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(800) 440-IEHP (4347)，TTY 使用者請撥 (800) 718-4347。 您也可以提出申訴。 請向醫師索取申訴表或選擇下面的選項。 線上申訴表 列印並郵寄申訴表 (PDF 文件在下方) 致電 IEHP 會員服務中心，我們會將申訴表郵寄給您 如果您採取郵寄方式，請將申訴表寄至： IEHP, Attention: Grievance Dept. P.O.Box 1800 Rancho Cucamonga, CA 91729-1800 您需使用 Adobe Acrobat Reader 6.0 或更高版本，才能檢視 PDF 檔案。 下載  Adobe Acrobat Reader。   Medi-Cal 會員申訴表 (PDF) IEHP DualChoice (HMO D-SNP) 投訴表 我們會在收到您的申訴後 5 天內寄信通知您，我們已經收到您的申訴。我們會在 30 天內寄送另一封信函給您，告訴您我們會如何解決您的問題。如果您致電 IEHP 並且提出與健康照護給付、醫療必要性或實驗性或研究性治療無關的申訴，而您的申訴在下個工作日結束後獲得解決，則您可能不會收到信函。  

工作人員與會員共聚一堂，為會員提供公開討論的平台。 在會議進行期間，會員們將有機會針對有關會員資料以及他們在接受 IEHP 照護時的整體體驗提供反饋意見。我們同時還會討論 IEHP 文化和語言 (Cultural and Linguistic, C&L) 服務計畫。 經過遴選參與計畫的會員每次出席會議將可獲得 75 美元的補助。  如果您有興趣在公共政策委員會服務，請按一下此處。 2022 會議排程：  2023 年 3 月 16 日 2023 年 6 月 15 日 2023 年 9 月 21 日 2023 年 12 月 21 日  

孕婦。 護理之家以及長期照護機構的住民。 6 個月或以上的兒童。 請記得，在許多情況下，流感疫苗可以預防流感，減緩感染流感時的症狀，並且減少傳播給其他人的機率。 關於流感疫苗常見的誤解 誤解 1：我會因為接種流感疫苗而患上流感。 錯誤。流感疫苗是由滅活病毒製作，因此不會造成感染。 誤解 2：我身體很健康，不需要接種流感疫苗。 錯誤。健康的人也會生病。甚至會很嚴重。流感疫苗有助於降低生病的機率。 誤解 3：我去年接種了流感疫苗。今年不需要再接種了。 錯誤。 流感病毒每年都會產生變異，因此請注射流感疫苗。您需要每年注射流感疫苗，以對抗今年的流行性感冒。  常見問答集 問：在哪裡可以接種流感疫苗？ 答：您的醫師診間 (成人和兒童)、特定網路內藥局 (例如 CVS、Rite Aid 和 Walgreens ，限成人) 或是發送簡訊 IEHPflu 至 90902，瞭解附近提供免費流感疫苗接種的藥局 (僅限成人)。 問：有哪些方法可以避免感染流感？ 答：要避免感染流感，您應該：   接種流感疫苗。 避免與生病之人密切接觸。 在公共區域戴上可以遮住口鼻的東西。 經常用肥皂和水清洗雙手。如果沒有肥皂和水，可以使用含酒精的洗手液。  避免碰觸眼睛、鼻子和嘴巴。  保持健康飲食。 喝大量液體，特別是要多喝水。  獲得充分休息。 清潔和消毒您周圍的表面。 問：如果感染流感，我應該怎麼做？答：如果不幸感染流感，請務必： 呆在家中休息。 避免與他人接觸。  喝大量液體，比方水和果汁。 如果症狀沒有改善，請就醫。 如果感染流感但是沒有辦法去看醫生，請致電 IEHP 的 24 小時護理師諮詢專線，電話 1-888-244-IEHP (4347)，TTY 使用者請撥 1-866-577-8355。我們的護理師可以幫助您透過電話或視訊聊天的網路看診方式，與有專科認證的醫師聯繫。  

