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康計畫。這項承諾也及於支持 IEHP 宗旨，願意為社區提供高品質、方便取得並以保健為目的的健康照護服務之業務夥伴以及指定代理機構。  我們的法規遵循計畫旨在： 確保我們遵循適用的法令、規則、法規 減少或消除詐欺、浪費與濫用 (FWA) 預防、偵查、矯正不符法規的情形 加強我們對於法規遵循文化的承諾，並為此而努力 建立並實現我們對於誠實、誠信、透明、負責的共同承諾 FDR 資訊 什麼是 FDR？ 第一階、下游或關聯實體 (First Tier, Downstream or Related Entity，FDR) 是指透過分包代表 IEHP 提供健康計畫相關服務的委派實體。  FDR 規定 FDR 必須*遵守 IEHP 的政策和程序、業務行為與道德規範，以及其他合約規定。   FDR 資源 法規遵循計畫規定*手冊/廠商第一階、下游、關聯實體 (FDR) - 本手冊與 IPA 無關。  IEHP 法規遵循計畫說明 IEHP 業務行為與道德規範  禁止報復政策 委任監督提供者手冊 PnP (即將提供) 文件留存 (即將提供) FDR 法規遵循計畫證明 CMS 法規遵循、FWA、HIPAA 訓練教材 ICE FWA 訓練 ICE 綜合法規遵循訓練 *如欲瞭解 IPA 規定，請造訪 提供者資源頁面。  業務行為與道德規範 Inland Empire Health Plan (IEHP) 期望團隊成員以及與 IEHP 有業務往來的業務實體在執行業務活動時符合道德與專業，並促進公眾對於 IEHP 誠信的信任與信心。本規範針對 IEHP 的法規遵循文化，以及每位團隊成員在建立與延續該文化上所扮演的角色提供相關指引，成員包含高階管理人員、高階主管、管理委員會、業務合作夥伴。 IEHP 業務行為與道德規範 法規遵循、詐欺、浪費與濫用 (FWA)、隱私權計畫訓練 IEHP 的法規遵循、FWA 與隱私權訓練計畫著重於成效良好的法規遵循計畫、行為與道德、詐欺、浪費與濫用 (FWA)、隱私權計畫的各部分。 IEHP 要求委派實體在聘僱/開始日期的 90 天內為 其員工、提供者、下游實體、董事會、承包商提供法規遵循訓練。 IEHP 致力於培養法規遵循、道德與誠信文化，法規遵循訓練的目標是賦予所有相關人員能力，展現對於 IEHP 規定的認知，包括與日常工作相關法規遵循有關的法規、政策、程序。 若有疑問或其他建議，請寄電子郵件至 IEHP 法規遵循部門：compliance@iehp.org 綜合法規遵循訓練 法規遵循詐欺、浪費與濫用 (FWA) HIPAA 隱私權與安全 (PDF) 報告資訊 IEHP 提供下列資源，供報告詐欺、浪費或濫用、隱私權問題以及其他法規遵循問題： 法規遵循熱線：(866) 355-9038 傳真：(909) 477-8536 電子郵件：compliance@iehp.org 郵件： IEHP Compliance Officer P.O.Box 1800 Rancho Cucamonga, CA 91729-1800 線上：報告法規遵循問題

