DHCS Medi-Cal Documenting and Reporting Immunization Requirements

Date: 05/10/18

The Department of Health Care Services (DHCS) notified California Health & Wellness Plan (CHWP) on January 31, 2018, in All Plan Letter (APL) 18-004, that DHCS requires participating providers to document each member’s need for Advisory Committee on Immunization Practices (ACIP)-recommended immunizations as part of all regular health visits and to report the administration of immunizations within 14 days.

Preventive care service guidelines include routine pediatric immunizations recommended jointly by the American Academy of Pediatrics (AAP), the Centers for Disease Control and Prevention (CDC) ACIP, and the American Academy of Family Physicians (AAFP), and routine adult immunizations recommended by ACIP that do not require prior authorization.

ACIP immunization recommendations are available on the CDC website.

Each encounter with a CHWP member is an opportunity to screen immunization status and administer needed vaccines.

In addition, participating providers are required to meet both CHWP and DHCS medical record documentation standards for preventive care as outlined in the CHWP Provider Manual, located in the Provider Resources section of this website. The CHWP Provider Manual has been revised to include the new DHCS documentation requirements outlined above.

ADDITIONAL INFORMATION

If you have questions regarding the information contained in this update, contact your provider relations representative or call 1-877-658-0305.