT Health Education Center Webinars
Courses Include:
HIV Prevention/PrEP at Health Centers: An Overview and Current Best Practices
What’s new in PrEP and STIs? Cases From a Sexual Health Clinic
Insurance Considerations for Navigating Gender-affirming Care
Building Your Family: LGBTQ Reproductive Options
Behavioral Health Assessments and Referral for Gender-Affirming Surgery
Navigating Gender Affirming Care
Collecting Sexual Orientation and Gender Identity (SO/GI) Data In Electronic Health Records
Providing Mental Health Assessments for Gender Affirming Surgery Referral Letters
Online Cultural Competency Training
AHRQ Health Literacy Modules Available for Continuing Education (CE) and Maintenance of Certification (MOC) Credit
Physicians and nurses can earn CE credits while learning about the challenges in caring for patients with low health literacy as well as strategies to improve overall patient communication and care. OptumHealth Education is issuing continuing education credit for taking the AHRQ-developed Health Literacy Knowledge Self-Assessment. No fees are charged for the two CE activities:
By clicking on these links, you will be leaving the IEHP website.
1. An Updated Overview of Health Literacy
Link (optumhealtheducation.com)
2. Improving Health Literacy by Improving Communication Skills
Link (optumhealtheducation.com)
Pediatricians and family physicians can earn credit for re-certification (MOC Part 2) as well as CE by taking the Health Literacy Knowledge Self-Assessment through the American Board of Pediatrics and the American Academy of Family Physicians, respectively.
To learn about AHRQ’s tools to address health literacy, visit Health Literacy Topics at:
https://www.ahrq.gov/health-literacy/index.html
To find out about other free AHRQ continuing education opportunities, go to:
https://www.ahrq.gov/patient-safety/education/continuing-ed/index.html
To contact AHRQ, visit https://www.ahrq.gov/contact/index.html
Office of Minority Health - https://cccm.thinkculturalhealth.hhs.gov/
CDC - www.cdc.gov
U.S. Department of Health and Human Service, Health Resources and Services Administration - www.hrsa.gov
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Join Our Network - Hospitals