、遺傳資訊、婚姻狀況、性別、性別認同或性傾向而非法歧視、排擠或差別對待他人。 IEHP 提供： 免費的援助和服務，以協助殘障人士與我們充分溝通，例如： 合格的手語翻譯員 其他格式的書面資訊（大字列印、語音、無障礙電子格式、其他格式）   針對母語非英語人士的免費語言服務，例如： 合格的口譯員 以其他語言撰寫的資訊 如需此類服務，包括假日在內的每天早上 8 點至下午 5 點（太平洋標準時間）均可撥打 1-800-440-IEHP (4347) 與 IEHP 會員服務中心聯絡。如在聽說方面有困難，請撥打 1-800-718-4347。此文件可應要求以點字、大字列印、盒式錄音磁帶或電子形式提供。如需獲取其他格式的副本，請致電或寫信： Inland Empire Health Plan 10801 6th St., Rancho Cucamonga, CA 91730-5987 1-800-440-4347（TTY：1-800-718-4347/加州轉接 711） 如何提出申訴 如果您認為 IEHP 並未提供此類服務，或因性別、種族、膚色、宗教、血統、國籍、族群認同、年齡、精神殘疾、身體殘疾、醫療狀況、遺傳資訊、婚姻狀況、性別、性別認同或性傾向而以其他方式進行非法歧視，您可以向 IEHP 的民權協調員提出申訴。您可以透過電話、書面、親洽或電子等形式提出申訴： 電話：早上 8 點至下午 5 點（太平洋標準時間）撥打 1- 800-440-4347 與 IEHP 的民權協調員聯絡。或者，如在聽說方面有困難，請撥打 TTY 專線：1-800-718-4347/加州轉接 711。 書面：填寫申訴表或寫信給 - IEHP 民權協調員，地址為 10801 6th St., Rancho Cucamonga, CA 91730-5987 親洽：前往醫師辦公室或 IEHP 並說想要提出申訴。 電子：線上提出申訴。 民權辦公室 - 加州醫療保健服務部 您也可以透過電話、書面或電子等形式向加州醫療保健服務部民權辦公室提交民權申訴： 電話：電話 (916) 440-7370。如在聽說方面有困難，請撥打 711（電信轉接服務）。 書面：填寫申訴表或寄信至 - Deputy Director, Office of Civil Rights Department of Health Care Services Office of Civil Rights, P.O。Box 997413, MS 0009 Sacramento, CA 95899-7413 電子：傳送電子郵件至 CivilRights@dhcs.ca.gov。 民權辦公室 - 美國衛生與公眾服務部 如果認為自己遭遇了基於種族、膚色、國籍、年齡、殘疾或性別的歧視，您也可以透過電話、書面或電子等形式向美國衛生與公眾服務部民權辦公室提出民權申訴： 電話：撥打 1-800-368-1019。如在聽說方面有困難，請撥打 TTY/TDD 專線：1-800- 537-7697。 書面：填寫申訴表或寄信至 - U.S. Department of Health and Human Services, 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 電子：造訪民權申訴辦公室入口網站 https://ocrportal.hhs.gov/ocr/portal/lobby.jsf 語言協助 English ATTENTION:If you need help in your language call 1-800-440-4347 (TTY: 1-800-718-4347).Aids and services for people with disabilities, like documents in braille and large print, are also available.Call 1-800-440-4347 (TTY: 1-800-718-4347).These services are free of charge. الشعار بالعربي ة (Arabic) يُر جى الانتباه:ى إذا احتجت إلى المساعدة بلغتك، فاتصل ب 1-800-440-4347 (TTY: 1-800-718-4347) .ى تتوفر ا ً أيض المساعدات والخدمات للأشخاص ذوي الإعاقة، مث ى ل المستندات المكتوبة بطريقة بريل والخ ى ط الكب ري.ى اتصل ب 1-800-440-4347 (TTY: 1-800-718-4347) . هذه الخدمات مجانيةى. Հայերեն պիտակ (Armenian) ՈՒՇԱԴՐՈՒԹՅՈՒՆ:Եթե Ձեզ օգնություն է հարկավոր Ձեր լեզվով, զանգահարեք 1-800-440-4347 (TTY: 1-800-718-4347)։ Կան նաև օժանդակ միջոցներ ու ծառայություններ հաշմանդամություն ունեցող անձանց համար, օրինակ` Բրայլի գրատիպով ու խոշորատառ տպագրված նյութեր։ Զանգահարեք 1-800-440-4347 (TTY: 1-800-718-4347)։ Այդ ծառայություններն անվճար են։ ឃ្លាសម្គាល់ជាភាសាខ្មែរ (Cambodian) ចំណំ៖ ប ើអ្នក ត្រូវ ការជំនួយ ជាភាសា រ ស់អ្នក សូម ទូរស័ព្ទបៅបេខ 1-800-440-4347 (TTY: 1-800-718-4347)។ ជំនួយ និង បសវាកមម សត្ា ់ ជនព្ិការ ដូចជាឯកសារសរបសរជាអ្កសរផុស សត្ា ់ជនព្ិការភ្ននក ឬឯកសារសរបសរជាអ្កសរព្ុមពធំ ក៏អាចរកបានផងភ្ដរ។ ទូរស័ព្ទមកបេខ 1-800-440-4347 (TTY: 1-800-718-4347)។ បសវាកមមទំងបនេះមិនគិរថ្លៃប ើយ។ 简体中文标语(Chinese) 请注意：如果您需要以您的母语提供帮助，请致电1-800-440-4347 (TTY: 1-800-718-4347)。另外还提供针对残疾人士的帮助和服务，例如盲文和需要较大字体阅读，也是方便取用的。请致电1-800-440-4347 (TTY: 1-800-718-4347)。这些服务都是免费的。 (Farsi) مطلب به زبان فارسی توجه: اگر میخواهید به زبان خود کمک دریافت کنید، با 1-800-440-4347 (TTY: 1-800-718-4347) تماس بگیرید. کمکها و خدمات مخصوص افراد دارای معلولیت، مانند نسخههای خط بریل و چاپ با حروف بزرگ، نیز موجود است. با 1-800-440-4347 (TTY: 1-800-718-4347) تماس بگیرید. این خدمات رایگان ارائه میشوند. ह िंदी टैगलाइन (Hindi) ध्यान दें: अगर आपको अपनी भाषा में सहायता की आवश्यकता है 1-800-440-4347 (TTY: 1-800-718-4347) पर कॉल करें। अशक्तता वाले लोगोों के ललए सहायता और सेवाएों, जैसे ब्रेल और बडे लरोंट में भी दस्तावेज़ उपलब्ध हैं। 1-800-440-4347 (TTY: 1-800-718-4347) पर कॉल करें। ये सेवाएों लन: शुल्क हैं। Nqe Lus Hmoob Cob (Hmong) CEEB TOOM:Yog koj xav tau kev pab txhais koj hom lus hu rau 1-800-440-4347 (TTY: 1-800-718-4347).Muaj cov kev pab txhawb thiab kev pab cuam rau cov neeg xiam oob qhab, xws li puav leej muaj ua cov ntawv su thiab luam tawm ua tus ntawv loj.Hu rau 1-800-440-4347 (TTY: 1-800-718-4347).Cov kev pab cuam no yog pab dawb xwb. 日本語表記 (Japanese) 注意日本語での対応が必要な場合は 1-800-440-4347 (TTY: 1-800-718-4347)へお電話ください。点字の資料や文字の拡大表示など、障がいをお持ちの方のためのサービスも用意しています。1-800-440-4347 (TTY: 1-800-718-4347) へお電話ください。これらのサービスは無料で提供しています。 한국어 태그라인 (Korean) 유의사항: 귀하의 언어로 도움을 받고 싶으시면 1-800-440-4347 (TTY: 1-800-718-4347) 번으로 문의하십시오. 점자나 큰 활자로 된 문서와 같이 장애가 있는 분들을 위한 도움과 서비스도 이용 가능합니다.1-800-440-4347 (TTY: 1-800-718-4347) 번으로 ___________문의하십시오. 이러한 서비스는 무료로 제공됩니다. ແທກໄລພາສາລາວ (Laotian) ປະກາດ: ຖ້າທ່ານຕ້ອງການຄວາມຊ່ວຍເຫ ຼືອໃນພາສາຂອງທ່ານໃຫ້ໂທຫາເບີ 1-800-440-4347 (TTY: 1-800-718-4347). ຍັງມີຄວາມຊ່ວຍເຫ ຼືອແລະການບໍລິການສໍາລັບຄົນພິການ ເຊັ່ນເອກະສານທີ່ເປັນອັກສອນນູນແລະມີໂຕພິມໃຫຍ່ ໃຫ້ໂທຫາເບີ 1-800-440-4347 (TTY: 1-800-718-4347). ການບໍລິການເຫ ົ່ານີ້ບໍ່ຕ້ອງເສຍຄ່າໃຊ້ຈ່າຍໃດໆ. Mien Tagline (Mien) LONGC HNYOUV JANGX LONGX OC:Beiv taux meih qiemx longc mienh tengx faan benx meih nyei waac nor douc waac daaih lorx taux 1-800-440-4347 (TTY: 1-800-718-4347).Liouh lorx jauv-louc tengx aengx caux nzie gong bun taux ninh mbuo wuaaic fangx mienh, beiv taux longc benx nzangc-pokc bun hluo mbiutc aengx caux aamz mborqv benx domh sou se mbenc nzoih bun longc.Douc waac daaih lorx 1-800-440-4347 (TTY: 1-800-718-4347).Naaiv deix nzie weih gong-bou jauv-louc se benx wang-henh tengx mv zuqc cuotv nyaanh oc. ਪੰਜਾਬੀ ਟੈਗਲਾਈਨ (Punjabi) ਧਿਆਨ ਧਿਓ: ਜੇ ਤੁਹਾਨ ੂੰ ਆਪਣੀ ਭਾਸਾ ਧ ਿੱਚ ਮਿਿ ਿੀ ਲੋੜ ਹੈ ਤਾਂ ਕਾਲ 1-800-440-4347 (TTY: 1-800-718-4347). ਅਪਾਹਜ ਲੋਕਾਂ ਲਈ ਸਹਾਇਤਾ ਅਤੇ ਸੇ ਾ ਾਂ, ਧਜ ੇਂ ਧਕ ਬ੍ਰੇਲ ਅਤੇ ਮੋਟੀ ਛਪਾਈ ਧ ਿੱਚ ਿਸਤਾ ੇਜ਼, ੀ ਉਪਲਬ੍ਿ ਹਨ| ਕਾਲ ਕਰੋ 1-800-440-4347 (TTY: 1-800-718-4347). ਇਹ ਸੇ ਾ ਾਂ ਮੁਫਤ ਹਨ| Русский слоган (Russian) ВНИМАНИЕ!Если вам нужна помощь на вашем родном языке, звоните по номеру 1-800-440-4347 (TTY: 1-800-718-4347).Также предоставляются средства и услуги для людей с ограниченными возможностями, например документы крупным шрифтом или шрифтом Брайля.Звоните по номеру 1-800-440-4347 (TTY: 1-800-718-4347).Такие услуги предоставляются бесплатно. Mensaje en español (Spanish) ATENCIÓN: si necesita ayuda en su idioma, llame al 1-800-440-4347 (TTY: 1-800-718-4347).También ofrecemos asistencia y servicios para personas con discapacidades, como documentos en braille y con letras grandes.Llame al 1-800-440-4347 (TTY: 1-800-718-4347).Estos servicios son gratuitos. Tagalog Tagline (Tagalog) ATENSIYON:Kung kailangan mo ng tulong sa iyong wika, tumawag sa 1-800-440-4347 (TTY: 1-800-718-4347).Mayroon ding mga tulong at serbisyo para sa mga taong may kapansanan,tulad ng mga dokumento sa braille at malaking print.Tumawag sa 1-800-440-4347 (TTY: 1-800-718-4347).Libre ang mga serbisyong ito. แท็กไลน์ภาษาไทย (Thai) โปรดทราบ: หากคุณต้องการความช่วยเหลือเป็นภาษาของคุณ กรุณาโทรศัพท์ไปที่หมายเลข 1-800-440-4347 (TTY: 1-800-718-4347)นอกจากนี้ ยังพร้อมให้ความช่วยเหลือและบริการต่าง ๆ สาหรับบุคคลที่มีความพิการ เช่น เอกสารต่าง ๆ ที่เป็นอักษรเบรลล์และเอกสารที่พิมพ์ด้วยตัวอักษรขนาดใหญ่ กรุณาโทรศัพท์ไปที่หมายเลข 1-800-440-4347 (TTY: 1-800-718-4347) ไม่มีค่าใช้จ่ายสาหรับบริการเหล่านี้ Примітка українською (Ukrainian) УВАГА!Якщо вам потрібна допомога вашою рідною мовою, телефонуйте на номер 1-800-440-4347 (TTY: 1-800-718-4347).Люди з обмеженими можливостями також можуть скористатися допоміжними засобами та послугами, наприклад, отримати документи, надруковані шрифтом Брайля та великим шрифтом.Телефонуйте на номер 1-800-440-4347 (TTY: 1-800-718-4347).Ці послуги безкоштовні. Khẩu hiệu tiếng Việt (Vietnamese) CHÚ Ý:Nếu quý vị cần trợ giúp bằng ngôn ngữ của mình, vui lòng gọi số 1-800-440-4347 (TTY: 1-800-718-4347).Chúng tôi cũng hỗ trợ và cung cấp các dịch vụ dành cho người khuyết tật, như tài liệu bằng chữ nổi Braille và chữ khổ lớn (chữ hoa).Vui lòng gọi số 1-800-440-4347 (TTY: 1-800-718-4347).Các dịch vụ này đều miễn phí.    

