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California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more
California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more

CCIPA Launches in Imperial County

Date: 10/18/16

One of our provider partners, Clinicas de Salud de Pueblo (Clinicas), has developed an Independent Practice Association (IPA) for patients they serve throughout Imperial County. If you are a Clinicas provider, your patients/our members will be assigned to the CCIPA as their primary care provider. We are working with Clinicas’ new Community Care IPA (CCIPA) to ensure that the 20,000 affected members continue to receive the care they need, when and where they need it.

California Health & Wellness (CH&W) members assigned to Clinicas will receive communications explaining that they will be enrolled in the new CCIPA but will keep Clinicas as their primary care provider (PCP) beginning November 1, 2016. There will be no disruption in their care or the services that they receive.

  • Members can opt out at any time but will need to be assigned to a non-Clinicas/CCIPA provider. They will not be able to see a Clinicas provider without being assigned to the CCIPA. CCIPA members will only be able to receive care at their assigned CCIPA provider and must obtain prior authorization for specialty or certain other services required by CCIPA.
  • CCIPA members will be provided new ID cards, which will indicate that they are assigned to the CCIPA. For new members, they will have an option to select CCIPA as their PCP. If they do not select a PCP, they will be auto assigned to a provider consistent with the normal assignment process.
  • Members who are assigned to Clinicas will be enrolled in the CCIPA. If you are not part of the CCIPA, you will retain your CH&W members and they will not be moved into CCIPA unless they actively select to be moved. Members have the right to select a new provider at any time.
  • Certain services that may be outside of CCIPA’s provider network do not need prior authorization. These services include Emergency Care, Family Planning Services, HIV testing and counseling, pregnancy termination and STD services. Behavioral health services will continue to be provided through California Health & Wellness.
  • Members who are assigned to Clinicas as their PCP will need to get care through specialists contracted with CCIPA. To access specialty care and certain other providers, members who have Clinicas as their PCP will be required to get prior approval from CCIPA for referrals.

For Medication Prior Authorizations, Please Note: CCIPA is responsible for all prior authorization of provider-administered medications EXCEPT for chemotherapy (including adjunctive therapy) and transplant immunosuppression. California Health & Wellness is responsible for prior authorization of all provider-administered medications for chemotherapy (including adjunctive therapy) and transplant immunosuppression. Envolve Pharmacy Solutions is responsible for prior authorization of all self-administered medications. For more information, please contact our Pharmacy Department at 1-877-658-0305.

California Health & Wellness members can contact Member Services at 1-877-658-0305 (V/TTY: 711) if they have any questions and/or concerns.