CA 92324
(909) 580-1000
(909) 580-6308
Barstow Community Hospital
820 E Mountain View
Barstow, CA 92311
(760) 256-1761
(760) 957-3397
Bear Valley Community Healthcare District
41870 Garstin Drive
Big Bear Lake, CA 92315
(909) 866-6501
(909) 878-8282
Chino Valley Medical Center
5451 Walnut Ave.
Chino, CA 91710
(909) 464-8600
(909) 464-8882
Colorado River Medical Center
1401 Baily Ave.
Needles, Ca. 92363
(909) 326-7100
(909) 326-7292
Community Hospital of San Bernardino
1805 Medical Center Dr #201
San Bernardino, CA 92411
(909) 887-6333
(909) 806-1044
Corona Regional Medical Center
800 S Main St.
Corona, CA 92882
(951) 737-4343
(951) 736-6310
Desert Regional Medical Center
1150 N Indian Canyon Dr.
Palm Springs, CA 92262
(760) 323-6511
(760) 323-6330
Desert Valley Hospital
16850 Bear Valley Rd.
Victorville, CA 92395
(760) 241-8000
(760) 951-2034
Eisenhower Medical Center
39800 Bob Hope Dr.
Rancho Mirage, CA 92270
(760) 340-3911
(760) 773-1532
Hemet Global Medical Center
1117 E Devonshire Ave.
Hemet, CA 92543
(951) 652-2811
(951) 765-4745
Hi-Desert Medical Center
6601 White Feather Rd.
Joshua Tree, CA 92252
(760) 366-3711
(760) 365-9309
Inland Valley Regional Medical Center
36485 Inland Valley Dr.,
Wildomar, CA 92595
(951) 677-1111
(951) 698-7721
John F. Kennedy Memorial Hospital
47111 Monroe St.
Indio, CA 92201
(760) 347-6191
(760) 775-8014
Loma Linda University Children's Hospital
11234 Anderson St.
Loma Linda, CA 92354
(909) 558-8000
(909) 558-3278
Loma Linda University Medical Center
11234 Anderson St.
Loma Linda, CA 92354
(909) 651-1702
(909) 478-3202
Loma Linda University Medical Center - Murrieta
28062 Baxter Rd.
Murrieta, CA 92563
(951) 290-4000
(951) 290-4092
Menifee Global Medical Center
28400 McCall Blvd.
Sun City, CA 92585
(951) 679-8888
(951) 766-6470
Montclair Hospital Medical Center
5000 San Bernardino St.
Montclair, CA 91763
(909) 625-5411
(909) 626-4777
Mountains Community Hospital
29101 Hospital Rd.
Lake Arrowhead, CA 92352
(909) 336-3651
(909) 336-4730
Palo Verde Hospital
250 N 1st St.
Blythe, Ca 92225
(760) 922-4115
(760) 921-5263
Parkview Community Hospital Medical Center
3865 Jackson St.
Riverside, CA 92503
(951) 688-2211
(951) 352-5363
Pomona Valley Hospital Medical Center
1798 N. Garey Ave.
Pomona, CA 91767
(909) 865-9500
(909) 865-2104
Rancho Springs Medical Center
25500 Medical Center Dr.
Murrieta, CA 92562
(951) 696-6000
(619) 627-5949
Redlands Community Hospital
350 Terracina Blvd.
Redlands, CA 92373
(909) 335-5500
(909) 335-6497
Riverside Community Hospital
4445 Magnolia Ave.
Riverside, CA 92501
(951) 788-3000
(951) 788-3201
Riverside University Health Care System
26520 Cactus Ave.
Moreno Valley, CA 92555
(951) 486-4000
(951) 486-4475
San Antonio Regional Hospital
999 San Bernardino Rd.
Upland, CA 91786
(909) 985-2811
(909) 920-6357
San Gorgonio Memorial Hospital
600 N Highland Springs Ave.,
Banning, CA 92220
(951) 845-1121
(951) 845-2836
St. Bernardine Medical Center
2101 N Waterman Ave.,
San Bernardino, CA 92404
(909) 883-8711
(909) 881-4337
St. Mary Medical Center
18300 US Highway 18
Apple Valley, CA 92307-2206
(760) 242-2311
(760) 946-8714
Temecula Valley Hospital
31700 Temecula Pkwy
Temecula, CA 92592
(951) 331-2200
(951) 331-2211
Victor Valley Global Medical Center
15248 Eleventh St.
Victorville, CA 92395
(760) 245-8691
(760) 245-6996
Plan Updates - Regulatory Updates
reventable Conditions. Visit Reporting of Provider Preventable Conditions for DHCS instructions for online reporting.
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Medicare Outpatient Observation Notice (MOON)
In the event any Medicare recipient has been in a status of outpatient observation for greater than 24 hours, Acute Hospitals are required to provide Medicare Members with a Medicare Outpatient Observation Notice (MOON). Medicare recipients must receive the MOON within 36 hours of admission to observation level of care.
Please refer to the following website for further details on MOON requirements at https://www.federalregister.gov/articles/2016/08/22/2016-18476/medicare-program-hospital-inpatient-prospective-payment-system-for-acute-care-hospitals-etc. By clicking on this link, you will be leaving the IEHP website.
Document Catalog:
MOON FAQs (PDF)
MOON Instruction Summary (PDF)
CMS Manual System 10611_Pub 100-04 Medicare Claims Processing MOON Instructions (PDF)
MOON Forms
MOON English (PDF)
MOON Spanish (PDF)
MOON Correspondence (PDF)
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Pharmacy Services - Formulary
most appropriate, high quality and cost-effective drug therapies.
The Inland Empire Health Plan Pharmacy and Therapeutics (P & T) Subcommittee develops and monitors the Formulary. The P & T is composed of the IEHP Chief Medical Officer, Medical Directors, Director of Pharmaceutical Services, physicians from various medical specialties, local communities, and clinical pharmacists. This panel reviews the medications in all therapeutic categories based on safety, clinical efficacy, and cost-effectiveness and selects the most appropriate drugs in each class.
Formulary development and maintenance is a dynamic process. The IEHP P & T Subcommittee is responsible for developing, managing, updating and administering the Formulary. The Subcommittee also ensures that the IEHP Formulary remains responsive to the needs of our members and providers.
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. Click here to download a free copy by clicking Adobe Acrobat Reader. By clicking on this link, you will be leaving the IEHP website.
IEHP Medi-Cal Formulary Items:
DHCS Noncapitated Physician Administered Drugs (PADs)
Medi-Cal Medical Benefit PA (PDF)
Medi-Cal Medical Benefit Formulary (PDF)
Referral Form for Medi-Cal Benefit (PDF)
Exceptions to criteria or requests for coverage of drugs not on the Medi-Cal Drug Benefit Formulary may be submitted by prescribers on the Referral Form for Medi-Cal Benefit.
Starting January 1, 2022, all IEHP Medi-Cal pharmacy services will be transitioned from managed care (MC) to fee for service (FFS). The Medi-Cal pharmacy benefits and services administered by the Department of Health Care Services (DHCS) will be identified collectively as "Medi-Cal Rx."
Magellan Medicaid Administration, Inc. (MMA) will assume operations for Medi-Cal Rx on behalf of DHCS.
For further information on Medi-Cal Rx, please visit: https://www.iehp.org/en/providers/pharmacy-services?target=medi-cal-rx
For more information on the Medi-Cal Rx Covered Drug List (CDL), please visit: https://medi-calrx.dhcs.ca.gov/home/cdl
IEHP DualChoice (HMO D-SNP) - Medicare-Medicaid Plan Items:
IEHP DualChoice (HMO D-SNP) Formulary Book(PDF)
Grievance Coverage Determination and Appeals Process
IEHP DualChoice (HMO D-SNP) Formulary Search Tool
10 Reasons Why You Should Be E-prescribing Brochure (PDF)
E-prescribing Tips (PDF)
Information on this page is current as of March 01, 2023
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河濱市 CRC 地址:
3590 Tyler Street, Suite 101, Riverside, CA 92503
河濱市 CRC 電話:
1-866-228-4347
TTY 使用者請致電 711
檢視我們的其他 CRC 據點:
聖貝納迪諾 CRC
維克多維爾 CRC
虛擬/線上
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聖貝納迪諾市社區資源中心
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聖貝納迪諾 CRC 地址:
805 West 2nd Street, Suite C, San Bernardino, CA 92410
聖貝納迪諾 CRC 電話:
1-866-228-4347
TTY 使用者請致電 711
檢視我們的其他 CRC 據點:
河濱市 CRC
維克多維爾 CRC
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維克多維爾社區資源中心
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維克多維爾 CRC 地址:
12353 Mariposa Road, Suites C-2 & C-3, Victorville, CA 92395
維克多維爾 CRC 電話:
1-866-228-4347
TTY 使用者請致電 711
檢視我們的其他 CRC 據點:
河濱市 CRC
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維克多維爾社區資源中心在此也想要應該我們的以下夥伴:
Goodwill Southern California:勞動力提供者協助個人透過生活所需的技能和工作支援服務提升自己的能力。
聖貝納迪諾市住宅管理局:透過房券或是平價住房單位為低收入家庭提供平價住房和租金援助。
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