下事項向您發送重要的醫療保健通知： 通知您如何透過 IEHP 接受照護與服務 提醒您有關關鍵預防性照護看診，協助您維持健康 告知您符合資格的健康教育與保健計畫 以及更多其他福利 若要註冊，會員需要發送短信 “Healthy” 至 90902。可能需要收取短信與數據費用。 如需協助，請發送短信 HELP 至 90902 或是發送電子郵件至 texthelp@iehp.org。會員可隨時回覆 STOP 取消注冊。短信頻率會有所不同。 此簡訊發送計畫適用於以下電訊公司訂閱者的會員：Boost、AT&T、T-Mobile®、Dobson、Verizon Wireless、U.S. Cellular、C Spire Wireless、Metro PCS、Cricket Communications、Virgin Mobile 及其他無線運營商。運營商對延遲或未送達的訊息不承擔任何責任。會員必須年滿 13 歲方可使用此服務。 您亦同意 IEHP 無線簡訊條款與條件。  我們尊重您的隱私。您可以在此找到我們的隱私權政策。 聯絡資訊： 10801 Sixth Street Rancho Cucamonga, CA 91730 1-800-440-IEHP (4347) 1-800-718-IEHP (4347)（TTY 使用者） 太平洋標準時間上午 8 點到下午 5 點 texthelp@iehp.org www.iehp.org *此短代碼計畫由 mPulse 管理。www.mpulsemobile.com  

You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking Adobe Acrobat Reader. By clicking on this link, you will be leaving the IEHP website. Medicare: For IEHP DualChoice (HMO D-SNP) - Medicare-Medicaid Plan - Formulary and Criteria information, please click here IEHP DualChoice (HMO D-SNP). Medicaid: On January 7, 2019, Governor Gavin Newsom issued Executive Order N-01-19 (EO-N-01-19) for achieving cost-savings for drug purchases made by the state. A key component of EO N-01-19 requires the Department of Health Care Services (DHCS) transition all Medi-Cal pharmacy services from managed care (MC) to fee for service (FFS). Click here to go to the “DHCS Medi-Cal Rx” page on IEHP website Click here to go to “Medi-Cal Rx: Transition” page on DHCS website Updated April 7, 2021, this document describes DHCS’ multi-faceted pharmacy transition policy, inclusive of “grandfathering” previously approved PAs from managed care and fee-for-service, as well as a 180-day period with no PA requirements for existing prescriptions, to help support the Medi-Cal Rx transition. During this transition period, Magellan will provide system messaging, reporting and outreach to provide for a smooth transition to Medi-Cal Rx. Click here to view “Medi-Cal Rx Pharmacy Transition Policy” from DHCS website To view Drug Criteria Referenced in Summary Table - Click Links Below: Clinical Practice Guidelines - CPGs Drug Prior Authorization Criteria HP Acthar (repository corticotropin injection) (PDF) Nucala (PDF) Spinraza (nusinersen) (PDF) Synagis (PDF) Xolair (omalizumab) (PDF)  Drug Class Prior Authorization Criteria Adult Enteral Nutritional Supplement (PDF) Antineoplastic Agents (PDF) Erythorpoieses-Stimulating Agents (PDF) Growth Hormones (PDF) Hepatitis C (PDF) Hereditary Angioedema (PDF) Immuno Globulins (PDF) Nutritional Supplement Infant Formula (PDF) Opioid Analgesics (PDF) Pediatric Enteral Nutritional Supplement (PDF) Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitor (PDF) Testosterone Hormone Replacement (PDF) Therapeutic Agents in Rheumatic And Inflammatory Diseases (PDF) Pharmacy Policies Discharge Policy (PDF) Drug Trial and Failure (PDF) High Daily Morphine Milligram Equivalent (PDF) IEHP Drug Prior Authorization Policy (PDF) Intradialytic Parenteral Nutrition (IDPN) Policy (PDF) Non-Formulary Drug (PDF) Non-Sterile Compounded Medication (PDF) Off-Label Indication Policy (PDF) Pharmacy Drug Management Program for Pain (PDF) Quantity Limit Policy (PDF) Information on this page is current as of January 1, 2022.