生以及其他參與您護理的人員所獲得的護理進行協調。在 IEHP，我們明白某些如糖尿病、高血壓或物質使用障礙的健康狀況可能複雜、令人困惑而且難以管控。IEHP 的 ECM 提供支援服務因應您的整體健康—照護您的身心。如果您符合以下特定標準，而且為了管理您的健康而需要更多協助，您可能有資格經由 IEHP 取得 ECM。 哪些人有申請資格？ 符合下列條件的會員適用 IEHP ECM ： 有複雜健康狀況和/或行為健康需求的無家可歸者 頻繁入院，短期停留於專業護理機構，或至急診室就診 有複雜社會需求的嚴重精神疾病或藥物濫用障礙 有複雜需求，並處於自河濱縣監禁回歸的過渡狀態。 如果您符合 ECM 的資格，您將有自身的護理團隊，配置一名帶隊的護理經理協調免費服務，如初級保健、行為健康、奠基於社區的長期照護服務 (Long-term services and supports, LTSS)、發展健康、口腔健康和社會服務。 誰是您的護理團隊的成員： 護理師護理管理者 行為保健管理者 照護協調員 社區健康工作者 IEHP 的 ECM 包含些什麼 如果您加入 ECM ，您的福利不會改變。 您可以保留您的醫生和醫療保健提供者，而且您的護理團隊將會協助您： 找尋醫生，並且預約身體、精神和物質使用等健康需求。 讓您的所有醫療保健提供者充分了解狀況。 為您前往就診安排交通事宜 於您出院後獲得後續服務 管理您的所有藥物 獲取與當地資源加以連結的協助，例如食物或其他社會服務 ECM 服務為免費提供，您可以隨時加入或停止 ECM。 在您需要時提供支持 您的護理團隊可以透過電話或面對面為您提供協助，他們甚至可以前往您所在的位置。有了 IEHP ECM，您並不孤單。 關於加入或停止 ECM，請於週一至週五上午 7 點 至晚上 7 點 以及週六至週日上午 8 點 至下午 5 點 致電 IEHP 會員服務中心，電話 1-800-440-IEHP (4347)。TTY 使用者請致電 1-800-718-4347。  

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

的家庭所設計。 此課程採用參與遊戲及社交互動的方式，提倡健康的成長與養育技巧。我們鼓勵父母們運用各種健康照護資源，並與兒科醫師合作進行發育篩檢和早期干預。瞭解健康素養，包括健兒門診、餵食、語言發育、安全、體能活動與疫苗接種。發育篩檢服務可應要求提供。   點選此處確認小組上課時間並報名。 如欲為您的子女申請發育篩檢服務，請寄電子郵件至 screening@iehp.org 與我們聯絡 亦可參閱： 點選下列任何連結，您將會離開 IEHP 網站。 發育里程碑 健兒門診時程表 疫苗接種時程表 健康兒童之旅

是，待該事件解決後，您所在的縣將 檢查您是否仍有資格獲得免費或低價的 Medi-Cal 服務。如果您或您的家人收到該縣的信函，要求您提供有關 Medi-Cal 承保範圍的資訊，請盡快為其提供。 情況變化    請繼續向當地縣辦公室報告您家庭的任何變化。其中包括： 收入變化 殘障情況 電話號碼或郵寄地址。 如果您的家中有孕婦 如果有人搬進家中，或有任何其他可能影響您的 Medi-Cal 資格的事項 報告這些變化或許對您在 COVID-19 PHE 結束後繼續享受 Medi-Cal 承保有所幫助。  報告聯絡資訊  持有您最新的聯絡資訊對您所在的縣非常重要。如聯絡資訊有任何變化，請向所在縣報告，以免錯過有關您的 Medi-Cal 承保範圍的重要資訊。請向當地的縣辦公室報告所有更新的聯絡資訊，例如您的電話號碼、電子郵件地址或家庭住址，或在 BenefitsCal.com 在線更新您的聯絡資訊。  河濱郡 Medi-Cal 辦公室：877:810-8827 聖貝納迪諾郡 Medi-Cal 辦公室：877-410-8829 申請資訊  如果您或您的家人收到該縣的信函，要求您提供有關 Medi-Cal 承保範圍的資訊，請為其提供。這將幫助 您所在的縣確保您的 Medi-Cal 承保持續有效。  有任何疑問？  如有任何疑問，請於週一至週五上午 7 點 至晚上 7 點 以及週六至週日上午 8 點 至下午 5 點 致電 IEHP 會員服務中心 (IEHP Member Services)，電話 1-800-440-IEHP (4347)。TTY 使用者請致電 1-800-718-4347。 

