Kev Tshawb Fawb Txog Kev Kho Mob thiab Kev Npaj Kho Kom Zoo
Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) ua haujlwm nrog Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DMHC) txhawm rau ua cov kev tshawb fawb kho mob niaj hnub ntawm Medi-Cal Managed Care Health Plans (MCPs) ntawm cov neeg xaiv txhua xyoo. Daim ntawv ntsuam xyuas kho mob yog ib qho kev ntsuam xyuas tag nrho ntawm MCP txoj kev ua raws li txoj cai tswj xyuas kev noj qab haus huv Sijhawm (Knox-Keene Health Care Service Plan Act).
DHCS 'Managed Care Quality and Monitoring Division (MCQMD) yog lub luag haujlwm los xyuas kom meej tag nrho cov kev saib xyuas thiab kev saib xyuas ntawm MCPs. MCQMD tau xaiv Lub Chaw Saib Xyuas Daim Ntawv Cog Lus & Kev Sau Npe (CERD) ntawm DHCS' Kev Tshawb Fawb thiab Kev Tshawb Fawb (A&I) txhawm rau ua cov kev soj ntsuam uas raug cai.
MCQMD thiab A&I tau koom tes ua ke los tsim Cov Kev Pabcuam Kev Pabcuam (TAG) rau txhua yam ntawm 6 pawg kev tshuaj xyuas hauv qab no. Cov TAGs tau tsim los txheeb xyuas cov ntsiab lus tseem ceeb uas yuav raug soj ntsuam ntau los qhia rau MCPs ntawm cov txheej txheem tshawb xyuas thiab ua kom pom tseeb.
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Kev tswj kev siv
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Case Management thiab Kev Sib Koom Tes ntawm Kev Kho Mob
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Nkag mus thiab Muaj
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Tswvcuab Txoj Cai
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Kev Txhim Kho Zoo
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Kev Tswj Xyuas thiab Kev Tswj Xyuas Kev Muaj Peev Xwm
- Kev Pabcuam Hauv Xeev
DHCS ua qhov kev tshawb pom qhov tseeb hais txog lub peev xwm ntawm MCPs los muab cov kev pabcuam kev noj qab haus huv zoo, kev ua haujlwm zoo ntawm kev txheeb xyuas cov phooj ywg, thiab cov txheej txheem tswj kev siv, thiab kev ua tau zoo tag nrho hauv kev muab cov txiaj ntsig kev noj qab haus huv rau nws cov neeg kawm. Cov kev tshuaj xyuas no pab DHCS nrog rau nws txoj kev saib xyuas tag nrho, thiab txheeb xyuas thaj chaw ntawm kev tsis ua raws cai, uas yog lub hauv paus rau kev kho kom raug.
MCPs yuav tsum tau muab Daim Phiaj Xwm Kho Kom Zoo (CAP) thaum ua tiav ntawm DHCS Kev Tshawb Fawb Kev Kho Mob lossis lwm yam kev soj ntsuam xyuas qhov kev tshawb pom tau pom. DHCS ua CAP kev ntsuam xyuas thiab muab kev pab cuam los xyuas kom meej tias ua raws.
Daim Ntawv Ceeb Toom Txog Kev Kho Mob thiab Cov Kev Npaj Kho Kom Zoo:
Saib hauv qab no rau Daim Ntawv Tshaj Qhia Kev Tshawb Fawb tsis ntev los no thiab cov phiaj xwm kho kom raug
Tshaj tawm
Aetna Better Health of California
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2023 Qhia
AIDS Healthcare Foundation
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2024 Qhia
Alameda Alliance for Health
2023 Kev Tshawb Fawb Txog Kev Tshawb Fawb
2025 Qhia
Anthem Blue Cross Partnership Plan
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2024 Qhia
Blue Shield ntawm CA Promise Health Plan
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2024 Qhia
California Kev Noj Qab Haus Huv thiab Kev Noj Qab Haus Huv
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2024 Qhia
CalOptima yog
2023 Kev Tshawb Fawb Txog Kev Tshawb Fawb
2025 Qhia
CalViva Health
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2024 Qhia
CenCal Health
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2024 Qhia
Central California Alliance for Health
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2025 Qhia
Community Health Group Partnership Plan
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2024 Qhia
Contra Costa Health Plan
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2024 Qhia
Gold Coast Health Plan
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2024 Qhia
Health Net Community Solutions, Inc.