打噴嚏在空氣中產生的飛沫進行傳染 (與普通的感冒或流感一樣)。州長 Newsom 於 2020 年 3 月 19 日發佈了一項適用全加州的命令，要求所有居民「待在家裡」，以最大限度地降低病毒傳播的風險，但有必要運作的實體除外。 COVID-19 的症狀有哪些？ 大部分罹患 COVID-19 的人都感覺像是得了流感。老年人，尤其是患病或有其他疾病 (如糖尿病) 者，比較容易因為此病毒而產生重症。 症狀從輕微到嚴重都有，包括發燒、咳嗽、呼吸問題、感覺冷、反复打冷顫、肌肉酸痛、頭痛、喉嚨痛以及失去味覺或嗅覺。 如果您出現了上述症狀，應該怎麼做？ 如果您認為自己可能感染了 COVID-19，請待在家中並先打電話給您的醫師診間。將您的症狀告訴他們，或告知他們您周遭是否有人的檢驗結果呈陽性。您的醫生可能會為您提供遠程醫療服務，或是告訴您接下來怎麼做。 如果您沒有辦法看醫生或者現在已經是下班時間，您可以致電 IEHP 的 24 小時護理師諮詢專線 1-888-244-4347，TTY 使用者請撥 711，此專線全年全天候 24 小時提供服務。我們訓練有素的護理師可提供醫療建議，同時如有需要，將會透過電話或是視訊聊天讓您與醫師連線。 何時應尋求緊急醫療照護 COVID-19 有幾個必須注意的緊急警訊 。若某人出現下列任何跡象，請立即尋求緊急醫療照護： 呼吸困難 胸部持續疼痛或胸悶 新的困惑情況 無法醒來或無法睡著 嘴唇或臉部發青 *此清單並未包含所有可能的症狀。如有任何其他嚴重症狀或您有所疑慮，請致電您的醫師。 COVID-19 檢測需要花費多少錢？ IEHP承保標準*COVID-19檢測及由服務提供者訂購的檢測。會員無需為此類檢測付費。IEHP將支付由服務提供者訂購的檢測，包括聚合酶鍊式反應 (Polymerase Chain Reaction, PCR) 檢測、快速檢測及居家快速檢測等。如果您的醫生為您訂購了檢測，IEHP將承保該檢測費用。您的服務提供者必須直接向IEHP發送這些檢測的帳單。 IEHP不會對任何選擇支付COVID檢測費用的會員進行補償。其中包括可以在當天出結果的快速COVID-19檢測。 *標準COVID-19檢測的檢測結果通常在兩天內得出。

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 $1,174 (one-fourth of $4,696) for the previous three months are likely to be incurred.   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 Cal MediConnect Plan (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 October 2022. H5355_CMC_20_1900233_Accepted 

ively manage members on multiple opioid therapies to prevent overutilization, identify unsafe and inappropriate opioid use, and address potential fraud, waste, and abuse. Identified members at risk of opioid overutilization will be evaluation through our Pharmacy Pain Management Program (PPM). A clinical team will be reviewing member therapy and reaching out to the primary provider to discuss the existence of multiple prescribing providers, member's total opioid utilization, appropriate level of opioid use for the member, and considerations for implementation of a member-level claim edit. After review and consultation with the prescribing provider, if the member's therapy is determined to be appropriate and medically necessary, no further action will be taken.  Results of consultation with provider and findings will be documented. After review and consultation with the prescribing provider, if the member's therapy is determined to be inappropriate, and the provider recommends member-level point of sale claim edit, the member will be mailed a notification letter-that entrails the provider's recommendation.  Medicare members will receive the notice 30 days in advance of the point of sale claim edit implementation. Member may also be referred for evaluation and monitoring by a pain management specialist.   You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking Adobe Acrobat Reader. By clicking on this link, you will be leaving the IEHP website. Resources and Tools: Pain Management CPG (PDF) Pain Quick Reference Guide (PDF) For convenience, the URL link to the State of California Department of Justice's Controlled Substance Utilization Review and Evaluation Systems (CURES), California Prescription Drug Monitoring Program (PDMP) site. By clicking on this link, you will be leaving the IEHP website. http://oag.ca.gov/cures-pdmp   Information on this page is current as of January 1, 2022  

here to download a free copy by clicking Adobe Acrobat Reader. By clicking on this link, you will be leaving the IEHP website.   To view IEHP’s current Pharmacy Network under IEHP DualChoice (HMO D-SNP) - Medicare-Medicaid Plan, please use this link: Under “How to Access Care” tab, click on “2022 IEHP DualChoice Provider and Pharmacy Directory (PDF)".   To view IEHP’s future Pharmacy Network under IEHP DualChoice (HMO D-SNP), please use this link: Under “How to Access Care” tab, click on “2023 IEHP DualChoice Provider and Pharmacy Directory (PDF)".   Information on this page is current as of November 02, 2022.

