ua Medi-Cal Dental Managed Care
Rov qab mus rau Medi-Cal Dental Program Homepage
Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) yog lub luag haujlwm los muab kev pabcuam kho hniav rau cov neeg tau txais txiaj ntsig Medi-Cal tsim nyog, thiab muab kev pabcuam los ntawm ob txoj kev xa khoom, Dental Fee-For-Service (FFS) thiab Dental Managed Care (DMC). Kev Kho Hniav FFS yog qhov kev xa khoom tshwj xeeb thiab thawj zaug muaj nyob hauv California 58 lub nroog. Txawm li cas los xij, xyoo 1995, raws li lub xeev txoj cai lij choj hloov pauv, DHCS tau siv DMC los tshawb txog qhov ua tau zoo ntawm DMC raws li kev xa cov kev pabcuam kho hniav. Tus qauv xa khoom DMC tam sim no ua haujlwm hauv ob lub xeev 58 lub nroog, Sacramento thiab Los Angeles. Hauv Nroog Sacramento, DMC tso npe kawm yog yuav tsum tau ua, nrog rau qee qhov kev zam. Hauv Nroog Los Angeles, tus neeg txais txiaj ntsig yuav tsum tau xaiv los koom nrog hauv DMC txoj haujlwm.
Lub Chaw Haujlwm tau cog lus nrog peb lub Geographic Managed Care (GMC) Plans hauv Sacramento County, thiab peb lub Prepaid Health Plans (PHP) hauv Los Angeles County uas muab kev pabcuam kho hniav rau cov neeg tau txais Medi-Cal. Txhua daim phiaj xwm Medi-Cal DMC tau txais daim ntawv tso cai los ntawm Lub Xeev California, Lub Tsev Haujlwm Saib Xyuas Kev Kho Mob, raws li Knox-Keene Health Care Service Plan Act xyoo 1975. Cov neeg tau txais kev pab kho hniav Medi-Cal DMC tau txais cov kev pab kho hniav los ntawm cov kws kho mob hauv lub network ntawm txoj kev npaj kho mob. Cov kev pab cuam kho hniav uas DMC them yog cov kev pab cuam tib yam uas muab los ntawm Dental Fee-for-Service (FFS).
Yog xav paub ntxiv lossis nug txog ib qho kev npaj kho hniav GMC thiab/lossis PHP, thov hu rau tus xov tooj hu dawb ntawm Txoj Kev Npaj uas teev nyob rau ntawm nplooj ntawv web Managed Care Plan Directory. Yog xav paub ntxiv txog cov kev xaiv kho mob hniav Medi-Cal, thov mus saib nplooj ntawv web Medi-Cal Managed Care Health Care Options .
Yog xav paub ntaub ntawv hais txog Dental Managed Care Directed Payment program, thov mus saib hauv Directed Payments webpage.
X12 274 x109 Kev Pabcuam Kev Noj Qab Haus Huv Directory Project
Cov ntaub ntawv hais txog 274 Txoj Haujlwm Qhia Txog Cov Kws Muab Kev Pab Kho Mob muaj nyob hauv qab no:
- X12 274 Cov Lus Nug Feem Ntau Txog Kev Tswj Xyuas Kev Kho Hniav (Lub Kaum Hli 12, 2018)
- Kev Sib Tham Pib PPT (Lub Kaum Hli Ntuj 23, 2018)
- 274 Pawg Neeg Ua Haujlwm Sib Tham #2 (Kaum Ib Hlis 6, 2018)
Cov Ntawv Cog Lus thiab Txhua Tsab Ntawv Npaj
Cov ntaub ntawv hais txog DMC cov ntawv cog lus thiab Txhua Daim Ntawv Npaj Ua Haujlwm muaj nyob rau ntawm DMC Cov Ntawv Cog Lus thiab Txhua Daim Ntawv Cog Lus lub vev xaib.
Tshaj tawm
Kev ntsuas kev ua tau zoo
Yog xav saib cov ntaub ntawv ntsuas kev ua haujlwm ntawm cov hniav thiab cov ntaub ntawv qhia txog cov hniav, thov mus saib nplooj ntawv web Dental Data Reports.