ero-wrapper{ } .uenroll-hero-column-left { background: #1e95d3; padding: 2em; padding-right: 56px; } .uenroll-hero-headline { color: #ffffff !important; font-size: 1.953rem; font-weight: bold; } .uenroll-hero-subheadline { color: #fdb913 !important; font-size: 1.563rem; } .uenroll-hero-body-text { color: #ffffff; font-size: 1.25rem; padding-top: 1em; padding-bottom: 1em; width: 80%; } .uenroll-cta-btn{ background: #fdb913 !important; padding-right: 2em; padding-left: 2em; padding-bottom: 0.6em; padding-top: 0.6em; border-radius: 8px; font-weight: bold; font-size: 1.25rem; } .uenroll-hero-img { height: 100% !important; object-fit: cover !important; } .uenroll-sidebar-img { height: 90% !important; object-fit: cover !important; text-align: right; } /** BEGIN MOBILE STYLES - Screens less than 769px **/ @media only screen and (max-width: 769px) { .uenroll-hero-column-left { background: #1e95d3; padding: 2em; padding-right: 2em; } .uenroll-hero-headline { color: #ffffff !important; font-size: 1.653rem; font-weight: bold; } .uenroll-hero-subheadline { color: #fdb913 !important; font-size: 1.263rem; } .uenroll-hero-body-text { color: #ffffff; font-size: 1.1rem; padding-top: 1em; padding-bottom: 1em; width: 100%; } .uenroll-cta-btn{ background: #fdb913 !important; padding-right: 0em; padding-left: 0em; padding-bottom: 0.6em; padding-top: 0.6em; border-radius: 8px; font-weight: bold; font-size: 1.1rem; } .uenroll-hero-img { height: auto !important; } .uenroll-sidebar-img { height: auto !important; } } 您的健康事關重大。 而非您的移民狀態。 直接透過電話申請免費健康保險。 立即撥打電話！1-866-294-4347 州法律向更多成人提供 Medi-Cal 服務 有史以來第一次，年滿 50 歲及以上的低收入加州居民，無論其移民身分為何，均有資格領取全範圍 Medi-Cal 福利。  依據《加州 AB 133 號法案》(California Assembly Bill 133, AB 133)，Inland Empire 健康計畫 (Inland Empire Health Plan, IEHP) 等健康計畫目前現在可讓這些成人使用預防性健康照護、行為健康服務、視力照護等服務。 在 2019 年，於健康平權的歷史性措施中，州政府首次為 0-26 歲的所有加州居民提供全範圍 Medi-Cal 服務。在 2022 年，該項新法律為國內低收入人士提供最具包容性的健康照護政策。全州有將近 185,000 人得以受益。   IEHP 醫療長 Takashi Wada 醫師說道：「當越來越多居民可以使用協調照護及預防性服務，健康及福址就得以改善，而社區也能蓬勃發展，」「所有社區（無論移民身分為何）都應該有機會獲得充滿活力的健康狀態。」 IEHP 理解無證居民對於申請 Medi-Cal 的恐慌。這也是我們之所以盡其所能使居民與值得信賴的資源和支持建立連結。這些努力包含社區活動，以及與 TODEC 等法律組織合作。 IEHP 執行長 Jarrod McNaughton 說道：「IEHP 渴望竭盡所能地支援這些成人，希望能讓他們獲得所需的照護及福利。」 如需申請 Medi-Cal，請於週一到週五上午 8 點至下午 5 點致電 1-866-294-IEHP (4347) 聯絡 IEHP 的協助註冊諮詢。TTY 使用者應致電 1-800-718-4347。 立即撥打電話！1-866-294-4347

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

中心，電話 1-800-440-IEHP (4347)。TTY 使用者請致電 1-800-718-4347。您也可以發送電子郵件至 MemberServices@iehp.org。 Medicare/Medi-Cal 會員：  如有任何疑問，請於上午 8 點 至晚上 8 點（太平洋標準時間）致電 IEHP DualChoice，電話：1-877-273-IEHP (4347)，每週七天（包括節假日）均提供服務。TTY 使用者請致電 1-800-718-4347。您也可以發送電子郵件至 MemberServices@iehp.org。 若您是提供者： 如需任何資訊，請於週一至週五上午 8 點至下午 5 點致電提供者關係團隊 (Provider Relations Team)，電話 (909) 890-2054。您也可以發送電子郵件至 ProviderServices@iehp.org。 如欲投保 IEHP： 如需投保醫療保健保險，請於週一至週五上午 8 點至下午 5 點致電  1-866-294-4347。TTY 使用者請致電  1-800-720-4347。我們會有親切友善的雙語投保顧問 (Enrollment Advisors) 與您洽談。 如需驗證 IEHP 員工的就業狀況  ，請向 IEHP 人力資源部門 (IEHP Human Resources Department) 提交請求：  電子郵件： Human_Resources@iehp.org。 傳真：909-477-8544 電話：909-890-2000（轉接人力資源部門） 我們的社區 如欲洽詢一般事務，請於週一至週五上午 8 點至下午 5 點致電 (909) 890-2000。TTY 使用者請致電 (909) 890-0731。 潛在供應商  若您有意成為 IEHP 的供應商，請造訪我們的「Procurement」（採購） 頁面。 對於所有記錄處理 請聯絡 IEHP 法務部門 (IEHP Legal Department)。法務部門負責處理牽涉受保護健康資訊 (Protected Health Information) (“PHI”)、傳票、監護權、公共記錄法 (Public Records Act) (“PRA”)，以及加州政府理賠申請的各項事宜。法務部門也是 IEHP 的傳票送達指定代收人。 Inland Empire Health Plan Attn:Legal Department 10801 Sixth Street Rancho Cucamonga, CA 91730 電子郵件：legal@iehp.org 傳真：(909) 477-8578 授權書 (Authorization of Release) (PDF) - 本表授權 IEHP 使用及披露受保護的健康資訊。 若您是媒體/新聞記者  請致電我們的媒體聯絡人： 傳播策略專家 Chelsea Galvez (909) 727-5263 press@iehp.org 我們的地址 10801 Sixth Street Rancho Cucamonga, CA 91730  郵寄地址 P.O. Box 1800 Rancho Cucamonga, CA 91729-1800 傳真：(909) 890-2003 IEHP 直接會員的索賠郵寄地址 Inland Empire Health Plan - Claims P.O. Box 4349 Rancho Cucamonga, CA 91729-4349 IEHP 直接會員的索賠上訴和爭議郵寄地址 Inland Empire Health Plan - Claims Appeals and Disputes P.O. Box 4319 Rancho Cucamonga, CA 91729-4319