th IEHP’s inspiring and compelling Mission to “Heal and Inspire the Human Spirit,” we are mindful of the cost of caring on clinician health and well-being and we want you to know we care about you, stand with you, and want to support you in ways that help you sustain joy in your work. We have provided best-practice and highly respected resources here for provider well-being. May you continue to find purpose and fulfillment in your calling to this very sacred work of health care.   Resources Standford Well MD A robust site of resources, courses, publications, self-assessments, research, innovation, conferences, and trainings. https://wellmd.stanford.edu/   National Academy of Medicine A compilation of key resources for improving clinician well-being. https://nam.edu/compendium-of-key-resources-for-improving-clinician-well-being/   American Association of Physician Leadership (AAPL) Resources, courses, and tools for Physician Wellness, Physician Leadership, and more. https://www.physicianleaders.org/resources/wellness   Coalition for Physician Wellness Resources, mobile app, research, podcasts, books and publications. https://www.forphysicianwellbeing.org/   Healthcare Burnout Symposium – February 2023 Annual conference that addresses the multiple facets of burnout crisis and how to increase the well-being of physicians, nurses and administrators. Visit website to learn more about conference agenda and how to earn continuing education credits. https://www.stophealthcareburnout.com/   American Medical Association Alliance (AMA) Steps Forward Program: Improving Physician Resilience Resources for physicians to enhance their resiliency and prevent burnout. Visit website to learn more about the AMA’s Steps Forward guide and module. Physicians might be able to earn continuing education credits by completing the training. https://amaalliance.org/physician-burnout/   American College of Physicians Online learning center with webinar and videos available on physician well-being and professional fulfillment. https://www.acponline.org/online-learning-center/physician-well-being-and-professional-fulfillment   Los Angeles County Medical Association (LACMA) Interactive Wellness dashboard and resources for physicians. https://www.lacmainteractive.com/mdlifeline   National Suicide Prevention Hotline The lifeline provides 24/7, free and confidential support, prevention and crisis resources for anyone in need and best practices for professionals in the United States. https://988lifeline.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.

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 for 2018 such as our Privacy Notice, Plan Transition Process and the section of CMS' website regarding Best Available Evidence. Service Area: Find out which zip codes in Riverside and San Bernardino counties are included in our service area.  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 December 29, 2022. H5355_CMC_19_1059755 Accepted      

e January 1, 2022, the Medi-Cal pharmacy benefits and services are administered by DHCS in the Fee-For-Service (FFS) delivery system, known as "Medi-Cal Rx." Magellan Medicaid Administration, Inc. (MMA) assumes operations for Medi-Cal Rx on behalf of the State of California Department of Health Care Services (DHCS). How to Register for the User Administration Console (UAC) (PDF) User Administration Console (UAC) Quick Start Guide (PDF) Medi-Cal Rx 101 Webinar Presentation (PDF) IEHP and DHCS strongly recommends our Providers to visit the new Medi-Cal Rx website (https://medi-calrx.dhcs.ca.gov) to register for the Magellan Medi-Cal Rx portal, review schedule of trainings available on the new Medi-Cal Rx Portal, and review general information about the transition. Communication from DHCS Please refer to the DHCS Medi-Cal Rx: Transition and DHCS Medi-Cal Provider Pharmacy News Bulletins pages for additional information.   Communication from IEHP While you can always refer to Pharmacy Communication and Provider Correspondence pages, the below list is provided for your convenience. January 02, 2023 - IEHP DualChoice (HMO D-SNP): PBM Update and Medicare Part B Coinsurance (PDF) December 22, 2022 - Cal MediConnect (CMC) to Medi-Cal Rx/HMO D-SNP Transition (PDF) October 28, 2022 - Cal MediConnect to Medi-Cal RX Transition (D-SNP) (PDF) July 29, 2022 - NEW DATE: Medi-Cal RX Gradual Reinstatement of Prior Auths (PAs) – Phase 1 – September 16, 2022 (PDF) July 13, 2022 - DHCS Medi-Cal Rx Update: Postponement of Implementation of NCPDP Reject Code 80 (PDF) July 11, 2022 - Medi-Cal Rx Gradual Reinstatement of PAs - Phase 1 (PDF) June 03, 2022 - Medi-Cal RX Transition: Blood Pressure Monitors and Cuffs (PDF) June 03, 2022 - Medi-Cal RX Billing Policy for Physician Administered Drugs (PADs) (PDF) February 17, 2022 - RETRACTION - Medi-Cal Rx Transition - Continuous Glucose Monitors (CGM - PCP) (PDF) February 17, 2022 - RETRACTION - Medi-Cal Rx Transition - Continuous Glucose Monitors (CGM - IPA)  (PDF) February 14, 2022 - Medi-Cal Rx Transition Survey - Your Response is Important! (PDF) February 11, 2022 - Updated - Medi-Cal Rx Transition - Implantable and Injectable Contraceptives FAQs (PDF) February 09, 2022 - Medi-Cal Rx Transition - Hyaluronic Acid Knee Injections (PDF) February 07, 2022 - Medi-Cal Rx UPDATE: Revised Prior Auth Policy for Prescribers and Emergency Fill Quantity Limit (PDF) February 07, 2022 - Medi-Cal Rx Transition - How To Assist IEHP Members (PDF) January 18, 2022 - Medi-Cal Rx Transition - Implantable and Injectable Contraceptives (PDF) January 18, 2022 - Medi-Cal Rx (Magellan) Customer Service (PDF) January 18, 2022 - Medi-Cal Rx Transition - Continuous Glucose Monitors (CGM) (PDF) January 04, 2022 - CORRECTION! Medi-Cal Rx: Mail Order for Blood Pressure Monitors and Nebulizers (PDF) You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

