IEHP has updated its requirements to align with the new Intermediate and Subacute Facilities benefit mandates. These mandates are provided in the Department of Health Care Services (DHCS) APL 23-023 (PDF), “Intermediate Care Facilities for Individuals with Developmental Disabilities – Long Term Care Benefit Standardization and Transition of Members to Managed Care” and APL 23-027 (PDF), “Subacute Care Facilities – Long Term Care Benefit Standardization and Transition of Members to Managed Care”.
ICF/DD and Subacute Care Facilities Benefit
Credentialing Requirements:
For the initial credentialing, ICF/DD Homes must submit the below items in addition to the ICF/DD Attestation:
- W-9 Request for Taxpayer Identification Number and Certification
- MCP Ancillary Facility Network Provider Application (PDF)
- Certificates of Insurance (Professional and General Liability)
- City of County Business License (excludes ICF/DD-H and -N homes with six or less residents)
- 5% Ownership Disclosure
The credentialing collateral and other supporting documents should be e-mailed to contract@iehp.org .
Resources:
- ICF/DD Billing Guideline (PDF) Updated: December 13, 2023
- ICF/DD Onboarding Presentation (PDF) Updated: December 18, 2023
- ICF/DD and Subacute Care Facilities - Plan Benefit Effective January 1, 2024 (PDF)
- CalAIM Subacute Care Facilities 101 for Managed Care Plans (PDF)
- CalAIM Intermediate Care Facility (ICF/DD) Carve-In Office Hours (PDF)
- CalAIM Data Guidance – Billing and Invoicing (PDF)
- Medi-Cal Subacute Care Contracting Fact Sheet (PDF)
- Frequently Asked Questions – Skilled Nursing Facility Long-Term Care Carve-in (PDF)
