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September 19th, 2021

Family Pact Provider Agreement

Family PACT is a public program that offers free family planning services to low-income men and women. The goal of the program is to provide the services you need to determine the timing, number of children, distance from your children and help you maintain reproductive health. Family PACT is California`s innovative approach to providing comprehensive family planning services to legitimate men and women. This clinical program increases access to services by expanding the network of providers to medical care providers, pharmacies and laboratories The application package can only be completed by the provider`s applicant. As of November 1, 2018, applications received by external consultants or registration brokers on behalf of the access applicant will not be accepted. How do I apply? PACT family providers determine the authorization and register customers. You can apply for Family PACT in person at SHCS during the registration periods. You can also download the application form and bring it to the office during your registration visit. Registration times: Monday-Thursday9:00-11:00 and 14:00-16:00 and Friday 9-11hWho is allowed? To be eligible for PACT family benefits, customers must meet all of the following criteria: the Family PACT programme terminates the Directive on the annual distribution of HAP cards with annual limits. All requests for ordering PAH cards are forwarded to the Family Planning Office for verification. All applications for additional PAH cards and the number of approved additional cards will be reviewed on a case-by-case basis. Initial orders for PAH cards for all new suppliers remain revised to 200 sequential boards and 50 blank PAH cards. The Telephone Service Center will continue to process approved PAH card distributions.

Family PACT recipients must be re-elected every three (3) years. Pact family registered suppliers who have decided to re-elect a new certification are informed by mail and must complete the steps described in the supplier registration in order to continue participating in the Family PACT programme. In accordance with the Welfare and Institution Act 24005 (i) (3), the department deactivates immediately and without notice […] if a provider has not submitted a claim for reimbursement of the program for one year. Hotline offers recommendations to PACT family providers throughout California. Disabling the Family PACT program does not affect Medi Cal registration. Deactivated suppliers are informed by a letter to the registered address. Effective January 1, 2019, the Department of Health Care Services begins the process of deactivating Family PACT program providers who have not applied for reimbursement from the program for one year. Please contact us with any questions at OFPprovidertrainings@dhcs.ca.gov or (916) 650-0414.

Fill out the Provider Enrollment Application DHCS 4468 form and send it by secure email to providerservices@dhcs.ca.gov. This is the first form in the application process. You will receive the others after the approval of it. Why should I register? Family PACT provides access to family planning services for men and women, as well as education, counselling and treatment to protect your reproductive health. Remember that suppliers are required to notify any changes in practitioner staff to DHCS OFP and PED within 35 days of the action taken and also to carry out all the necessary training mentioned above….

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