、資源，並討論如何替未投保的兒童投保符合資格的健康計畫。最重要的是， 所有與會者都會貢獻他們的專長，以各種方式進行聯繫及合作，從而協助 Inland Empire 的所有家庭。 如何加入 IEHP 社區合作夥伴網路？ 若您對於加入 IEHP 社區合作夥伴網路感興趣，請發送電子郵件至  communityhealthreps@iehp.org 以獲取相關資訊。若您的組織有興趣成為 IEHP 社區合作夥伴，請按一下此處。 會議將在何時召開？ 以下是 IEHP 社區合作夥伴會議的日程。 2023 年日程 2 月16 日，週四 4 月 20 日，週四 (虛擬) 6 月 15 日，週四 (虛擬) 8 月 17 日，週四 (虛擬) 10 月 19 日，週四 (虛擬) 12 月 14 日，週四 (虛擬) Webex： 按一下這裡加入會議。  時間： 上午 11:00 至中午 12:30

als who are dual eligible for both Medicare and Medi-Cal in Riverside and San Bernardino counties, including the most vulnerable population. This also includes members transitioning from IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan). IEHP has identified the most vulnerable as the following: Age 21-70 Identified as High and Rising Risk Diagnosed with Cardiovascular Disease AND/OR Diabetes RUB Score of 4 & 5. *RUB is Resource Utilization Band which is a predictor of using acute or costly services. IEHP will identify the most vulnerable members assigned to IPAs IEHP and its IPAs must design care management specific interventions to demonstrate how they support these member's health and wellness goals. Examples of Specially Tailored Services for the Most Vulnerable Population Remote Patient Monitoring Medically Tailored Meals and Other Community Supports Nutrition Education Pharmacy Services (medication reconciliation and other programs) Long-Term Services and Supports (LTSS) Telehealth Behavioral Health Services Transportation More frequent care management contact 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, Chrome or MS Internet Explorer    You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

EHP's contracted Providers understand how IEHP functions and understand the rules and regulations IEHP must comply with, as governed by the California Department of Health Care Services (DHCS), California Department of Managed Health Care (DMHC), the Centers for Medicare and Medicaid Services (CMS) and the National Committee for Quality Assurance (NCQA). The Delegate or Provider has the responsibility to ensure review, understanding, and attestation of the information contained in the Manual. Acknowledgement of Receipt (AOR) 2023 Providers: 2023 Provider eAOR Providers are encouraged to attest electronically using the following recommended browsers: Google Chrome, Microsoft Edge, Mozilla Firefox 2023 Hospital & IPA AORs For more information regarding 2023 Manuals, click here.

pating Network Provider private hospitals through uniform dollar increases for select inpatient and outpatient services based on actual utilization of qualifying services as reflected in encounter data reported to DHCS. PHDP utilization-based payments will be calculated by DHCS in accordance with the CMS approved preprint, and must be issued by IEHP to private hospitals, in six-month increments: January through June, and July through December Enhanced Payment Program (EPP) EPP provides supplemental reimbursement to Network Provider DPHs through uniform dollar increases for select inpatient and non-inpatient services, based on the actual utilization of qualifying services as reflected in encounter data reported to DHCS. In addition, for Network Provider DPHs that are primarily reimbursed on a capitated basis, DPH EPP provides supplemental reimbursement through uniform percentage increases to their contracted capitation rates. EPP utilization-based payments and Capitation based payments will be calculated by DHCS in accordance with the CMS-approved preprint and must be issued by to DPHs, in six-month increments: January through June, and July through December For more information about PHDP and EPP Programs, please visit the DHCS website at https://www.dhcs.ca.gov/services/Pages/DirectedPymts.aspx. District and Municipal Public Hospital Quality Incentive Pool and Designated Public Hospital Quality Incentive Pool QIP provides supplemental incentive payments to participating DPH and DMPH systems based on their performance on specified quality measures that address primary, specialty, and inpatient care, including measures of appropriate resource utilization. QIP payments are linked to delivery of services under MCP contracts. For additional details on QIP incentive program please visit DHCS website at https://www.dhcs.ca.gov/services/Pages/DP-DPH-QIP.aspx or contact DHCS at qip@dhcs.ca.gov. For disputes of payments issued under Private Hospital Directed Payment Program (PHDP) and or Enhanced Payment Program (EPP)- Hospital is to send email to PHDP-EPP@iehp.org stating the service period and dispute reason in detail. Hospital has six months from IEHP’s payment check date to dispute payment. FAQ’s on Hospital Directed Payments Please e-mail any inquiries related to the PHDP or EPP Program to PHDP-EPP@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.

護指示，為什麼我需要他人協助？預先照護指示是一種特定類型的授權書或健康 照護 委託書，在此指示中，某人授權他人 (代理人) 在其無法做出決定時，代表其做出決定。決定可大可小。 例如，「誰負責與您的家人溝通？」或「在生命的最終階段，您是否想要待在家中？」 IEHP 提供免費的預先照護指示研討會以為您提供協助。請致電 IEHP 健康教育部門，電話 1-866-224-IEHP (4347)，TTY 使用者請撥  1-800-718-4347 ，以瞭解您所在地附近是否有研討會將要舉行！ 亦可參閱： 預先照護指示指南 (PDF) 預先照護指示表單 (PDF) 準備：協助您為自己及他人做出醫療決定的加州計畫。 美國國家醫學圖書館：老年保健 您需使用 Adobe Acrobat Reader 6.0 或更高版本，才能檢視 PDF 檔案。 下載 Adobe Acrobat Reader。