獲得最佳照護和充滿活力，IEHP 會竭盡所能。結合州 Medi-Cal，您可以獲得當地數千位醫生的服務，以滿足您的醫療、牙科和視力需求。 請立即致電我們，以詳細瞭解 IEHP 和 Medi-Cal。 河濱郡的醫療服務 未投保的美國人在需要醫療保健時不太可能會主動尋求服務，而這可能會加劇已有的醫療問題。透過選擇 IEHP 並結合 Medi-Cal，您將獲得保護自己的健康和全家人健康的機會。 低收入或無收入不再是獲取優質醫療保健的阻礙。透過由 IEHP 管理的 Medi-Cal，享受您理應獲得的承保服務。 周全的醫療服務 Medi-Cal 不僅僅承保基礎醫療服務，例如門診服務、安寧照護、急診服務和住院治療。利用 IEHP 和 Medi-Cal 承保服務，會員還可以獲得： 戒癮治療 兒科照護 新生兒照護 跨性別支援服務 放射線治療承保服務 實驗室檢驗服務 透過 IEHP，您可以獲得網絡內 8,000 多名醫生和專家的服務。 請立即致電 IEHP，以瞭解 IEHP 會員享受的福利，以及申請 Medi-Cal 的方式。 視力服務 視力低下會影響生活品質。投保 IEHP 和 Medi-Cal 計畫後，獲取所需照護會變得輕而易舉。成為 IEHP 計畫會員後，您每 24 個月便能免費進行一次視力檢查，如果在醫療上具有必要性（例如對於糖尿病患者），額外或更頻繁的眼部檢查也在承保範圍內。如果您獲得有效處方，您還能每 24 個月就獲得一副眼鏡（包含鏡框和鏡片）。  如果因為眼部疾病或醫療狀況（例如喪失一隻耳朵）而無法佩戴眼鏡，則隱形眼鏡檢查和隱形眼鏡可能也在承保範圍內。 透過河濱郡 Medi-Cal 獲取牙科服務 Medi-Cal（透過 Medi-Cal 牙科計畫）承保部分牙科服務，包括： 診斷和預防性牙科衛生（例如檢查、X 射線治療和牙齒清潔） 為止痛而提供的緊急服務 拔牙 根管治療（前／後） 刮牙術與牙周整平 牙冠（預製／實驗室製作） 符合條件的兒童齒顎矯正 全口義齒或部分義齒 局部塗氟 牙科照護與醫療照護同樣重要。如果您對於牙科服務有疑問或想瞭解更多資訊，請撥打 Medi-Cal 牙科計畫電話：1-800-322-6384（TTY 使用者請撥 1-800-735-2922 或 711）。您還可以造訪 Medi-Cal 牙科計畫網站：https://www.dental.dhcs.ca.gov 或 https://smilecalifornia.org/。 申請河濱郡的 Medi-Cal IEHP 治愈疾病和鼓舞心靈的使命之所以能夠實現，是因為其設立了一個願景 — 為了讓社區獲得最佳照護和充滿活力而竭盡所能。   每個人都應該獲得醫療保健，而且現在比以往都更容易獲得承保服務。 如何申請河濱郡的 Medi-Cal 申請 Medi-Cal 的方式有多種，其中包括： 致電 IEHP 於週一至週五上午 8 點至下午 5 點撥打 1-866-294-4347。TTY 使用者請撥 1-800-720-4347。您將與 IEHP 友善的雙語投保顧問進行交流。 郵寄 您可以將填妥並簽名的申請表郵寄至：   Covered California P.O.Box 989725 West Sacramento, CA 95798-9725 或郵寄至河濱郡 Medi-Cal 辦公室。 現場申請 按一下此處以查找河濱郡 Medi-Cal 辦公室的地點。 線上申請 按一下此處以在線上申請。   立即獲得健康承保服務 成為 IEHP 計畫會員，享受一流的加州醫療保險服務。在超過 25 年的時間裡，IEHP 為辛勤工作的市民及其家人提供服務並以此為傲。立即加入 IEHP，讓您的健康成為我們的重心。  

「發瘋」或是「發狂」的人們一直被社會所排斥。這是由於對心理健康的無知所致。 很遺憾，目前社會對心理健康仍然存在太多的恐懼和誤解。許多人都患有心理健康疾病。鑑於目前 COVID-19 帶來的危機，遭受心理疾病所苦的人變得更多。 太多人默默地承受著心理疾病的折磨 根據 COVID 爆發前的最新統計資料，美國 5 人當中就有 1 人被診斷患有心理疾病 這一數字在 COVID-19 危機期間將會呈現增長趨勢 心理健康包括保健、自我照護、情緒管理、關係問題以及育兒等日常生活的各方面 心理健康對每一個人來說都很重要 每個人都有可能罹患心理疾病 每個人都應獲得心理健康治療。 您可以做些什麼以瞭解更多資訊或獲得協助 瞭解心理健康保健的重要性以及什麼是心理疾病。 請按這裡以瞭解更多資訊。 從頸部快速檢查。 請按此處進行線上篩查。  在 COVID-19 期間維持心理健康的秘訣 自我照護非常重要：聆聽您的情緒掙扎警示訊號，並透過做一些基本的事情來緩和，如洗澡、吃飯、睡覺與運動 每天做一些能夠讓您保持心情愉悅的事：與您的子女或配偶一起玩遊戲、散步、讀書以及其他可激發創造力的活動 每天透過電話或其他影像技術，與家人以外的他人聯絡 營養飲食，不要暴飲暴食或吃太多甜食 避免喝酒 繼續透過遠距醫療接受治療師的治療 持續照顧您的身體、財務與精神需求 對自己與他人保持耐心 隨時寬恕自己 運動、瑜珈、散步。  保持活力，但是不要過度 必要時，尋求心理健康治療 IEHP 行為健康服務不僅重視您的心理健康，也看重您的身體健康。您的心理健康包括情緒、精神與社會福祉的平衡。 它不但影響您思考，也影響您的感受以及您的行為模式。  您的心理與身體是相連的，兩者會互相影響。當您的心理承受痛苦時，您的身體也會感受到苦痛。IEHP 行為健康服務的目標是協助您活出最棒且最健康的人生，包括心理與生理。   心理疾病比您想像的還要普遍，IEHP 可隨時為您提供協助與支援。您是否知道，美國每五個人就有一人患有心理疾病，而心理疾病是可以治療的？這些人都在與心理疾病做鬥爭，如沮喪、焦慮，甚至是藥品或酒精濫用。   若您認為您可能遭受行為或心理健康問題，並且希望獲得治療，請預約您的醫師。若您沒有醫師，可以在您所在區域 尋找行為健康專科醫師 ，請致電 1-800-440-IEHP (4347) 聯絡 IEHP 會員服務中心 (Member Services)，服務時間為週一至週五上午 7 點 至晚上 7 點 以及週六至週日上午 8 點 至下午 5 點。TTY 使用者請致電 1-800-718-4347，要求與行為健康部門 (Behavioral Health Department) 通話。 若您出現自我傷害或傷害他人的想法，請前往您附近的急診室、致電 911 或聯繫 全國自殺預防熱線 ，電話 1-800-273-8255。 請記住，您並不孤單。   許多人在這段期間都在或是即將面臨情緒和焦慮方面的問題。求助他人。  有一些心理健康的求助管道，而我們也希望您尋求幫助。 可用資源 聖貝納迪諾郡行為健康 河濱郡行為健康 聖貝納迪諾郡藥物使用 河濱郡藥物使用 精神疾病治療免預約診所 (Montclair) 精神疾病治療免預約診所 (Palm Desert) 精神疾病治療免預約診所 (Victorville) 青少年心理健康指南 COVID-19 孕期心理健康常見問答集 物質濫用與心理健康服務管理局 尋找提供者 孕期心理健康與保健資源  National Postpartum Support International 本地 Inland Empire 孕產婦心理健康合作資源

