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 siv cov qauv kev nkag mus rau lub sijhawm rau cov neeg muab kev pabcuam thiab kev txhawb nqa mus sij hawm ntev (LTSS) uas mus rau tus 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 thov txog Cov Qauv Kev Txaus ntawm Network piav qhia txog txoj hauv kev uas DHCS tau ua los tsim cov qauv thiab piav qhia txog cov haujlwm saib xyuas kom ua raws li txoj cai tas mus li.​​ 

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)​​ 

Xyoo 2025 Kev Tswj Xyuas Kev Kho Hniav​​ 

• Daim Ntawv Qhia Txog Kev Txaus thiab Kev Nkag Mus Rau Hauv Network Xyoo 2025 (Kev Kho Hniav)​​ 

Xyoo 2025 Kev Saib Xyuas uas Muaj Kev Tswj Xyuas​​ 

• Daim Ntawv Qhia Txog Kev Txaus thiab Kev Nkag Mus Rau Hauv Network Xyoo 2025 MCP​​ 

Xyoo 2024 Kev Noj Qab Haus Huv ntawm Tus Kheej​​ 

• 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)​​ 

Xyoo 2024 Kev Tswj Xyuas Kev Kho Hniav​​ 

• 2024 Network Adequacy and Access Assurances Report (Dental)​​ 

Xyoo 2023 Kev Noj Qab Haus Huv thiab Kev Tswj Xyuas Kev Kho Mob​​ 

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

Xyoo 2023 Kev Tswj Xyuas Kev Kho Hniav​​ 

• 2023 Network Adequacy and Access Assurances Report (Dental)​​ 

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

• 2022 Medi-Cal Kev Tswj Xyuas Kev Noj Qab Haus Huv, DMC-ODS Phiaj Xwm, Kev Npaj Kev Noj Qab Haus Huv Lub Siab thiab Medi-Cal Kev Kho Hniav Kev Tswj Xyuas Kev Noj Qab HausHuv​​ 

Managed Care Plans​​ 

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

• 2025 NAAAR SNC​​ 

Daim ntawv pov thawj Network Txhua Xyoo​​ 

• Xyoo 2025 ANC Cov Kev Thov Nkag Mus Rau Lwm Txoj Cai​​ 

Archived Network Certification Reports txhua xyoo​​ 

• 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​​ 

Txhua Txoj Kev Npaj Kho Mob Kev Coj Tus cwj pwm (MHPs & DMC-ODS Plans)​​ 

• FY2025-26 Federal Network Certification Requirements Webinar FAQ​​ 
• 2022 Network Adequacy Certification Requirements Webinar - FAQ​​ 

Cov Kev Npaj Kho Mob Hlwb (MHPs)​​ 

Xyoo 2025 Kev Xa Ntawv:​​ 

• Xyoo 2025 SMHS Cov Kev Tshawb Pom Thawj Zaug thiab Zaum Kawg Txog Kev Ua Raws Cai​​ 
• Xyoo 2025 MHP Tau Pom Zoo Cov Qauv Kev Nkag Mus Rau Lwm Txoj Kev​​ 

2024 Kev xa tawm:​​ 

• Xyoo 2024 SMHS Cov Kev Tshawb Pom Thawj Zaug thiab Zaum Kawg Txog Kev Ua Raws Cai​​ 
• SMHS Methodology Description​​ 

Xyoo 2023 Kev Xa Ntawv:​​ 

• Xyoo 2023 SMHS Cov Kev Tshawb Pom Thawj Zaug thiab Zaum Kawg Txog Kev Ua Raws Cai​​ 
• SMHS Methodology Description​​ 

2022 Kev xa tawm:​​ 

• 2022 Daim Ntawv Pov Thawj Network CAP Daim Ntawv Qhia Txhua Xyoo​​ 
• SMHS 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​​ 

Cov Ntawv Qhia Txog Kev Pov Thawj ntawm Lub Koom Haum Kev Npaj Kho Mob Hlwb uas Tau Khaws Cia​​ 

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

Xyoo 2025 Kev Xa Ntawv:​​ 

• Xyoo 2025 DMC-ODS Cov Kev Tshawb Pom Thawj Zaug thiab Zaum Kawg​​ 
• Xyoo 2025 DMC-ODS Tau Pom Zoo Cov Qauv Nkag Mus Rau Lwm Txoj Kev​​ 

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​​ 

Xyoo 2023 Kev Xa Ntawv:​​ 

• 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​​ 
• Xyoo 2022 DMC-ODS Tau Pom Zoo Cov Qauv Nkag Mus Rau Lwm Txoj Kev​​ 
• 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​​ 

Cov Ntawv Qhia Txog Kev Pom Zoo ntawm Lub Koom Haum Kev Xa Khoom Tshuaj Medi-Cal Uas Tau Khaws Cia​​ 

Cov Phiaj Xwm Kev Kho Mob Hniav (DMC)​​ 

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​​ 
• Tsab Ntawv Qhia Txog Kev Txaus Siab Rau Kev Pabcuam Kho Hniav Xyoo 2021​​ 
• 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​​ 
• Xyoo 2018 Cov Qauv Kev Nkag Mus Rau Lwm Txoj Kev Tau Txais Kev Pom Zoo - Kev Nkag Mus​​ 
• Cov Qauv Kev Nkag Mus Rau Lwm Txoj Kev Tau Txais Kev Pom Zoo Xyoo 2018 - Health Net​​ 
• Xyoo 2018 Cov Qauv Kev Nkag Mus Rau Lwm Txoj Kev Tau Txais Kev Pom Zoo - Kev Ywj Pheej​​ 
• 2018 Corrective Action Plan Closeout Letters (Timely Access) – Health Net​​ 
• Cov Ntawv Kaw Tawm Txoj Kev Npaj Kho Kom Zoo Xyoo 2018 (Timely Access) - Liberty​​