Cov ntawv ceeb toom rau Pawg Neeg Saib Xyuas
- DMC Daim Ntawv Qhia rau Cov Cai Lij Choj rau 2020 Kev Ua Haujlwm (Sau Lub Yim Hli 2021)
- DMC Daim Ntawv Qhia rau Cov Cai Lij Choj rau 2019 Kev Ua Haujlwm (Xa Lub Rau Hli 2020)
- DMC Daim Ntawv Qhia rau Cov Cai Lij Choj rau 2018 Cov Haujlwm (Xa Lub Rau Hli 2019)
- DMC Daim Ntawv Qhia rau Cov Cai Lij Choj rau Kev Ua Haujlwm 2017 (Xa Lub Yim Hli 2018)
- Daim Ntawv Qhia Txog DMC rau Pawg Neeg Cai Lij Choj rau Cov Haujlwm Xyoo 2016 (Xa Lub Xya Hli 2017)
Daim Ntawv Qhia Txog Tus Neeg Tau Txais Kev Kho Hniav (BDE).
Txhawm rau saib BDE cov ntaub ntawv, thov mus saib ntawm BDE lub vev xaib.
Daim Ntawv Qhia Txog Kev Pom Zoo
Nco tseg: 42 CFR 438.332 xav kom lub xeev Medicaid cov koom haum ua kom muaj kev lees paub rau txhua qhov kev cog lus tswj hwm kev saib xyuas muaj nyob hauv lawv lub vev xaib. Raws li qhov yuav tsum tau ua, DHCS sau tseg tias tsis muaj ib qho ntawm Cov Kev Kho Hniav Tswj Xyuas Kev Kho Hniav tsis tau txais kev lees paub rau lawv cov Medi-Cal kab kev lag luam nrog lub koom haum ntiag tug uas muaj kev lees paub.
Kev Tshawb Fawb Txog Kev Tshawb Fawb
2025
| DMC Plan | Cov hnub txheeb xyuas | Kev Tshawb Fawb Tshaj Tawm | CAP thiab DHCS teb |
|---|---|---|---|
| Access Dental Plan | 4/21/2025 – 4/25/2025 | 2025 Audit Report | Kaum Ib Hlis 25, 2025 DHCS Teb rau CAP |
| Health Net Community Solutions, Inc. | 9/2/2025-9/12/2025 | 2025 Audit Report | Lub Ob Hlis 20, 2026 DHCS Cov Lus Teb rau CAP Peb Hlis 20, 2026 Npaj teb nrog CAP Plaub Hlis Ntuj 16, 2026 DHCS Teb rau CAP Tsib Hlis 15, 2026 Npaj teb nrog CAP Lub Rau Hli 15, 2026 DHCS Teb rau CAP |
| Liberty Dental Plan of California, Inc. | 2/17/2026-2/27/2026 | 2025 Audit Report | Cuaj hlis 10, 2026 DHCS Teb rau CAP |
2024
| DMC Plan | Cov hnub txheeb xyuas | Kev Tshawb Fawb Tshaj Tawm | CAP thiab DHCS teb |
|---|---|---|---|
| Access Dental Plan | 3/18/2024 – 3/29/2024 | 2024 Audit Report | Kaum Ob Hlis Ntuj 20, 2024 Npaj teb nrog CAP Lub Ib Hlis 16, 2025 DHCS Teb rau CAP Lub Ob Hlis 14, 2025 Npaj teb nrog CAP Lub Peb Hlis 19, 2025 DHCS Teb rau CAP Plaub Hlis Ntuj 18 , 2025 Npaj teb nrog CAP Tsib Hlis 19, 2025 DHCS Teb rau CAP Lub Rau Hli 18, 2025 Npaj teb nrog CAP Lub Xya Hli 18, 2025 DHCS Teb rau CAP |
| Health Net ntawm California, Inc. | 7/22/2024 – 8/2/2024 | 2024 Audit Report | Plaub Hlis Ntuj 3 , 2025 Npaj teb nrog CAP Tsib Hlis 2, 2025 DHCS Teb rau CAP Tsib Hlis 5, 2025 Npaj teb nrog CAP Lub Rau Hli 2, 2025 DHCS Teb rau CAP Lub Xya hli ntuj 2, 2025 Npaj teb nrog CAP Lub Yim Hli 1, 2025 DHCS Teb rau CAP |