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2024 Qhia
Health Plan ntawm San Joaquin
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2024 Qhia
Health Plan ntawm San Mateo
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2024 Qhia
Inland Empire Health Plan
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2024 Qhia
Kern Health Systems
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2024 Qhia
Kaiser
2023 Kev Tshawb Fawb Txog Kev Tshawb Fawb (Sacramento)
2023 Kev Tshawb Fawb Txog Kev Tshawb Fawb (San Diego)
2024 Qhia
LA Care Health Plan
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2024 Qhia
Molina Healthcare ntawm California Partner Plan, Inc.
2023 Kev Tshawb Fawb Txog Kev Tshawb Fawb
2025 Qhia
Partnership Health Plan of California
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2024 Qhia
Rady Children's Hospital-San Diego
2021 Qhia
San Francisco Health Plan
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2025 Qhia
Santa Clara Family Health Plan
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2025 Qhia
Senior Care Action Network Plan Health Plan
2023 Kev Tshawb Fawb Kev Tshawb Fawb Tshaj Tawm
2025 Qhia
United Healthcare Community Plan of California, Inc.
2022 Qhia
Kho kom raug Action Plans
Aetna Better Health of California
2023 Corrective Action Plan
AIDS Healthcare Foundation
2024 Corrective Action Plan
Alameda Alliance for Health
Txoj Kev Npaj Kho Kom Zoo tau ua tiav
Anthem Blue Cross Partnership Plan
Txoj Kev Npaj Kho Kom Zoo tau ua tiav
Blue Shield ntawm CA Promise Health Plan
2024 Corrective Action Plan
California Kev Noj Qab Haus Huv thiab Kev Noj Qab Haus Huv
Kev Kho Kom Zoo Tsis Xav Tau
CalOptima yog
Txoj Kev Npaj Kho Kom Zoo tau ua tiav
CalViva Health
2024 Corrective Action Plan
CenCal Health
2024 Corrective Action Plan
Central California Alliance for Health
Txoj Kev Npaj Kho Kom Zoo tau ua tiav
Community Health Group Partnership Plan
2024 Corrective Action Plan
Contra Costa Health Plan
Txoj Kev Npaj Kho Kom Zoo tau ua tiav
Gold Coast Health Plan
2023 Corrective Action Plan
Health Net Community Solutions, Inc.
2024 Corrective Action Plan
Health Plan ntawm San Joaquin
Txoj Kev Npaj Kho Kom Zoo tau ua tiav
Health Plan ntawm San Mateo
2023 Corrective Action Plan
Inland Empire Health Plan
2024 Corrective Action Plan
Kern Health Systems
Txoj Kev Npaj Kho Kom Zoo tau ua tiav
Kaiser
Txoj Kev Npaj Kho Kom Zoo tau ua tiav
LA Care Health Plan
Txoj Kev Npaj Kho Kom Zoo tau ua tiav
Molina Healthcare ntawm California Partner Plan, Inc.
Txoj Kev Npaj Kho Kom Zoo tau ua tiav
Partnership Health Plan of California
2023 Corrective Action Plan
Rady Children's Hospital-San Diego
Kev Kho Kom Zoo Tsis Xav Tau
San Francisco Health Plan
Txoj Kev Npaj Kho Kom Zoo tau ua tiav
Santa Clara Family Health Plan
Txoj Kev Npaj Kho Kom Zoo tau ua tiav
Senior Care Action Network Plan Health Plan
Txoj Kev Npaj Kho Kom Zoo tau ua tiav
United Healthcare Community Plan of California, Inc.
Kev Kho Kom Zoo Tsis Xav Tau
Archived Reports thiab CAPS
