Medi-Cal Update

Long Term Care | November 2019 | Bulletin 513

Print Medi-Cal Update
 

1. DME and Medical Supplies for Recipients Impacted by the State of Emergency

Update: Replacement Durable Medical Equipment (DME) and Medical Supplies for Recipients Impacted by Fires and Extreme Weather Conditions or Public Safety Power Shutoff

On October 28, 2019, in response to the Governor’s recent proclamation of a statewide state of emergency due to the risk of wildfires, the Department of Health Care Services (DHCS) issued guidance for dispensing replacement medication(s) to recipients impacted by fires and extreme fire weather conditions or public safety power shutoff. This article provides additional guidance for dispensing DME and medical supplies.

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 Treatment Authorization Requests (TAR) for DME, medical supplies or situations requiring a TAR.

DME and medical supply providers must provide requested equipment or supplies immediately or, for items not in stock, as soon as possible, if the need to dispense DME or medical supplies is related to the recipient’s displacement or subjection to fires and extreme fire weather conditions or public safety power shutoff. Providers must not have the recipient return after receiving TAR approval. The need for a TAR should not negatively affect the decision to provide DME or medical supplies immediately or as soon as possible, and the TAR can be submitted retroactively. It is imperative that the impacted recipient receive the DME or medical supply in a timely manner to facilitate compliance and assist the recipient to perform activities of daily living.

TARs for new or replacement DME or medical supplies will be automatically approved if the TAR indicates that the recipient is impacted by fire or by power shutoffs, and the provider will be paid for the claim for the DME or medical supply. 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. Questions regarding this notice may be directed to the Telephone Service Center (TSC) at 1-800-541-5555, Monday through Friday, except holidays.

Print Article | Return to Top
 

2. Get the Latest Medi-Cal News: Subscribe to MCSS Today

MCSS Logo

The Medi-Cal Subscription Service (MCSS) is a free service that keeps you up-to-date on the latest Medi-Cal news. Subscribers receive subject-specific emails shortly after urgent announcements and other updates post on the Medi-Cal website.

Subscribing is simple and free!

  1. Go to the MCSS Subscriber Form

  2. Enter your email address and ZIP code and select a subscriber type

  3. Customize your subscription by selecting subject areas for NewsFlash announcements, Medi-Cal Update bulletins and/or System Status Alerts

After submitting the form, a welcome email will be sent to the provided email address. If you are unable to locate the welcome email in your inbox, check your junk email folder.

For more information about MCSS, please visit the MCSS Help page.

Print Article | Return to Top
 

3. Provider Manual Revisions

Pages updated due to ongoing provider manual revisions:

Print Article | Return to Top


Note:

If you cannot view the MS Word or PDF (Portable Document Format) documents correctly, please visit the Web Tool Box to link to a download site for the appropriate reader.