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Beginning March 1, 2026, providers contracted with HPSM will no longer receive quarterly paper provider directory data attestations in the mail. This means that provider’s office administrators must register for HPSM’s provider portal to attest digitally through the new Provider Data Accuracy Tool. If you haven’t already, please register for the portal.

Register for the portal

Additional benefits for providers and their offices when they register for the provider portal: 

• Available 24/7 
• Verify members’ eligibility 
• Check claims payment 
• Submit prior authorization requests and check request status 
• Sign up for and update Electronic Funds Transfer/Electronic Remittance Advice (EFT/ERA) 

Please contact [email protected] with any questions about our portal.

Some Health Plan of San Mateo (HPSM) members with certain immigration statuses will no longer be eligible for full-scope Medi-Cal starting July 1, 2026. This will impact their dental benefit, as California’s Medi-Cal program will stop covering dental services for these members except during emergencies. New HPSM members will likely be impacted each month, as any member with certain immigration statuses turning 19 will lose their full-scope dental coverage.

This is a network-wide change that will impact many members – including your patients, possibly. Here is information you may need in case a member has questions:

Eligibility or immigration status 

Refer them to San Mateo County Human Services Agency at 650-802-6470

Monday through Friday between 8:00 a.m. and 5:00 p.m.

Medi-Cal healthcare benefits 

Have them call HPSM Member Services at 1-800-750-4776

Monday through Friday between 8:00 a.m. and 6:00 p.m.

Rights 

Have them email [email protected] or call 1-888-452-8609.

Affected members can use their HPSM Dental benefit for non-emergency services until June 30, 2026. Starting July 1, 2026, members can find a Medi-Cal Dental provider near them by visiting: https://dental.dhcs.ca.gov/find-a-dentist/home 

Some members who fall into this category will not be impacted. Exceptions to this rule include: 

• People younger than 19 years of age will not be affected by this change. 
• People 19 years and older with certain immigration statuses will continue to be eligible for non-emergency dental services through Medi-Cal Dental (fee-for-service) if they are: 
  • Pregnant, and up to one year after pregnancy. 
  • Between 19-26 and were in foster care on their 18th birthday. 

For the full list of exceptions, or if a member wants to find out if this change applies them, have them visit: https://www.dhcs.ca.gov/Medi-Cal/Pages/immigration-status-categories.aspx.

Vaccine hesitancy has been on the rise in San Mateo County since the COVID-19 global health pandemic. However, many Health Plan of San Mateo (HPSM) members feel more uncertain than ever because of confusing guidance and the recent changes to vaccination policy at the federal level. Because of this, we are seeing more members question vaccine safety, and/or refusing vaccination altogether.

Conversations about vaccination can be challenging and time-consuming for providers, but the recent rise in vaccine-related illness makes it clear that these conversations must happen to keep our community safe. Providers should be prepared to have these conversations with members, as well as parents who are concerned about the well-being of their children. 

Tried and true ways to help tackle vaccine hesitancy

Resource pulled from American Family Physician.

1. Take your own pulse: Approach vaccine safety concerns with curiosity and without judgment. This helps members feel understood and makes them more willing to follow recommendations. 
2. Take the member’s pulse: There are a wide range of reasons why a member may hesitate when it comes to vaccination for themselves or their child. Utilize strong listening skills and motivational interviewing to build trust.  
3. Give a strong recommendation: A clear, confident recommendation from a physician can go a long way. Persistence here matters. 
4. Live to fight another day: Some members will refuse vaccines no matter what. Maintaining a relationship built on mutual respect may lead to vaccine acceptance in the future.  

Vaccinate school-aged members this summer 

Summer is a great time to vaccine students to catch up family for school readiness. Check out our newsletter article on getting pediatric patients vaccinated here. If you happen to come across a vaccine-hesitant parent, you can use this resource from the American Academy of Pediatrics. 

Additional resources to support you in your work: 

• HPSM Clinical Guidelines Immunizations 
• California Department of Public Health Immunization Recommendations