California Family PACT | Planning Access Care Treatment

Time 2021-08-16 16:05:23

Web Name: California Family PACT | Planning Access Care Treatment

WebSite: http://www.familypact.org

ID:186667

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PACT,Family,California,

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Birth Control MethodsLearn about the birth control methods covered by the Family PACT programAm I Eligible for Family PACT?Family PACT covers the family planning needs of California residents who are low income and who have no other source of coverage. Learn if you are eligible for Family PACT.To stay informed with the latest available information on the COVID-19 developments and how it impacts Family PACT providers, please visit Family PACT s COVID-19 page.24/7 Free Medi-Nurse Call Line Launches for COVID-19 QuestionsDHCS launched a free, 24/7 Medi-Nurse advice line to answer questions about COVID-19 for anyone who:Doesn’t have insurance, orIs a Medi-Cal beneficiary but doesn’t have a regular doctor or managed care plan to oversee their care.The nurses who field the questions can help callers:Understand if symptoms might be related to COVID-19Determine whether they need to self-isolateDecide if they need to see a doctor to get tested and/or treatedConnect with a Medi-Cal provider who can help determine presumptive eligibility for Medi-CalMedi-Nurse Call Line:  (877) 409-9052About The Office of Family Planning and Family PACTThe Office of Family Planning (OFP) is charged by the California Legislature “to make available to citizens of the State who are of childbearing age comprehensive medical knowledge, assistance, and services relating to the planning of families”. The purpose of family planning is to provide people a means by which they can decide for themselves the number, timing, and spacing of their children.OFP administers the Family Planning, Access, Care, and Treatment (Family PACT) program. Family PACT is California’s innovative approach to provide comprehensive family planning services to eligible low income (under 200% federal poverty level) residents. Family PACT serves 1.1 million income eligible Californians of childbearing age through a network of 2,200 public and private providers. Services include comprehensive education, assistance, and services relating to family planning.News and UpdatesHealth Access Programs Client Enrollment System UpdatedThe Family PACT bulletin posted to the Medi-Cal website on April 16, 2021 announced effective May 3, 2021, the Health Access Programs (HAP) client enrollment system for the Family Planning, Access, Care and Treatment (Family PACT) Program will be updated. As a result, the Family PACT Client Eligibility Certification (CEC) form (DHCS 4461) and Retroactive Eligibility Certification (REC) form (DHCS 4001) have also been updated. A preview of the new CEC form will be posted on the Family PACT website on April 28, 2021. The new CEC (English and Spanish) and the REC (English and Spanish) forms will be posted and available for downloading from the Medi-Cal Provider Forms web page and also at familypact.org. Previous versions of the Family PACT eligibility forms should not be used on or afterMay 3, 2021.Medi-Cal News: BCCTP Applicants Granted Presumptive Eligibility (PE) (April 16, 2021)In the continued effort to align all Presumptive Eligibility (PE) Programs, Breast and Cervical Cancer Treatment Program (BCCTP) applications granted PE will populate in the Medi-Cal Eligibility Data System (MEDS) with an automated termination date of the end of the following month.Read the full article for additional information.Health Access Programs Client Enrollment System: Family PACT(February 9, 2021)The Department of Health Care Services (DHCS) is updating the Health Access Programs (HAP) client enrollment system utilized by the Family Planning, Access, Care and Treatment (Family PACT) Program.The HAP system is used to certify Family PACT clients as eligible and activate the clients HAP card. The HAP client enrollment system is being updated to capture additional data elements and delete data elements that are no longer being utilized for program analysis. As a result of this update, the Family PACT Client Eligibility Certification (CEC) form (DHCS 4461) and Retroactive Eligibility Certification (REC) form (DHCS 4001) will also be updated. Further details will be released in a future Family PACT update.Medi-Cal News: California Department of Public Health Resources for DGI and CS (January 27, 2021)For information and resources related to disseminated gonococcal infections (DGI) and congenital syphilis (CS), providers are encouraged to review the following resources from the California Department of Public Health (CDPH):CDPH Dear Colleague Letter for Medical Providers Increasing DGI in CACDPH Dear Colleague Letter Expanded Syphilis Screening Recommendations for the Prevention of Congenital SyphilisExpanded Syphilis Screening Recommendations for the Prevention of Congenital Syphilis: Guidelines for California Medical Providers 2020Posted January 4, 2021: 2021 CPT Annual Update: FPACTEffective for dates of service on or after January 1, 2021, CPT® code 99201 (office or other outpatient visit for the evaluation and management of a new patient, which requires these three components: a problem focused history, a problem focused examination, straightforward medical decision making) is no longer a benefit of the Family Planning, Access, Care and Treatment (Family PACT) program.Specific billing policy related to 99201 will be released in a future Family PACT update.Increasing Reports of Disseminated Gonococcal Infections (DGI)In recent months, the California Department of Public Health (CDPH) has received increasing number of reports of disseminated gonococcal infection (DGI), an uncommon but severe complication of untreated gonorrhea. On November 5, 2020, CDPH issued a Dear Colleague Letter providing additional information about DGI in California.In light of the increase in DGI cases, CDPH recommends the prioritization of routine screening, testing, and treatment of sexually transmitted infections (STIs) per the Centers for Disease Control and Prevention (CDC) guidelines for gonococcal infections. The Family PACT Program covers the diagnosis and treatment of specified STIs for Family PACT clients as clinically indicated, when care is provided coincident, or pursuant, to a family planning service in a family planning setting. For additional information, providers may refer to the following sections of the Policies, Procedures and Billing Instructions manual:Benefits Grid (ben grid)Benefits: Family Planning (ben fam)Benefits: Family Planning-Related Services (ben fam rel)HHS Expands Provider Relief Fund Eligibility and Updates Reporting RequirementsThe U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is announcing the latest Provider Relief Fund (PRF) application period has been expanded to include provider applicants such as residential treatment facilities, chiropractors, and eye and vision providers that have not yet received Provider Relief Fund distributions. These providers and all Phase 3 applicants will have until 11:59PM EST on November 6, 2020 to submit their applications for payment considerationList of Eligible Practices and Types of Providers:Today, HHS is expanding the pool of eligible Phase 3 applicants to include providers across a broad category of practices. Many providers who accept Medicare and Medicaid within these categories have already received a PRF payment, but others have not and HHS is working to ensure even more providers are able to receive Phase 3 funding. The list below includes eligible practices where providers may now apply for Phase 3 funding regardless of whether they accept Medicaid or Medicare.Behavioral Health ProvidersAllopathic Osteopathic PhysiciansDental ProvidersAssisted Living FacilitiesChiropractorsNursing Service and Related ProvidersHospice ProvidersRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersEmergency Medical Service ProvidersHospital UnitsResidential Treatment FacilitiesLaboratoriesAmbulatory Health Care FacilitiesEye and Vision Services ProvidersPhysician Assistants Advanced Practice Nursing ProvidersNursing Custodial Care FacilitiesPodiatric Medicine Surgery Service ProvidersUpdated Reporting Requirements:In response to concerns raised, HHS is amending the reporting instructions to increase flexibility around how providers can apply PRF money toward lost revenues attributable to coronavirus. After reimbursing healthcare related expenses attributable to coronavirus that were unreimbursed by other sources, providers may use remaining PRF funds to cover any lost revenue, measured as a negative change in year-over-year actual revenue from patient care related sources.Links to Information:Press Release.Policy memorandum on the reporting requirement decision  PDF*.Amended reporting requirements guidance  PDF.*For updates and to learn more about the Provider Relief Program, visit: hhs.gov/providerrelief.Trump Administration Announces $20 Billion in New Phase 3 Provider Relief FundingThe administration released $20B in Phase 3 of the Provider Relief Funds – deadline 11:59pm Eastern on November 6 – CMS recommends applying early.Very important:1. Providers who have already received funds can receive more funding– new opportunity to recover costs due to COVID as well as operating losses2. Providers just starting practice in early 2020 are now eligible3. New opportunity for a wide variety of mental health and SUD providersCDC Dear Colleague Letter regarding Diagnostic Test Shortage (September 3, 2020)Erroneously Denied Family PACT Claims for HCPCS Code T1014 with RAD Code 9516The Department of Health Care Services (DHCS) has identified a claims processing issue that causes Family PACT claims billed for HCPCS Code T1014 (telehealth transmission, per minute, professional services bill separately) to be denied with Remittance Advice Details (RAD) Code 9516: The secondary diagnosis code is missing or invalid for the procedure code.No action is required of providers. An Erroneous Payment Correction (EPC) will be implemented to reprocess affected claims. Providers should continue to submit claims in a timely manner and are encouraged to check the Medi-Cal website regularly for updates regarding this issue.Replacement Medication for Family PACT Clients Impacted by the State of Emergency (August 20, 2020)Pharmacy and clinic providers must dispense the full amount of the requested medication covered under the Family Planning, Access, Care