HP 臨床藥師團隊負責生產您的藥物，確保您所使用的藥物劑量符合您的健康狀況。若您是符合 MTM 計畫資格的會員，我們將會發送一封信函給您。除非您選擇不加入，否則您將自動投保計畫。符合資格的會員投保計畫無需花費任何費用。 誰可能符合資格？  本計畫的部分合格會員可能僅享有 IEHP 的 Medi-Cal 給付，   或者可能已經投保 IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid 計畫)。該等會員必須符合相關條件，且將會獲得 Medicare MTM 計畫的服務。(請參閱下列說明。)  MTM 服務包括哪些？  IEHP 的  MTM 服務包括 下列核心要素： 藥物治療審查 藥物教育 - 包括藥物行動計畫 疾病管理 我們的 IEHP 臨床藥師團隊會審查會員的藥物、家族病史、疾病狀態與藥物治療目標。該團隊會依據完整審查結果，為會員與提供者提供建議。  持照藥劑師與技師團隊將會與您的醫師 (或其他提供者) 及藥局合作提供完整照護。我們也會與照護管理團隊合作，為會員提供「全方位健康」照護。 Medicare MTM 計畫 IEHP 臨床藥師團隊為符合下列條件的 IEHP DualChoice 會員提供 MTM 服務，不另收取費用： 患有多種疾病； 使用許多處方藥； 需支付高額藥物費用 加入此計畫後，您將收到一份包含詳細資訊的郵寄資料包。此資料包也會提供如何退出計畫的相關資訊，以便您選擇不加入計畫時使用。若您決定不參與計畫，您獲得 IEHP DualChoice 給付的狀態及相關資格將不會有任何變化。誠摯希望您在符合資格時能夠加入，此計畫完全免費，還可協助您更好地管理您的藥物。  MTM 計畫包括年度綜合用藥審查 (CMR) 及針對性用藥審查 (TMR)。以下為 MTM 服務的部分內容： 綜合用藥審查  (CMR) IEHP 臨床藥劑師將透過電話為您提供年度綜合用藥審查服務。藥劑師會逐一確認您的藥物，以確保您所使用的藥物符合您的健康狀況，並協助您避免藥物相互作用等。  在完成您的 CMR 後，我們會將您的藥物行動計畫 (Medication Action Plan, MAP) 及個人藥物清單 (Personal Medication List, PML) 郵寄給您。您可致電會員服務中心並要求與臨床藥師團隊通話，以取得相關 MTM 服務文件及個人藥物清單的副本。 針對性用藥審查  (TMR) IEHP 臨床藥師團隊也會在一年當中提供 TMR 服務，審查參與計畫之 IEHP DualChoice 會員的藥物。該團隊會每三個月為所有保險受益人進行一次 TMR。保險受益人會透過郵件收到 TMR 建議，其初級照護提供者則可能會透過傳真收到相關建議 (若 IEHP 臨床藥師團隊認定有必要)。 符合 CMR 或 TMR 服務資格的 IEHP DualChoice 會員如需瞭解詳細資訊，可致電 1-877-273-IEHP (4347)，服務時間為 (太平洋標準時間) 每天早上 8 點至下午 5 點，假日亦提供服務。TTY 使用者請撥 1-800-718-4347。  按一下此處獲取空白個人藥物清單。 資格條件 該等 MTM 計畫服務可能有一些適用的資格條件，且不屬於福利。MTM 計畫服務適用於符合下列條件的會員： 1.會員罹患至少三 (3) 種下列疾病： 骨骼疾病 - 關節炎 - 骨質疏鬆症 骨骼疾病 - 關節炎 - 類風濕性關節炎 慢性心臟衰竭 (Chronic Heart Failure, CHF) 糖尿病 血脂異常 末期腎臟病 (End-Stage Renal Disease, ESRD) 高血壓 心理健康慢性疾病/殘障心理健康疾病 呼吸系統疾病 – 哮喘 呼吸系統疾病 – 慢性阻塞性肺病 (Chronic Obstructive Pulmonary Disease, COPD) 2. 醫師為會員開立至少五 (5) 種不同的處方藥，以治療下列疾病： 血管緊張素 I 型轉化酶抑制劑 血管緊張素 II 型受體阻斷劑 (Angiotensin II Receptor Blocker, ARB) 抗憂鬱劑 降血脂藥 降血壓藥 抗精神病藥物 乙型阻斷劑 支氣管擴張劑 鈣通道阻斷劑 疾病調節抗風濕藥物 (Disease-Modifying Anti-Rheumatic Drug, DMARD) 利尿劑 胰島素 口服降血糖藥 選擇性血清素再吸收抑制劑 (Selective Serotonin Reuptake Inhibitor, SSRI) 腫瘤壞死因子 (Tumor Necrosis Factor, TNF) 吸入式皮質類固醇 擬鈣製劑 強心配糖體 聚落刺激因子 昇糖素類似胜肽 糖皮質激素 腦啡肽酶抑制劑 非類固醇消炎止痛藥 (NSAID) 磷酸鹽結合劑 維生素 D 類似物  3.前三個月可能須支付 1,174 美元 (4,696 美元的四分之一) 的藥物費用。 如欲進一步瞭解 MTM，請致電  IEHP DualChoice 會員服務中心，電話：1-877-273-IEHP (4347)。服務時間為 (太平洋標準時間) 每天早上 8 點至晚上 8 點，假日亦提供服務。TTY 使用者 請 撥 1-800-718-4347。 此頁面資訊為截至 2021 年 10 月 8 日的資訊。 H5355_CMC_22_2246727 已接受  

好記，便於陷入危機中的人致電。該熱線會將他們轉至全國自殺預防熱線（現稱為 988 自殺和危機熱線 (988 Suicide & Crisis Lifeline)）。 對於處於危機中的人士來說，這是一個拯救生命的資源。 此號碼的接聽對象是受過訓練的危機顧問，並非警察。 當人們致電或發簡訊至 988 時，會將其轉至受過訓練的顧問，這些顧問是現有熱線網絡的成員。他們會做人們的聆聽者，瞭解來電者的問題如何對其造成了影響，並為其提供支持和在必要時將他們與資源建立聯絡。 988 和 911 有何區別？ 988 不是一種新的服務，只是一個新號碼。設立 988 區號的目的是改善獲取危機服務的機會，以滿足我國日益增長的自殺和心理健康相關危機護理需求。它可以讓人們更輕鬆地存取熱線網絡和相關的危機資源，這與 911 的公共安全用途（其重點是根據需要派遣緊急醫療服務、消防和警察）不同。 988 是否可以處理藥物濫用危機？ 任何需要自殺、心理健康和/或藥物濫用危機方面等幫助的人都可以致電此熱線。 988 熱線是免費服務嗎？ 是的，熱線會以多種語言提供全天候接聽服務。988 服務還可以回覆簡訊或訊息（僅限英文）。移動運營商的標準數據速率可能適用於向此熱線發送簡訊的人員。如果在通訊需求方面需要資金援助，請造訪 www.fcc.gov/lifeline-consumers 以瞭解詳細資訊。任何需要心理健康相關或自殺危機幫助的人員皆可致電、發送簡訊和訊息。  每個人都可以致電此熱線嗎？  所有美國民眾都可以致電此熱線，它可以為陷入自殺危機或情緒困擾的人提供全天候的免費支持並確保私密性。988 熱線每天幫助無數人同自殺念頭和健康問題作鬥爭。 如果您或認識的人處於危機之中，請致電下方的當地危機電話號碼。全國 988 服務持續在線，請根據需要利用當地資源。  Riverside 1-800-273-TALK (951) 686-HELP (4357) 1-877-727-4747 和危機簡訊熱線：741-741 San Bernardino 24 小時危機熱線：(760) 365-6558 East Valley:(909) 421-9233 West Valley:(909) 458-9628 High Desert:(760) 956-2345 心理健康緊急照護診所 Riverside 緊急照護診所 Riverside（年滿 18 歲的成年人） 9990 County Farm Rd. Bldg. 2, Riverside, CA 92503 (951) 509-2499 Perris（年滿 13 歲的青少年及成年人） 85 Ramona Expressway, Suites 1-3, Perris, CA 92571 (951) 349-4195 San Bernardino 緊急照護診所 Victorville（免預約危機中心） 12240 Hesperia Rd., Ste.A, Victorville, CA 92395 (760) 245-8837 Yucca Valley（免預約危機中心） 7293 Dumosa Ave., Ste.2, Yucca Valley, CA 92284 (760) 365-2233 Merrill 中心 - Fontana（危機平息部門） 14677 Merrill Ave., Fontana, CA 92335 (951) 643-2340 Windsor 中心 - San Bernardino（危機平息部門） 1481 N. Windsor Dr., San Bernardino, CA 92404 (909) 361-6470 其他資源 Take My Hand，一個心理健康支持聊天熱線 Medi-Cal 心理健康服務護理熱線 1-800-499-3008

