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Health Net Federal Services experiences significant challenges with TRICARE transition

On January 1, 2018, Health Net Federal Services (HNFS) became the new Defense Heath Agency (DHA) managed care contractor for the TRICARE West Region, serving approximately 2.9 million beneficiaries in 21 western states, including California. HNFS took over the contract previously held by UnitedHealthcare Military and Veterans’ Services (UMVS). The California Medical Association (CMA) has learned that HNFS has experienced implementation issues related to provider contracting and credentialing, beneficiary reassignment to new primary care managers (PCM), and provider directory inaccuracies. Read More

Health Net to rescind recently announced payment policies

Since Health Net first notified physicians in March of planned changes to its modifier 25 and emergency services payment policies for Medicare and Medi-Cal lines of business, the California Medical Association (CMA) has been working to educate the payor about physician concerns with the new policies. Last month Health Net agreed to delay implementation of the new policies until July 1, 2018, to allow time to review provider concerns with the new policies and to continue discussions with CMA and other stakeholders. “We believe a more collaborative approach to identify alternative ...

CMA urges Health Net to rescind recently announced payment policies

Since Health Net first notified physicians in March of planned changes to its modifier 25 and emergency services payment policies for Medicare and Medi-Cal lines of business, the California Medical Association (CMA) has been working to educate the payor about physician concerns with the new policies.   Last month, at CMA’s urging, Health Net agreed to delay implementation of the new policies until July 1, 2018, to allow time to review provider concerns with the new policies and to continue discussions with CMA and other stakeholders.   CMA recently wrote to Health Net ...