and Treatment (Family PACT) Program immediately if the need to dispense is related to the client’s displacement or subjection to fires and extreme fire weather conditions or public safety power shutoff.This includes drugs that may require a Treatment Authorization Request (TAR). The need for a TAR should not negatively affect the decision to dispense the full amount of the required medication immediately and the TAR can be submitted retroactively. Providers are instructed to incorporate the statement “Patient impacted by fires and extreme fire weather conditions or public safety power shutoff” within the Miscellaneous Information field on the TAR for those drugs or situations requiring a TAR. It is imperative that the impacted client receive the full amount of the necessary medication in a timely manner to facilitate compliance and to not cause a delay or break in therapy.TARs for medications (new, refill or replacement), if required, will be automatically approved if the TAR indicates that the client is impacted by fire, or by power shutoffs, and the provider will be paid for the claim for the dispensed medications. The negative impact of the fire or power shutoff, alone, will meet the criteria of medical necessity.Providers are encouraged to monitor the Medi-Cal website for future updates.Notice Regarding State Nondiscrimination Requirements (Updated June 13, 2020)Full notice regarding nondiscrimination requirements.Additional Screening of Family PACT Provider Applicants in Certain Counties (December 2019)Pursuant to Welfare and Institutions Code (W I Code), Section 14132(aa)(2) and 24005(e), the Department of Health Care Services (DHCS) Office of Family Planning (OFP) has the authority to screen Family Planning, Access, Care and Treatment (Family PACT) Program provider applicants pursuant to requirements developed by DHCS to determine suitability for the Family PACT Program. Accordingly, OFP requires that any Family PACT provider applicant located in Los Angeles, Orange, Riverside or San Bernardino counties seeking enrollment in the Family PACT Program for the first time or submitting an application for a change in enrollment will be subject to certain screening requirements, with the exception of entities who are licensed as clinics under Health and Safety Code (H S Code), Section 1204, clinics exempt from licensure under H S Code, Section 1206, student health centers and those operated by government entities.DHCS has assessed the risk of fraud, waste and abuse from a program integrity perspective posed by the specific geographic locations described above. DHCS has determined that newly enrolling Family PACT provider applicants or existing Family PACT providers submitting an application for a change in enrollment in Los Angeles, Orange, Riverside or San Bernardino counties should be deemed to pose a risk of fraud, waste and abuse to the Family PACT Program, with the exception of entities who are licensed as clinics under H S Code, Section 1204, clinics exempt from licensure under H S Code, Section 1206, student health centers and those operated by government entities. This designation is based upon criteria including, but not limited to, the following:DHCS continues to find significant program integrity issues with certain Family PACT providers in Los Angeles, Orange, Riverside and San Bernardino countiesDHCS’ reviews and investigations of Family PACT providers have led to numerous disenrollments from the Family PACT Program, Medi-Cal suspensions and referrals to the California Department of JusticeDHCS’ experience with claims data that identify fraudulent billing practicesDHCS’ expertise in investigating and identifying Medi-Cal fraud across a broad spectrum of providersDue to the potential risk of fraud, waste and abuse, the Family PACT provider applicants described above are subject to the following additional enrollment screening:DHCS will conduct onsite visits prior to any application approval, including newly enrolling Family PACT provider applicants or existing Family PACT providers submitting an application for a change in enrollment, as described above.Essure NewsFlash (December 2019)This notice is to inform providers of the US Food and Drug Administration’s (FDA) communication on Essure Permanent Birth Control units that have not been implanted. On December 31, 2018, Bayer stopped selling and distributing the Essure device in the United States. Bayer informed their customers that all Essure units that have not been implanted should be returned to Bayer by the end of 2019.For additional information, refer to the FDA website at https://www.fda.gov/medical-devices/essure-permanent-birth-control/fda-activities-essureBreast and Cervical Cancer Treatment Program (BCCTP) “Directions to Apply for Medi-Cal” for All ApplicantsBCCTP has a new “Directions to Apply for Medi-Cal” document for ALL BCCTP applicants. The English and Spanish versions, will eventually be automatically generated with the confirmation document that prints after the enrolling provider submits a BCCTP application. This covers ALL applicants regardless of whether or not they are approved for presumptive eligibility.  English directions to apply.  Spanish directions to apply.Older News and Updates

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