nardino County, HACSB) 合作，成為聖貝納迪諾郡地區第一個 EnVision Center，同時也是美國住房與城市發展部 (United States Department of Housing and Urban Development, HUD) 第九區 (AZ、CA、HI、NV) 第一個與健康計畫合作的中心 (在加州境內則是第七個合作中心)。 這項任命消息由美國住房與城市發展部 (HUD) 宣佈，其內容強調本中心為家庭提供資源並支持弱勢族群自立的能力與承諾。EnVision Center 提供的資源包括經濟賦權、教育推廣、健康與保健以及品格領導力。為加強履行這項承諾，HACSB 目前也開始在本健康計畫的 Victorville CRC 為會員及社區居民服務。 IEHP Victorville CRC 經理 Delia Orosco 表示：「HACSB 進駐對社區來說是個好消息。他們的存在有助於推廣各種平價住房計畫，而在彼此通力合作之下，我們可以努力提升鄰里素質，讓我們的居民更有能力過上最好的生活。」 IEHP Victorville CRC 成立於 2019 年，現在是內陸帝國境內三個中心之一，在河濱郡和聖貝納迪諾郡皆設有據點。在三個中心共同合作之下，CRC 於 2020 年調整其努力目標，成立多個日用品發放處、流感疫苗接種點以及完成其他多項任務，努力成為社區居民的後盾。  過去，這些中心提供青少年輔導、移民服務、法律服務、健康與保健課程、兒童課程以及健康照護給付教育，而且分英文和西班牙文兩種版本，更與 Goodwill Southern California、Community Action Partnership of San Bernardino、TODEC Legal Services 以及 Young Visionaries Youth Leadership Academy 建立了合作關係。 HUD 區域行政主管 Christopher Patterson 說道：「如果以 Inland Empire Health Plan 的 Victorville 社區資源中心服務過的人數來計算，或許可以說是達到了一定程度的成就，但若要真正衡量成敗，應以順利改善自立能力的人數來評斷。我們培養這些人獨力租房/購房的經濟能力，這是值得我們所有人慶祝的成就。」 為符合接受指定的資格條件，HSCSB 參加了一項嚴謹的審查和申請流程，過程中會評估 Victorville CRC 的運作計畫，包括經費來源和策略、推廣方案以及中心目標。 HACSB 執行董事 Maria Razo 表示：「我們長期與 IEHP 合作，所以很興奮能透過這種方式合作，並且拓展 Victorville CRC 能夠提供的資源。這項具有策略意義的合作關係讓我們得以將資源分享給有需求的族群，也讓我們更有機會與合作夥伴展開更多合作，一起在我們的整個郡以及其他地方履行這項承諾。我們很感謝 IEHP 的合作，在他們的協助之下，我們的家人能夠方便地獲取完善的駐點服務。」  加州 HUD EnVision Center 目前只有七處據點，IEHP Victorville CRC 將加入其中成為一處新的中心；現有的七處據點包括：康普頓 NHS Center for Sustainable Communities、沙加緬度 La Familia’s Maple Neighborhood Center 和 Fruit Ridge Community Collaborative、洛杉磯 Coalition for Responsible Community Development、聖地牙哥 Metro Career Center，以及赫米特 Hemet Envision Center。 IEHP 執行長 Jarrod McNaughton 表示：「我們的社區樂於合作、願意奉獻、承認需求，而且致力於促進整個社區的健康與福祉，因此能夠被指定為中心設立處。我們很高興能有 HACSB 這樣的合作夥伴，該單位真正落實了我們治癒及啟發人文精神的宗旨，而且願意透過合作方式，致力於讓最弱勢的族群獲得資源和機會，有能力自力更生並過上更健康的生活。」 如欲深入瞭解 HUD EnVision Center，請造訪 https://protect-us.mimecast.com/s/WtJ_CDko98soZ6Du5Bwr_Q?domain=hud.gov。

為健康臨床主任 Amrita Rai 表示：「課外活動可降低兒童和年輕人發生危險行為的可能性，並且強化聯繫感和歸屬感。任何有助於支持健康情感發展的活動機會，都可以增加自尊心以及與同伴互動的能力，並且對成年期有所助益。」 IEHP 的社區資源中心可以幫助培養和改善年輕一代 Inland Empire 居民的心理健康。這些中心在河濱郡、聖貝納迪諾 和 Victorville 的三個地點提供包括 Zumba、創意藝術、烹飪和園藝等課程和活動。活動於週一至週六舉行，詳見 iehp.org 。 美國公共衞生署長 2021 年諮詢報告  進一步強調了 COVID-19 對持續發生的青少年心理健康危機的影響，指出為了正面應對這些挑戰，迫切需要社區和聯邦組織的合作行動，並承認心理健康是整體健康的重要組成部分。 這個概念對 IEHP 而言並不陌生，IEHP 目前正與一些社區組織和當地教育機構合作，擴展學校內外的行為健康服務（學生行為健康激勵計畫）。  該健康計畫還透過與 Young Visionaries Youth Leadership Academy 合作，探索在其中心為青少年和年輕人增加更多免費課程和活動的機會。   IEHP Victorville 社區資源中心經理 Delia Orosco 表示：「我們期待在未來數周和數個月內，將更多樂趣添加到我們中心的安排表中。我們的中心為所有參與的人提供安全空間，無論他們年齡為何，都能夠在這裡真正釋放自己，我們非常重視這一點。」 如需了解更多關於 IEHP 資源中心和課程表的資訊，請造訪 iehp.org。