Cwj Pwm Kev Noj Qab Haus Huv Sab Nraud Zoo Saib Xyuas
BH EQR Annual Technical Reports – DMC-ODS & MH Services
Behavioral Health (BH) External Quality Review (EQR) is mandated by Title 42, Code of Federal Regulations, Part 438, Subpart E, requiring the Department of Health Care Services (DHCS) to contract with an External Quality Review Organization (EQRO) to fulfill these federal EQR requirements. California’s BH Prepaid Inpatient Health Plans (PIHPs) offer Specialty Mental Health Services (SMHS) and/or Drug Medi-Cal Organized Delivery System (DMC-ODS) services to Medi-Cal members throughout the state. The EQRO conducts the EQR of these PIHP Behavioral Health Plans (BHPs) to analyze and validate existing state and plan processes in alignment with the Centers for Medicare and Medicaid Services’ (CMS’) EQR Protocols.
EQR cov haujlwm ntsig txog yog npaj rau:
1. Txhim kho Lub Xeev txoj kev muaj peev xwm los saib xyuas thiab tswj cov phiaj xwm kev saib xyuas uas lawv tau cog lus nrog rau cov kev pabcuam.
2. Pab cov phiaj xwm saib xyuas kev tswj hwm txhim kho lawv cov kev ua tau zoo raws li kev ua tau zoo, raws sijhawm, thiab kev nkag mus rau kev saib xyuas.
Tsis tas li ntawd, DHCS siv EQR cov txiaj ntsig los qhia txog cov cai thiab txhawb kev txhim kho rau Medi-Cal Cov Tswv Cuab los ntawm cov tswv yim zoo thoob plaws lub xeev thiab nrog rau kev soj ntsuam zoo thiab kev txhim kho kev ua haujlwm thoob plaws BHPs.
Cov ntaub ntawv ntxiv txog Kev Kho Mob Zoo EQR , thiab 2024 Medicaid thiab CHIP Managed Care Final Rule, tuaj yeem nrhiav tau ntawm CMS lub vev xaib: www.Medicaid.gov.
Cov lus qhia hauv qab no yog koj qhov chaw tseem ceeb kom yooj yim nrhiav tau tsib xyoos dhau los ntawm Mental Health (MH) thiab Drug-Medi-Cal Organized Delivery System (DMC-ODS) EQR Technical reports. Cov ntawv qhia tshiab uas tau tso tawm yuav raug tshaj tawm thaum Lub Plaub Hlis Ntuj hnub tim 30 ntawm txhua xyoo.
Cov Ntawv Qhia Txog BH EQR
DMC-ODS
| Qhia | Xyoo | Lub Nroog | Cov ntaub ntawv npe |
|---|---|---|---|
| DMC-ODS EQR TR Vol 1 – Daim Ntawv Qhia Tseem Ceeb | Xyoo-2024-25 | CA2024-25-DMC-ODS-BH-EQR-TR-Vol1-F1.pdf | |
| DMC-ODS EQR TR Vol 2 - Cov Ntaub Ntawv Tshwj Xeeb ntawm Txoj Kev Npaj | Xyoo-2024-25 | CA2024-25-DMC-ODS-BH-EQR-TR-Vol2-F1.pdf | |
| DMC-ODS EQR TR Vol 3 - Cov Txiaj Ntsig ntawm Kev Tshuaj Xyuas Kev Ua Raws Cai | Xyoo-2024-25 | CA2024-25-DMC-ODS-BH-EQR-TR-Vol3-F1.xlsx | |
| DMC-ODS EQR TR Vol 4 - Kev Txheeb Xyuas Qhov Txaus ntawm Network | Xyoo-2024-25 | CA2024-25-DMC-ODS-BH-EQR-TR-Vol4-NAV-F1.pdf | |
| DMC-ODS EQR TR Vol 5 - Cov Qauv Nkag Mus Rau Lwm Txoj Kev | Xyoo-2024-25 | CA2024-25-DMC-ODS-BH-EQR-TR-Vol5-AAS-F1.pdf | |
| Cov Lus Qhia Tseem Ceeb ntawm MCMC BH | Xyoo-2024-25 | CA2024-25-MCMC-BH-EQR-TR-ExecSum-F2.pdf | |
| Daim ntawv qhia txog DMC-ODS | TSO-2023-24 | FY-2023-24-DMC-ODS-Statewide-ATR.pdf | |
| Daim ntawv qhia txog DMC-ODS | TSO-2023-24 | FY-2023-24-DMC-ODS-ATR-Attachments.pdf | |
| Daim ntawv qhia txog DMC-ODS | TSO-2023-24 | Yolo | 2023-24-Yolo-Report-DMC-ODS.pdf |
| Daim ntawv qhia txog DMC-ODS | TSO-2023-24 | Ventura | 2023-24-Ventura-Report-DMC-ODS.pdf |
MH Cov Kev Pabcuam
| Qhia | Xyoo | Lub Nroog | Cov ntaub ntawv npe |
|---|---|---|---|
| Daim Ntawv Qhia Txog Kev Saib Xyuas MHP | Xyoo-2024-25 | CA2024-25-MHP-FosterCareRpt-F1.pdf | |
| SMHS EQR TR Vol 1 – Daim Ntawv Qhia Tseem Ceeb | Xyoo-2024-25 | CA2024-25-SMHS-BH-EQR-TR-Vol1-F2.pdf | |
| SMHS EQR TR Vol 2 - Cov Ntaub Ntawv Tshwj Xeeb ntawm Txoj Kev Npaj | Xyoo-2024-25 | CA2024-25-SMHS-BH-EQR-TR-Vol2-F1.pdf | |
| SMHS EQR TR Vol 3 - Cov Txiaj Ntsig ntawm Kev Tshuaj Xyuas Kev Ua Raws Cai | Xyoo-2024-25 | CA2024-25-SMHS-BH-EQR-TR-Vol3-F1.xlsx | |
| SMHS EQR TR Vol 4 - Kev Txheeb Xyuas Qhov Txaus ntawm Network | Xyoo-2024-25 | CA2024-25-SMHS-BH-EQR-TR-Vol4-NAV-F1.pdf | |
| SMHS EQR TR Vol 5 - Cov Qauv Nkag Mus Rau Lwm Txoj Kev | Xyoo-2024-25 | CA2024-25-SMHS-BH-EQR-TR-Vol5-AAS-F1.pdf | |
| Daim Ntawv Qhia MH | TSO-2023-24 | FY-2023-24-MHP-Statewide-ATR-Attachments.pdf | |
| Daim Ntawv Qhia MH | TSO-2023-24 | FY-2023-24-MHP-Statewide-ATR.pdf | |
| Daim Ntawv Qhia MH | TSO-2023-24 | Yolo | 2023-24-Yolo-Report-MHP.pdf |
| Daim Ntawv Qhia MH | TSO-2023-24 | Ventura | 2023-24-Ventura-Report-MHP.pdf |
Tiv tauj peb
Yog xav paub ntxiv, hu rau BH EQRO Pab Pawg ntawm DHCSEQRO@dhcs.ca.gov.
rov qab mus rau nplooj ntawv Cov Ntaub Ntawv Kho Mob Puas Hlwb