nd Empire Health Plan (IEHP) is now responsible for coverage of the Major Organ Transplant (MOT) benefit for adult and pediatric transplant recipients and donors, including related services such as organ procurement and living donor care.   What Transplant Services are Available for Members? Autologous Islet Cell Bone Marrow Cornea Heart Heart-Lung Liver Liver-Heart Liver-Intestinal Liver -Lung Lung Kidney Kidney-Liver Kidney - Pancreas Pancreas (after Kidney)   Centers of Excellence (COE) For transplant care, IEHP has partnered with various, local, Centers of Excellence (COE). A COE is a recognized program within an existing healthcare center that provides a concentration of specialized care,  delivered in a comprehensive, interdisciplinary manner. Their focused care in distinct areas provides exceptional, integrated care that can lead to better Member outcomes.   Bone Marrow - CHLA, City of Hope, LLUMC, UCSD, USC (Norris) Heart - USC (Keck), LLUMC, Rady's Children, Sharp Memorial, UCSD Intestinal - CHLA Kidney-Pancreas - LLUMC, UCI Liver- CHLA, LLUMC, USD, USC (Keck) Lung - UCSD      You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here  

參加時，您可能會收到不同的醫療保健通知，例如透過 IEHP 獲得護理的方式、重要的健康提醒，另外還將通知您有關健康教育和健康計畫的資訊 。短信頻率會有所不同。 本條款與條件有可能變更。 IEHP 保留隨時更新或修改本條款與條件的權利。 IEHP 或其服務提供者可自行決定因為任何原因終止、調整或暫停任何使用者使用本服務或本服務的任何一部分。 您亦可隨時終止或暫停服務，只需要您發送簡訊「STOP」至 90902 或發送電子郵件至 texthelp@iehp.org 以取消訂閱。如需協助，請發送簡訊 HELP 至 90902，也可致電 1-800-440-4347 聯絡 IEHP 會員服務中心 (IEHP Member Services)。 您必須至少年滿 13 歲，方符合使用本服務之資格。不過，如果您至少年滿 13 歲但未滿 18 歲，您可以在獲得家長或監護人事前准許的情況下使用本服務，而且只有在此情況下才能使用本服務。任何情況下，未滿 13 歲者皆不得使用本服務。  IEHP 不會因為本服務收費，不過可能會收取簡訊費用和資料費用。例如，您的呼叫器或行動電話的服務提供者可能會向您收取接收無線簡訊的費用。IEHP 及其承包商皆不對使用本服務的任何相關費用負責。 您同意您負責支付您的電信業者費用以使用本服務，或是如果您未滿 18 歲，您同意您已獲得負責支付電信業者費用的成年人准許，可使用本服務。運營商對延遲或未送達的訊息不承擔任何責任。 IEHP「依原樣」提供本服務，沒有任何形式的保證。IEHP 明確聲明不對本服務做任何明示或暗示的保證，包括對適售性、特定用途的適用性、不侵權的任何暗示保證，或是對服務一定安全、不受中斷或沒有錯誤、病毒或其他有害成分做任何保證。* 某些州不允許暗示保證的免責聲明，因此以上免責聲明對您可能不適用。 任何情況下，IEHP 或其員工、主管或董事皆不對您因為使用本服務而產生或是與使用本服務相關的任何間接、偶然、衍生性質、特殊或懲罰性質的損害負責，不論 IEHP 是否被告知上述損害的可能性。 如果您對本服務或任何 IEHP 網站上的任何內容不滿意，或對本條款與條件不滿意，您唯一的救濟方式是中止使用本服務。您若使用本服務，即承認您對本服務的使用自行承擔所有風險。 您同意賠償與保護 IEHP、其合作夥伴、客戶、員工、主管、董事，使他們免於承擔下列事項所產生的任何及所有索賠、責任、處罰、清算、判決、費用 (包括合理的律師費)：(i) 您或任何使用您帳戶的人可能提交、發布或傳輸至本網站的任何內容；(ii) 您對本服務的使用；(iii) 您違反本條款與條件的條款之情事；(iv) 任何您違反或未能遵守與本服務相關的所有法令與法規。 未獲得 IEHP 事前書面同意時，不論您是自願還是依據法令行事，您皆不得完全或部分讓與您在本文中的任何權利，或是完全或部分委託本文中的任何義務。未獲得 IEHP 適當的事前書面同意時，您進行上述的任何讓與或委託行為皆屬無效，不具任何效力及作用。 IEHP 致力於守護您的隱私。 您可以在此找到我們的隱私權政策 (Privacy Policy)。 聯絡資訊 10801 Sixth Street, Rancho Cucamonga, CA 91730 1-800-440-IEHP (4347) TTY 使用者請撥 1-800-718-IEHP (4347) 服務時間：太平洋標準時間上午 8 點至下午 5 點    

and achieve health goals. IEHP’s Health & Wellness Programs help Members learn how to manage their health and make healthy lifestyle changes. You can refer your IEHP Members to these programs anytime by logging into the Secure Provider Website and completing the Health Education Program Request Form. Health Resources Kids and Teens Managing Your Illness Pregnancy and Postpartum Senior Health Weight Management Health & Wellness Brochures and Handouts Inland Empire Health Plan (IEHP) offers many Wellness Programs that focus on the health and well-being of our Members. All of our programs are free, join us at our next session and learn ways to stay healthy.  Get information on important health topics through our health education brochures and handouts: Controlling Asthma (PDF) Diabetes. What's next? (PDF) Eat Healthy, Feel Better (PDF) Fever in Children (PDF) Flu Decision Guide (PDF) Flu Shot (PDF) High Blood Pressure (PDF) Immunizations - English (PDF) Immunizations - Spanish (PDF) Immunizations - Chinese (PDF) Immunizations - Vietnamese (PDF) PAP and HPV Tests: What to Expect (PDF) Diabetes Prevention Program (DPP) - Live the Life You Love Format: Online (small group) Duration: One year Ages: 18 years and over This online year-long lifestyle change program helps you make real changes that last.  During the first 6 months, you will meet weekly with a small online group to learn how to make healthy choices into your life. In the second 6 months, you will meet monthly to practice what you have learned. No person is alike, so the program will be tailored to meet your needs and honor your customs and values. You will also be paired with a health coach for one year to help you set your goals, such as how to: Eat healthier Add physical activity into your daily life Reduce stress Improve problem-solving and coping skills Studies have shown that those who finish the program can lose weight and prevent Type 2 Diabetes. Small changes can have big results! Let's start living the best version of you and living the life you love. Find out if you qualify! Click here to visit the Skinny Gene Project online, or Call Skinny Gene Project at (909) 922- 0022, Monday - Friday 8am – 5pm., or Email hello@skinnygeneproject.org For Providers DPP Rx Pad (PDF) Educational Resources 2021 Population Needs Assessment (PNA) Report IEHP’s Population Needs Assessment (PNA) identifies Member health status and behaviors, Member health education priorities, cultural/linguistics needs, health disparities, and gaps in service related to these issues. The findings of the PNA may help Providers better understand and serve our Members. For questions, please contact IEHP Health Education Department at healthed@iehp.org 2021 Population Needs Assessment (PNA) Report Loving Support Program IEHP supports and sponsors the Loving Support Program that is run by Riverside University Health System (RUHS). Loving Support is a program committed to helping mothers achieve their breastfeeding goals. This service offers help and support with the first days at home, return to work, support groups, and timely answers to challenges nursing mothers face. Members can directly contact the Loving Support 24/7 Helpline at 888-451-2499. No referral is necessary. English and Spanish-speaking certified lactation specialists and Internationally Board Certified Lactation Consultants (IBCLCs) are available 24 hours a day, 7 days a week to answer questions. Messages are recorded after hours and promptly addressed. Member Education Resources The following websites are good sources of easy-to-read patient information that can be downloaded, printed, or ordered. By clicking on these links, you will be leaving the IEHP website.  RESOURCE  DESCRIPTION Medline Plus A service of the US National Library of Medicine and the National Institutes of Health. Easy to read information and audio tutorials on many health topics in English and Spanish. Topics are available in multiple languages. Food and Drug Administration - Office of Women's Health Easy-to-read handouts in English, Spanish and other languages on nutrition, diabetes, depression, and other topics related to women’s health. Learning About Diabetes, Inc. Easy to read “Handouts and Visual Aids” in color on diabetes care and nutrition to help patients eat the right foods to control blood sugar. Weight Control Information Network An extensive list of health education materials about healthy weight and physical activity in English and Spanish. Materials can be printed or ordered. Health Information Translations Easy-to-read educational handouts on many health topics and in multiple languages.   You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