| Liberty Dental Plan of California, Inc. | 11/4/2024 – 11/15/2024 | 2024 Audit Report | N/A |
2023
| DMC Plan | Cov hnub txheeb xyuas | Kev Tshawb Fawb Tshaj Tawm | CAP thiab DHCS teb |
|---|---|---|---|
| Health Net ntawm California, Inc. | 6/5/2023 – 6/16/2023 | 2023 Audit Report | Plaub Hlis Ntuj 12 , 2024 Npaj teb nrog CAP Tsib Hlis 10, 2024 DHCS Teb rau CAP |
| Liberty Dental Plan ntawm Califonia, Inc. | 11/27/2023 – 12/8/2023 | 2023 Audit Report | N/A |
2022
| DMC Plan | Cov hnub txheeb xyuas | Kev Tshawb Fawb Tshaj Tawm | CAP thiab DHCS teb |
|---|---|---|---|
| Access Dental Plan | 2/6/2023 – 2/17/2023 | 2022 Audit Report | Plaub Hlis Ntuj 12 , 2024 Npaj teb nrog CAP Tsib Hlis 10, 2024 DHCS Teb rau CAP Lub Rau Hli 7, 2024 Npaj teb nrog CAP Lub Xya Hli 3, 2024 DHCS Teb rau CAP |
| Health Net ntawm California, Inc. | 3/21/2022 – 4/1/2022 | 2022 Audit Report | Plaub Hlis Ntuj 12 , 2024 Npaj teb nrog CAP Tsib Hlis 10, 2024 DHCS Teb rau CAP Lub Rau Hli 10, 2024 Npaj teb nrog CAP Lub Xya Hli 2, 2024 DHCS Teb rau CAP Lub Xya hli ntuj 31, 2024 Npaj teb nrog CAP Lub Yim Hli 27, 2024 DHCS Teb rau CAP |
| Liberty Dental Plan of California, Inc. | 8/8/2022 – 8/19/2022 | 2022 Audit Report |
2021
| DMC Plan | Cov hnub txheeb xyuas | Kev Tshawb Fawb Tshaj Tawm | CAP thiab DHCS teb |
|---|---|---|---|
| Access Dental Plan | 11/1/2021 – 11/12/2021 & 12/13/2021 – 12/21/2021 | 2021 Audit Report | Kaum Ib Hlis 28, 2022: Kev Npaj Teb nrog CAP Kaum Ob Hlis Ntuj 22, 2023: DHCS Teb rau CAP |
| Health Net ntawm California, Inc. | 4/26/2021 – 5/7/2021 | 2021 Audit Report | Lub kaum hli ntuj 15, 2021: Npaj teb nrog CAP Kaum Ob Hlis Ntuj 21, 2023: DHCS Teb rau CAP |
| Liberty Dental Plan of California, Inc. | 7/6/2021 – 7/16/2021 | 2021 Audit Report | Lub Kaum Ob Hlis Ntuj hnub tim 29, 2021: Kev Npaj Teb nrog CAP Kaum Ib Hlis 22, 2023: DHCS Teb rau CAP |
2020
| DMC Plan | Cov hnub txheeb xyuas | Kev Tshawb Fawb Tshaj Tawm | CAP thiab DHCS teb |
|---|---|---|---|
| Access Dental Plan | 2/24/2020 – 2/28/2020 | 2020 Audit Report | Lub yim hli ntuj 12, 2020: Npaj teb nrog CAP Kaum Ob Hlis Ntuj 16, 2020: DHCS Teb rau CAP |
| Health Net ntawm California, Inc. | 3/16/2020 – 3/19/2020 | 2020 Audit Report | Lub yim hli ntuj 12, 2020: Npaj teb nrog CAP Cuaj hlis 24, 2020: DHCS Teb rau CAP |
Thov nco ntsoov: Lub Tsev Haujlwm tab tom hloov kho tag nrho cov lus teb rau Txoj Haujlwm.
Cov Kev Tsis Txaus ntawm Txoj Kev Npaj DMC
2026
| DMC Plan | Daim ntawv ceeb toom ntawm Deficiency Date | Daim Ntawv Ceeb Toom Txog Kev Tsis Txaus | CAP thiab DHCS teb |
|---|---|---|---|
| California Dental Network | Cuaj hlis 9, 2026 | Tsab Ntawv Ceeb Toom (WL) thiab Kev Thov Kom Muaj Txoj Kev Npaj Kho Kom Zoo (CAP): Kev Tshaj Tawm Tsis Raws Sijhawm & Tsis Tseeb | |
| Health Net ntawm California | Cuaj hlis 9, 2026 | Tsab Ntawv Ceeb Toom (WL) thiab Kev Thov Kom Muaj Txoj Kev Npaj Kho Kom Zoo (CAP): Kev Tshaj Tawm Tsis Raws Sijhawm & Tsis Tseeb | |
| California Dental Network | Cuaj hlis 29, 2026 | Warning Letter (WL) and Demand for Corrective Action Plan (CAP): DentaQuest Data Breach | |
| Health Net ntawm California | Cuaj hlis 29, 2026 | Warning Letter (WL) and Demand for Corrective Action Plan (CAP): DentaQuest Data Breach Impact to Health Net |
2025
2024
| DMC Plan | Daim ntawv ceeb toom ntawm Deficiency Date | Daim Ntawv Ceeb Toom Txog Kev Tsis Txaus | CAP thiab DHCS teb |
|---|---|---|---|
| Access Dental Plan | Lub Xya Hli 16, 2024 | Management Information System | Lub yim hli ntuj 14, 2024 Npaj teb nrog CAP Cuaj hlis 12, 2024 DHCS Teb rau CAP Lub kaum hli ntuj 10, 2024 Npaj teb nrog CAP Kaum Ib Hlis 18, 2024 DHCS Teb rau CAP Kaum Ob Hlis Ntuj 13, 2024 Npaj teb nrog CAP Lub Ib Hlis 13, 2025 DHCS Teb rau CAP Lub Ob Hlis 12, 2025 Npaj teb nrog CAP Lub Peb Hlis 14, 2025 DHCS Teb rau CAP |
2023
| DMC Plan | Daim ntawv ceeb toom ntawm Deficiency Date | Daim Ntawv Ceeb Toom Txog Kev Tsis Txaus | CAP thiab DHCS teb |
|---|---|---|---|
| Access Dental Plan | Lub Rau Hli 30, 2023 | Hu rau Center Report | Lub Xya hli ntuj 24, 2023: Npaj teb nrog CAP Lub Yim Hli 18, 2023: DHCS Teb rau CAP Lub yim hli ntuj 25, 2023: Npaj teb nrog CAP Cuaj hlis 25, 2023: DHCS Teb rau CAP Lub kaum hli ntuj 4, 2023: Npaj teb nrog CAP Kaum Hli Ntuj 26, 2023: DHCS Teb rau CAP |
| Access Dental Plan | Lub Rau Hli 30, 2023 | Sib ntsib cov ntaub ntawv | Lub Xya hli ntuj 27, 2023: Npaj teb nrog CAP Lub Yim Hli 18, 2023: DHCS Teb rau CAP Cuaj hlis 1, 2023: Npaj teb nrog CAP Cuaj hlis 29, 2023: DHCS Teb rau CAP Lub kaum hli ntuj 13, 2023: Npaj teb nrog CAP Kaum Ib Hlis 14, 2023: DHCS Teb rau CAP |
Cov Ntawv Tshaj Tawm Txog Kev Txaus Siab Rau Kev Kho Hniav Rau Menyuam
2022
| DMC Plan | Hnub tim | Daim ntawv ntsuam xyuas | Kev Tshawb Fawb Teb |
|---|---|---|---|
| Access Dental Plan | Lub Ib Hlis 2023 | Cuaj hlis 6, 2023: Kev Npaj Teb | |
| Health Net ntawm California, Inc. | Lub Ib Hlis 2023 | 2022 CAHPS Kev Tshawb Fawb | Lub Ib Hlis 5, 2024: Plan Response |
| Liberty Dental Plan of California, Inc. | Lub Ib Hlis 2023 | 2022 CAHPS Kev Tshawb Fawb | Lub Plaub Hlis 1, 2021: Npaj teb |
2021
| DMC Plan | Hnub tim | Daim ntawv ntsuam xyuas | Kev Tshawb Fawb Teb |
|---|---|---|---|
| Access Dental Plan | Kaum Ob Hlis 2021 | Kev Tshawb Fawb CAHPS Xyoo 2021 | Cuaj hlis 6, 2023: Kev Npaj Teb |
| Health Net ntawm California, Inc. | Kaum Ob Hlis 2021 | Kev Tshawb Fawb CAHPS Xyoo 2021 | Lub Ib Hlis 5, 2024: Plan Response |
| Liberty Dental Plan of California, Inc. | Kaum Ob Hlis 2021 | Kev Tshawb Fawb CAHPS Xyoo 2021 | Lub Plaub Hlis 1, 2021: Npaj teb |
2020
| DMC Plan | Hnub tim | Daim ntawv ntsuam xyuas | Kev Tshawb Fawb Teb |
|---|---|---|---|
| Access Dental Plan | Lub Ib Hlis 2021 | 2020 CAHPS Kev Tshawb Fawb | Cuaj hlis 6, 2023: Kev Npaj Teb |
| Health Net ntawm California, Inc. | Lub Ib Hlis 2021 | 2020 CAHPS Kev Tshawb Fawb | Lub Ib Hlis 5, 2024: Plan Response |
| Liberty Dental Plan of California, Inc. | Lub Ib Hlis 2021 | 2020 CAHPS Kev Tshawb Fawb | Lub Plaub Hlis 1, 2021: Npaj teb |
2019
| DMC Plan | Hnub tim | Daim ntawv ntsuam xyuas | Kev Tshawb Fawb Teb |
|---|---|---|---|
| Access Dental Plan | Lub Ib Hlis 2020 | 2019 CAHPS Survey | Tsis Muaj |
| Health Net ntawm California, Inc. | Lub Ib Hlis 2020 | 2019 CAHPS Survey | Tsis Muaj |
| Liberty Dental Plan of California, Inc. | Lub Ib Hlis 2020 | 2019 CAHPS Survey | Tsis Muaj |
2018
| DMC Plan | Hnub tim | Daim ntawv ntsuam xyuas | Kev Tshawb Fawb Teb |
|---|---|---|---|
| Access Dental Plan | Lub Kaum Hli 2018 | 2018 CAHPS Survey | Tsis Muaj |
| Health Net ntawm California, Inc. | Lub Kaum Hli 2018 | 2018 CAHPS Survey | Tsis Muaj |
| Liberty Dental Plan of California, Inc. | Lub Kaum Hli 2018 | 2018 CAHPS Survey | Tsis Muaj |
2017
| DMC Plan | Hnub tim | Daim ntawv ntsuam xyuas | Kev Tshawb Fawb Teb |
|---|---|---|---|
| Access Dental Plan | Lub Kaum Hli 2017 | 2017 CAHPS Survey | Tsis Muaj |
| Health Net ntawm California, Inc. | Lub Kaum Hli 2017 | 2017 CAHPS Survey | Tsis Muaj |
| Liberty Dental Plan of California, Inc. | Lub Kaum Hli 2017 | 2017 CAHPS Survey | Tsis Muaj |
Thov nco ntsoov: Lub Tsev Haujlwm tab tom hloov kho tag nrho cov lus teb rau Txoj Haujlwm.
Cov Ntawv Tshaj Tawm Txog Kev Tshawb Fawb
2020
| DMC Plan | Cov hnub tshawb fawb | Daim ntawv ntsuam xyuas |
|---|---|---|
| Access Dental Plan | 2/19/2019 – 21/2/2019 | 2020 DMHC Survey Report |
| Health Net ntawm California, Inc. | 2/5/2019 – 2/7/2019 | 2020 DMHC Survey Report |
2019
| DMC Plan | Cov hnub tshawb fawb | Daim ntawv ntsuam xyuas |
|---|---|---|
| Liberty Dental Plan of California, Inc. | 3/28/2018 | 2019 DMHC Survey Report |
2016
| DMC Plan | Cov hnub tshawb fawb | Daim ntawv ntsuam xyuas |
|---|---|---|
| Access Dental Plan | 3/29/2016 – 3/31/2016 | 2016 DMHC Survey Report |
| Health Net ntawm California, Inc. | 23/23/2016 – 3/25/2016 | 2016 DMHC Survey Report |
Xyoo 2014
| DMC Plan | Cov hnub tshawb fawb | Daim ntawv ntsuam xyuas |
|---|---|---|
| Liberty Dental Plan of California, Inc. | 1/14/2014 – 1/17/2014 | 2014 DMHC Survey Report |
Thov mus saib lub vev xaib ntawm Lub Chaw Haujlwm Saib Xyuas Kev Kho Mob (DMHC) kom pom cov ntaub ntawv tshuaj xyuas nyiaj txiag.
Network Certification
Yog xav saib daim ntawv qhia txog Kev Pov Thawj Txog Kev Siv Network Txhua Xyoo, thov mus saib nplooj ntawv web Network Adequacy.
Kev Ntsuam Xyuas Sab Nraud Zoo
Yog xav saib daim ntawv qhia txog kev tshuaj xyuas zoo sab nraud ntawm Medi-Cal Dental Managed Care xyoo 2020-2021, thov mus saib nplooj ntawv web ntawm Medi-Cal Managed Care Quality Improvement Reports.
Stakeholder Engagement
- Main Dental Stakeholders Page
- Los Angeles Dental Stakeholder Meetings
- Sacramento Medi-Cal Dental Advisory Committee