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Information for Indian Health Care Providers regarding the Novel Coronavirus (COVID-19)

March 18, 2020

The Department of Health Care Services (DHCS) continues to closely monitor the emerging COVID-19 situation, and encourages Medi-Cal Indian Health Care providers to stay updated on COVID-19 developments. As the number of confirmed COVID-19 cases in California rises, it is critical that providers assess their respective policies and follow recommended general healthcare facility safety procedures and protocols from the federal Centers for Disease Control and Prevention (CDC) and California Department of Public Health (CDPH) to help prevent spread of the virus. Generally, Indian Health Care Providers are encouraged to adhere to CDC’s recommendations, including but not limited to the following steps, to prevent the spread of illness:

  • Avoid close contact with people who are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Avoid touching your eyes, nose, and mouth.
  • Clean and disinfect frequently touched objects and surfaces.
  • Stay home when you are sick, except to get medical care.
  • Wash your hands often with soap and water for at least 20 seconds

In addition, please note that in light of both the federal Health and Human Services (HHS) Secretary’s January 31, 2020 public health emergency declaration, as well as the President’s March 13, 2020 national emergency declaration, DHCS is exploring additional possibilities and options under Section 319 of the Public Health Service Act, whereby the HHS Secretary is authorized to take certain actions in addition to his regular authorities, which includes temporarily waiving and/or modifying certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements under Section 1135 of the Social Security Act (called an “1135 Waiver”). DHCS will issue additional guidance to Medi-Cal providers, as needed, upon approval of its 1135 Wavier request.

Preparedness Strategies
Indian Health Care providers should share current COVID-19 information and discuss preparedness strategies with their staff. To enhance the health and safety of Indian Health Care provider offices, DHCS encourages Indian Health Care providers to adhere to the CDC’s and CDPH’s recommendations to prepare for COVID-19. Some helpful preparedness strategies include but are not limited to the following:

Indian Health Care providers can also find helpful resources to download, print, and display in their clinics and offices to educate their patients on preventive best-practices and to enhance awareness of COVID-19. These resources are available in select threshold languages on the Communications Resources page of the CDC website.

Indian Health Care Provider Operational Reminders
Indian Health Care Providers should be aware of the following Medi-Cal related information that may be of assistance in the provision of care for Medi-Cal patients potentially impacted by COVID-19:

  • Out-of-Network Services: American Indian/Alaskan Natives enrolled in a Medi- Cal Managed Care Plan are eligible to receive services from out-of-network Indian Health Care Providers. Indian Health Care providers have the right to receive their applicable encounter rate, for the provision of covered services to American Indian/Alaskan Native enrollees, regardless of whether they participate in the network of a Managed Care Plan entity or not.
  • Telehealth: Indian Health Care providers may utilize DHCS telehealth as an alternative modality for delivering covered services when medically appropriate, as a means to limit patients’ exposure to others who may be infected with COVID-19, and to increase provider capacity. Please refer to DHCS’ existing policies relative to telehealth, which are outlined in the following sections of the Medi-Cal Provider Manual: “Medicine: Telehealth,” Federally Qualified Health Centers/Rural Health Clinics, and Indian Health Services Memorandum of Agreement 638 Clinics. Please also refer to DHCS’ telehealth Frequently Asked Questions document on the public website.
  • Billing Inquiries: For questions regarding Medi-Cal billing, please contact Telephone Service Center (TSC): 1-800-541-5555

Additional Resources
For additional COVID-19 information and resources, DHCS encourages you to review the following federal and state resources: