Cov txheej txheem daws teeb meem tau txais txiaj ntsig
In accordance with Title 9, California Code of Regulations, Chapter 11, Subchapter 5, and the Mental Health Plan Contract, Mental Health Plans (MHP) must have problem resolution processes that enable a beneficiary to resolve a problem or concern about any issue related to the MHP’s performance, including the delivery of specialty mental health services.
Each MHPs beneficiary problem resolution process must include a system to receive and resolve beneficiary grievances, appeals, expedited appeals, and State Fair Hearings. The MHPs process must meet State and Federal requirements outlined in MHSUDS Information Notice 18-010E.
If a beneficiary disagrees with the MHP’s appeal or expedited appeal decision, the beneficiary may request a State Fair Hearing, or an Expedited State Fair Hearing.
Daim Ntawv Qhia Txog Kev Tsis Txaus Siab thiab Kev Txiav Txim Dua Txhua Xyoo (ABGAR)
MHPs yuav tsum tau tshaj tawm rau Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv txhua xyoo nyob rau lub Kaum Hlis 1st txog tag nrho cov kev tsis txaus siab, kev thov rov hais dua, thiab kev thov rov hais dua sai dua nyob rau xyoo dhau los, muab faib los ntawm hom thiab kev coj ua.
Lub Sijhawm Tshwj Xeeb thiab Cov Txheej Txheem #5 xav kom lub xeev yuav muab rau Lub Tsev Haujlwm Saib Xyuas Kev Pabcuam Medicare thiab Medicaid cov ntaub ntawv tsis txaus siab txhua xyoo thiab kev thov rov hais dua los ntawm Lub Kaum Ib Hlis 1st ntawm txhua xyoo.
The ABGAR statewide summary data is now housed on the California Health and Human Services Open Data Portal.