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Clinical Review: Recommendations for the tapering of Benzodiazepines
In 2020, the U.S. Food and Drug Administration (FDA) announced that the Boxed Warning on benzodiazepines must be updated to address the serious risks of abuse, misuse, addiction, physical dependence, and withdrawal reactions. Due to these warnings, it is important to regularly assess the need for benzodiazepine use in patients who take these medications and discuss strategies for dose reduction or discontinuation.
When benzodiazepine therapy is no longer indicated or when the risk associated with the use of benzodiazepines outweighs the benefit, a benzodiazepine taper may be indicated. Healthcare providers should make the following considerations when tapering benzodiazepines:
- A rapid taper is usually recommended for individuals who have been on benzodiazepines for four weeks or less. A slow taper should be considered for patients who have been on benzodiazepines for greater than four weeks.
- Educate the patient before starting the taper and involve the patient in decision-making regarding the taper schedule. Frequently monitor and follow up with the patient.
- Tailor the rate of the taper based on the patient’s level of tolerance and consider incorporation of other treatment modalities, such as adjunctive medications if the patient has psychological comorbidities or is at risk of severe withdrawal symptoms.
- If the patient is struggling with withdrawal or rebound symptoms, consider stabilizing the patient on a reduced dose before further reductions.
- If complete discontinuation of benzodiazepines is not possible, taper the benzodiazepine to the lowest dose possible and encourage only as needed or intermittent use.
Read more about this on the DHCS website.
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Safety Update: Potential increased arrhythmia risk from Lamotrigine
On March 31, 2021, the U.S. Food and Drug Administration (FDA) announced a review of in vitro study findings that showed a potential increased risk of arrhythmias in patients with heart disease who take Lamotrigine. Laboratory tests showed that at drug concentrations within therapeutic range, Lamotrigine can increase the risk of serious arrhythmias (possibly life-threatening) in patients with clinically important structural or functional heart disorders.
Due to these findings, the FDA is now requiring additional studies to assess heart risk across the entire class of sodium channel blockers. At this time, other sodium channel blockers approved for epilepsy, bipolar disorder, and other indications should not be considered safer alternatives to Lamotrigine in the absence of additional information.
To minimize risk to patients who take Lamotrigine, healthcare providers should consider the following actions:
- Evaluate whether the potential benefits of Lamotrigine outweigh the potential risk of arrhythmias.
- Advise patients to contact their provider or seek immediate medical attention if they experience an abnormal heart rate or irregular rhythm, a racing heartbeat, skipped or slow heartbeat, shortness of breath, dizziness, or fainting.
- Report side effects involving Lamotrigine to the FDA MedWatch program.
Read more about this on the DHCS website.
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Refer your patients to SCFHP’s Healthy Moms, Healthy Babies program
To encourage timely prenatal and postpartum care, SCFHP offers a Healthy Moms, Healthy Babies (HMHB) program that connects members to community resources and provides support. Members can also receive rewards. See current rewards and enroll your patients today!
Visit our website for more information about the program.
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Our UM Department is available to you
There may be times when you would like to speak with our Utilization Management (UM) Department regarding criteria for decisions about your patient’s authorization. You may obtain a copy of the criteria on which a UM decision was based on by sending a request in writing to the following address:
ATTN: Utilization Management
Santa Clara Family Health Plan
PO Box 18880
San Jose, CA 95158
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SDOH Survey | Take 10 minutes for a chance to win a $100 Amazon gift card
Social determinants of health (SDOH) are non-medical factors that affect a person’s ability to lead a healthy life. Social and economic circumstances can affect up to 40% of an individual’s health outcome. The physical environment, such as pollution or transportation and technology access, can affect 10%.
SCFHP is developing a SDOH strategy to better identify and address the social needs of our members. We want your input!
This quick survey should take no more than 10 minutes to complete. Complete the survey by June 22, 2021 to be entered into a drawing to win a $100 Amazon gift card.
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Office closures
The SCFHP office will be closed on the following date(s):
- July 5, 2021 in observance of Independence Day
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Provider Link
Visit providerportal.scfhp.com to download your member roster and report cards, check authorizations and claims status, and check member eligibility.
- Gaps-in-Care and PPP 2021 report cards are now available on the portal
Interactive Voice Response (IVR)
Call our IVR line at 1-408-874-1473 to verify member eligibility, check claims status based on your TIN, and request confirmation of eligibility verification or claim(s) processed.
Resources on our website
Resources from the County
Find important updates, the COVID-19 case report form, information about PPE, and much more on the Santa Clara County website.
Questions?
Please contact Provider Services at ProviderServices@scfhp.com.
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Memo roundup
We are dedicated to keeping our providers informed about operational and regulatory changes. Below are important memos that were sent recently:
- June 2, 2021 – Social Determinants of Health Survey - chance to win $100 gift card
- May 25, 2021 – 2021 Medi-Cal Wellness Rewards Program
- May 24, 2021 – Timely access to care standards
- May 5, 2021 – 2021 Medi-Cal Healthy Moms, Healthy Babies Program
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Providers (unique NPI)
Primary care
Medi-Cal: 826
Cal MediConnect: 543
Specialists
Medi-Cal: 4,248
Cal MediConnect: 3,068
Ancillary
Medi-Cal: 836
Cal MediConnect: 253
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Pharmacies
Medi-Cal: 145
Cal MediConnect: 148
Members
Medi-Cal: 272,590
Cal MediConnect: 10,080
Total: 282,670
As of June 2021
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