d by APL 19-004, all Providers currently in IEHP's network and those looking to join the network are mandated to enroll in the Medi-Cal Program. This requirement to enroll in the Medi-Cal Program applies to all IEHP Providers, including those participating through an IPA. If a Provider currently active with IEHP fails or declines to complete their enrollment in the Medi-Cal Program, IEHP will be required to terminate their participation from the network.  How to Enroll The Provider Enrollment Division (PED), a unit within the Department of Health Care Services (DHCS), is responsible for the timely enrollment of Providers into the Medi-Cal Program. PED now offers an improved web-based application via their Provider Application and Validation Enrollment (PAVE) portal. Please note the current PAVE release may not support specific Provider types or submissions from new out-of-state Providers. PAVE is being implemented in a series of releases to include Provider types and enrollment actions. Here is a current list of Provider types supported in PAVE. Provider Resources All Plan Letter 19-004 This APL supersedes 17-019, the APL mandating Providers to enroll in the Medi-Cal Program. All Plan Letter 17-019 Access the APL on DHCS's website regarding the screening and enrollment of all Providers rendering services to Medi-Cal beneficiaries.  California Health & Human Services (CHHS) Agency Open Data Portal Utilize the Open Data Portal to identify Providers who have successfully enrolled in the Medi-Cal Program through DHCS. The portal is maintained and updated by PED monthly. Frequently Asked Questions (FAQ) The document contains responses from DHCS to frequently asked questions regarding screening and enrollment requirements. Provider Resources from DHCS Access to PAVE Provider Types, PAVE 101 Training Slides, Provider Job Aides, FAQs, PAVE Support Resources Contact Information Department of Healthcare Services Attn:  Provider Enrollment Division MS4704 PO BOX 997412 Sacramento, CA 95899-7412 PED Message Center (916) 323-1945 After reaching the welcome message, please select Option 4, then Option 1 to speak with a live agent. PAVE Technical Assistance (866) 252-1949 PAVE@dhcs.ca.gov PED Policy Assistance PEDCORR@dhcs.ca.gov IEHP Provider Assistance ProviderNetwork@iehp.org

成 IEHP DualChoice (HMO D-SNP)。如您未更改計畫，IEHP DualChoice (HMO D-SNP) 將為您提供 Medicare 福利。您可以繼續領取 Medicare 及 Medi-Cal 的福利。您的保險不存在任何差價。 您將自動加入 IEHP DualChoice，並且可以無條件地繼續享受這些服務。IEHP DualChoice 與您目前的 Cal MediConnect 計畫十分相似。加入 IEHP DualChoice 後，IEHP DualChoice 會員服務團隊會繼續為您服務以幫助滿足您的需求。如果您在與我們健康計畫合作的提供者處看診，您將無需支付保費以及醫師看診或其他醫療護理的費用。如欲進一步瞭解處方藥費用，請致電 IEHP DualChoice 會員服務中心 (Member Services)。如欲詢問您的初級保健醫生 (Primary Care Physician, PCP) 或其他提供者是否於 2023 年加入我們的網路，請致電 IEHP DualChoice 會員服務中心。 按一按此處以瞭解 IEHP DualChoice 的更多資訊。 我的 Medicare Medi-Cal 計畫將承保哪些服務？ IEHP DualChoice 將承保您現在領取的 Medicare 和 Medi-Cal 以下多種福利： Medicare 承保的所有服務、醫生、醫院、實驗室和 X 光片 您有權造訪包含與您當前計畫相同的多位提供者的提供者網路 Medicare 承保的處方藥 整合您現在獲得或可能需要的服務 前往醫療服務處的交通費用 醫療用品 耐用醫療設備 (Durable Medical Equipment, DME) 護理之家照護 社區成人服務 (Community-Based Adult Services, CBAS) 您有權造訪包含與您當前計畫相同的多位提供者的提供者網路您的保險不存在任何差價。您將自動加入 IEHP DualChoice 提供的 Medicare Medi-Cal 計畫。您可以無條件加入此計畫（如有意願）。如欲更換計畫，請致電 IEHP DualChoice 會員服務中心。  如有任何疑問，請於上午 8 點 至晚上 8 點（太平洋標準時間）致電 IEHP DualChoice，電話：1-877-273-IEHP (4347)，每週七天（包括節假日）均提供服務。TTY：1-800-718-4347。

OS June 30, 2022, payments will run out through June 2023. The Proposition 56 VBP Program provided direct payments incentivizing Providers to meet specific measures aimed at delivering key quality healthcare services that improve the quality of care to Medi-Cal beneficiaries. Targeted areas were behavioral health integration, chronic disease management, prenatal/post-partum care and early childhood prevention. For more information about the VBP Program, please visit the DHCS website at https://www.dhcs.ca.gov/provgovpart/Pages/VBP_Measures_19.aspx. By clicking on this link, you will be leaving the IEHP website.  Value Based Payments Program Guide Value Based Payments (VBP) Program Guide (PDF) - Published: January 01, 2022 Value Based Payments Dispute Forms Value Based Payments Program - Paid Claims Dispute Request (PDF) Published: January 19, 2022 Value Based Payments Program - Encounter Dispute Request (PDF) Published: January 19, 2022 Please e-mail completed forms to ValueBasedPaymentsProgram@iehp.org At-Risk Condition Codes The At-Risk Condition Codes list includes diagnosis codes to identify Serious Mental Illness, Substance Use Disorder or Homelessness Conditions for the VBP Program. These conditions qualify Providers for an additional payment amount for VBP services. Please refer to page 4 of the VBP Program Guide for additional details. At-Risk Condition Codes (PDF) Published: March 25, 2020 You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

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