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Cal MediConnect Effective January 1, 2015

January 1, 2015

Santa Clara Family Health Plan’s (SCFHP) Cal MediConnect program begins on January 1, 2015.

Contracted SCFHP providers can see a Cal MediConnect member without a referral.

There is a short list of services that require prior authorization. The list can be found on our website: www.scfhp.com/sites/default/files/mmppriorauthgrid.pdf.

SCFHP Cal MediConnect enrollees will have the following ID card:

Important message from CDPH Director on PERTUSSIS

August 18, 2014

A pertussis epidemic has been declared in California.  The California Department of Public Health (CDPH) is urging prenatal care providers to immunize ALL pregnant women between 27 and 36 weeks gestation with Tdap during EACH pregnancy, regardless of the number of doses of Tdap previously received. Additionally, infants should be immunized without delay.

Recommendation to Providers:

Vaccinate your adult patients, pregnant women and pediatric patients per the Advisory Committee Immunization Practices (ACIP) recommendations.

SCFHP Transition to Abbott Test Strips and Meters

November 17, 2014

Effective 12/1/2014, Santa Clara Family Health Plan (SCFHP) will be converting from Foracare to Abbott Freestyle or Precision products.

Members can receive a free meter at network pharmacies or by calling Abbott at 866-224-8892 or visiting www.choosefreestyle.com. Pharmacies may be reaching out to you to request new prescriptions for meters and test strips. 

Meters:

  • FreeStyle Lite
  • FreeStyle Freedom
  • FreeStyle InsuLinx
  • Precision Xtra

Test Strips:

Changes to Medi-Cal in Santa Clara County

June 23, 2014

Beginning July 1, 2014

Minimum requirements for comprehensive tobacco cessation services - effective November 1, 2014.

October 13, 2014

Tobacco use is the leading preventable cause of death in the United States and Medi-Cal members have a higher prevalence of tobacco use than the general California population.

Spring 2014 issue of member newsletter "Winning Health" now available.

May 16, 2014

Our Spring 2014 issue of our member newsletter "Winning Health" is now available. Visit our newsletters page to access current and past issues in English, Spanish and Vietnamese.

In this edition:

  • Keep fitness fun this summer
  • Sorting out the symptoms - cold, flu or allergy?
  • Diabetes: dealing with burnout
  • Important notice about your Medi-Cal benefits

New Medi-Cal benefit effective September 15 – Behavioral Health Treatment/Applied Behavior Analysis

September 15, 2014

Effective September 15, 2014, Medically Necessary Behavioral Health Treatments (BHT), including Applied Behavioral Analysis (ABA) will be a covered benefit for SCFHP Medi-Cal members 0 to 21 years of age, including those who have special health care needs. These services will be covered under the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program, and must meet the Department of Health Care Services (DHCS) criteria and be prior authorized by SCFHP.

New Medi-Cal Benefit: Screening, Brief Intervention, and Referral to Treatment (SBIRT)

April 14, 2014

Effective January 1, 2014, California offers a Screening, Brief Intervention, and Referral to Treatment (SBIRT) benefit to adult Medi-Cal beneficiaries. The SBIRT is to be offered annually but can be completed up to three times per year if needed, for all Medi-Cal beneficiaries, 18 years and older, in primary care settings.

The information below is required for Provider training.

General Information

What is SBIRT?

Interim Policy for the Provision of Behavioral Health Treatment (BHT) Coverage for Children Diagnosed with Autism Spectrum Disorder

September 12, 2014

Effective September 15, 2014, Medically Necessary Behavioral Health Treatments (BHT), including Applied Behavioral Analysis (ABA) will be a covered benefit for SCFHP Medi-Cal members 0 to 21 years of age, including those who have special health care needs. These services will be covered under the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program, and must meet the Department of Health Care Services (DHCS) criteria and be prior authorized by SCFHP.

NEW DHCS REQUIREMENTS - Staying Healthy Assessment

April 1, 2014

The Department of Health Care Services (DHCS) recently updated the Staying Healthy Assessment (SHA) in collaboration with health plan representatives and providers.

Highlights of the recent changes

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