Tsev Cov Ntawv, Cov Cai, thiab Cov Ntawv Tshaj Tawm Kev Txaus ntawm Network

Network txaus

Rov qab mus rau Managed Care Final Rule Homepage

Txhawm rau ntxiv dag zog rau kev nkag mus rau cov kev pabcuam hauv lub network tswj hwm, Txoj Cai Kawg xav kom cov xeev tsim cov qauv tsim nyog hauv lub network hauv Medicaid tswj kev saib xyuas rau cov neeg muab kev pabcuam tseem ceeb, thaum tawm hauv lub xeev kom hloov tau cov qauv tseeb. Txoj Cai Kawg yuav tsum hais tias:

Tsim thiab siv sijhawm thiab nyob deb cov qauv rau kev saib xyuas thawj zaug thiab tshwj xeeb (tus neeg laus thiab menyuam yaus), kev noj qab haus huv ntawm tus neeg laus thiab menyuam yaus), OB/GYN, kho hniav rau menyuam yaus, tsev kho mob, thiab chaw muag tshuaj;
Tsim thiab ua raws li cov qauv kev nkag mus raws sij hawm rau cov kev pab cuam mus sij hawm ntev thiab kev txhawb nqa (LTSS) cov neeg muab kev pab uas mus rau cov neeg tau txais txiaj ntsig los muab kev pabcuam; thiab
Txheeb xyuas thiab ua pov thawj qhov txaus ntawm cov phiaj xwm kev tswj hwm tus neeg muab kev pab cuam network tsawg kawg ib xyoos ib zaug.

Txoj Cai Kawg Kev Tsim Nyog Kev Tsim Nyog tau txais txiaj ntsig hauv Lub Xya Hli 1, 2018 xyoo daim ntawv cog lus kev noj qab haus huv.

Daim Ntawv Qhia Txog Kev Txaus Siab Network qhia txog txoj hauv kev uas DHCS tau ua los tsim cov qauv thiab piav qhia txog kev saib xyuas cov dej num rau kev ua raws li niaj hnub no.

Pib txij xyoo 2022, CMS tau thov DHCS xa ib Daim Ntawv Pov Thawj Network Txhua Xyoo rau Medi-Cal Managed Care Health Plans (MCPs), Medi-Cal Dental Managed Care (Dental MC), county Drug Medi-Cal Organized Delivery System (DMC- ODS) cov phiaj xwm, thiab lub nroog Mental Health Plans (MHPs).

Daim ntawv pov thawj Network Txhua Xyoo (ANC)

2024 Managed Care

2024 Tus Cwj Pwm Kev Noj Qab Haus Huv

2024 Dental Managed Care

2024 Network Adequacy and Access Assurances Report (Dental)

2023 Tus Cwj Pwm Kev Noj Qab Haus Huv thiab Kev Tswj Xyuas Kev Kho Mob

2023 Network Adequacy and Access Assurances Report (Managed Care and Behavioral Health)

2023 Dental Managed Care

2023 Network Adequacy and Access Assurances Report (Dental)

2022 Tus Cwj Pwm Kev Noj Qab Haus Huv, Kev Kho Hniav, thiab Kev Tswj Xyuas

2022 Medi-Cal Managed Care Health Plans, DMC-ODS Plans, Mental Health Plans and Medi-Cal Dental Managed Care Plans

Managed Care Plans

Subcontractor Network Certification (SNC) kom tau raws li 1915(b) STC A4 yuav tsum tau

Daim ntawv pov thawj Network Txhua Xyoo

Archived Network Certification Reports txhua xyoo

Tseem ceeb Hloov Network Certifications

Tag nrho Cov Kev Npaj Noj Qab Haus Huv (MHPs & DMC-ODS Plans)

Mental Health Plans (MHPs)

2024 Kev xa tawm:

2023 Kev xa tawm:

2022 Kev xa tawm:

2021 Kev xa tawm:

Archived Mental Health Plans Network Certification Reports

Tshuaj Medi-Cal Organized Delivery System (DMC-ODS) Plans

2024 Kev xa tawm:

2023 Kev xa tawm:

2022 Kev xa tawm:

2021 Kev xa tawm:

Archived Drug Medi-Cal Organized Delivery System Network Certification Reports

De ntal Managed Care (DMC) Plans

Cov ntawv xa tuaj:

2024 DMC Summary Document
2024 Medi-Cal Methodology Txheej txheem cej luam
DMC Summary Document
Medi-Cal DMC Methodology Overview
2021 Dental Network Certification
2021 Dental Network Adequacy Cover Letter
2020 Kev lees paub ntawm Network Certification
2020 Daim Ntawv Pov Thawj Network Txhua Xyoo
2019 Kev lees paub ntawm Network Certification
2019 Daim Ntawv Pov Thawj Network Txhua Xyoo
2018 Kev lees paub ntawm Network Certification
2018 Daim Ntawv Pov Thawj Network Txhua Xyoo
2018 Approved Alternative Access Standards – Access
2018 Approved Alternative Access Standards – Health Net
2018 Approved Alternative Access Standards – Liberty
2018 Corrective Action Plan Closeout Letters (Timely Access) – Health Net
2018 Corrective Action Plan Closeout Letters (Timely Access) – Liberty