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 MCP Network Adequacy and Access Assurance Report (AIDS Health Foundation-Community Health Plan of Imperial Valley)
- 2024 MCP Network Adequacy and Access Assurance Report (Contra Costa Health Plan-Molina Healthcare of California)
- 2024 MCP Network Adequacy and Access Assurance Report (Partnership Health Plan of California-SCAN Health Plan)
2024 Tus Cwj Pwm Kev Noj Qab Haus Huv
- 2024 DMC-ODS Network Adequacy and Access Assurances Report (Alameda-Merced)
- 2024 DMC-ODS Network Adequacy and Access Assurances Report (Monterey-San Bernardino)
- 2024 DMC-ODS Network Adequacy and Access Assurances Report (San Diego-Tulare)
- 2024 DMC-ODS Network Adequacy and Access Assurances Report (Ventura-Yolo)
- 2024 MHP Network Adequacy and Access Assurances Report (Alameda-Fresno)
- 2024 MHP Network Adequacy and Access Assurances Report (Glenn-Madera)
- 2024 MHP Network Adequacy and Access Assurances Report (Marin-Orange)
- 2024 MHP Network Adequacy and Access Assurances Report (Placer/Sierra-San Luis Obispo)
- 2024 MHP Network Adequacy and Access Assurances Report (San Mateo-Sutter/Yuba)
- 2024 MHP Network Adequacy and Access Assurances Report (Tehama-Yolo)
2024 Dental Managed Care
2023 Tus Cwj Pwm Kev Noj Qab Haus Huv thiab Kev Tswj Xyuas Kev Kho Mob
2023 Dental Managed Care
2022 Tus Cwj Pwm Kev Noj Qab Haus Huv, Kev Kho Hniav, thiab Kev Tswj Xyuas
Managed Care Plans
Subcontractor Network Certification (SNC) kom tau raws li 1915(b) STC A4 yuav tsum tau
- 2023 NAAAR SNC
- 2023 SNC Analysis Methods
- 2023 SNC Analysis Methods Exhibit A
- 2023 SNC Lub Sijhawm lossis Txoj Kev Sib Tw Sib Nqus Cov Qauv Nkag Mus
Daim ntawv pov thawj Network Txhua Xyoo
- 2024 ANC Analysis Methods
- 2024 ANC MCP Cov Ntsiab Lus Qhia tshwj xeeb
- 2024 ANC Lwm Txoj Cai Kev Nkag Mus Rau Cov Qauv Thov
Archived Network Certification Reports txhua xyoo
Tseem ceeb Hloov Network Certifications
- 2019 Lub Ob Hlis Kev lees paub ntawm Network Certification
- 2019 Lub Ob Hlis Network Certification Report
Tag nrho Cov Kev Npaj Noj Qab Haus Huv (MHPs & DMC-ODS Plans)
- FY2025-26 Federal Network Certification Requirements Webinar FAQ
- 2022 Network Adequacy Certification Requirements Webinar - FAQ
Mental Health Plans (MHPs)
2024 Kev xa tawm:
- Xyoo 2024 SMHS Cov Kev Tshawb Pom Thawj Zaug thiab Zaum Kawg Txog Kev Ua Raws Cai
- SMHS Methodology Description
2023 Kev xa tawm:
- Xyoo 2023 SMHS Cov Kev Tshawb Pom Thawj Zaug thiab Zaum Kawg Txog Kev Ua Raws Cai
- SMHS Methodology Description
2022 Kev xa tawm:
2021 Kev xa tawm:
- 2021 Pom Zoo Lwm Txoj Kev Nkag Mus Rau Cov Qauv
- 2021 Daim Ntawv Pov Thawj Network CAP Daim Ntawv Qhia Txhua Xyoo
- 2021 Daim Ntawv Pov Thawj Network Txhua Xyoo
- 2021 Kev lees paub ntawm Network Certification
Archived Mental Health Plans Network Certification Reports
Tshuaj Medi-Cal Organized Delivery System (DMC-ODS) Plans
2024 Kev xa tawm:
- Xyoo 2024 Cov Kev Tshawb Pom Thawj Zaug thiab Zaum Kawg ntawm SUD
- Xyoo 2024 DMC-ODS Tau Pom Zoo Cov Qauv Nkag Mus Rau Lwm Txoj Kev
- DMC-ODS Methodology Description
2023 Kev xa tawm:
- Xyoo 2023 Cov Kev Tshawb Pom Thawj Zaug thiab Zaum Kawg ntawm SUD
- 2023 DMC-ODS Pom Zoo Lwm Txoj Cai Kev Nkag Mus Nkag
- DMC-ODS Methodology Description
2022 Kev xa tawm:
- 2022 Daim Ntawv Pov Thawj Network CAP Daim Ntawv Qhia Txhua Xyoo
- 2022 DMC-ODS Pom Zoo Lwm Txoj Cai Kev Nkag Mus
- DMC-ODS Methodology Description
2021 Kev xa tawm:
- 2021 Pom Zoo Lwm Txoj Kev Nkag Mus Rau Cov Qauv
- 2021 Daim Ntawv Pov Thawj Network CAP Daim Ntawv Qhia Txhua Xyoo
- 2021 Daim Ntawv Pov Thawj Network Txhua Xyoo
- 2021 Kev lees paub ntawm Network Certification
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