Submission Processes for Executed MOUs and the Quarterly Report FAQs
1. What is the submission process for completed Managed Care Plan (MCP) Memorandum of Understanding (MOUs)?
The Base MOU and Bespoke MOU Templates include the minimum mandatory requirements the parties must include in their executed MOUs as well as optional provisions the parties may choose to include. If the parties execute the MOU without altering or removing any of the minimum mandatory requirements, regardless of whether they include the optional provisions, the MCPs must submit the executed MOU to the Managed Care Operations Division (MCOD)-MCP Submissions Portal on SharePoint for file and use. In its submission, MCPs must attest that they did not modify or remove any of the mandatory requirements set forth in the relevant MOU Template except to add provisions that do not conflict with or materially change either party’s obligations under the MOU.
If the parties modify or remove any of the mandatory requirements from their negotiated MOU that were set forth in the applicable MOU Template, the MCP must submit a redlined version of the proposed changes to the MOU to the MCOD-MCP Submissions Portal for review and approval prior to execution. In situations where multiple MPCs are entering into an MOU and are proposing redline edits to the MOU, only one MCP is required to submit the redline MOU to the Department of Health Care Services (DHCS) for review and approval. If the MCP chooses to add additional or optional provisions, a redline is not required as long as the additional or optional provisions do not conflict with the relevant MOU Template.
If the parties agree to combine multiple Bespoke Templates into a single MOU, without altering or removing any of the minimum mandatory requirements, the combined MOU can be submitted without redline for file and use, as described above. If the parties modify or remove any of the mandatory requirements, the MCP must submit a redlined version of the proposed MOU for review and approval, as described above, prior to execution.
Due to the large volume of these artifacts, DHCS created a specific MCP MOU View in the Submissions Portal to help MCPs easily locate them. These artifacts are only visible on the MCP MOU View; they will not show up on the normal MCP View. It is the responsibility of the MCP to ensure they are submitting in compliance with DHCS requirements. For additional support on how to submit MOU artifacts to the MCOD-MCP Submission Portal, please visit the MOU Quick Reference Guides (QRG) folder.
2. Are MCPs required to submit all amendments to the MOUs as redline MOUs for review and approval?
No. MCPs are not required to submit all amendments for review and approval. MCPs are only required to submit amendments as redline MOUs for DHCS review and approval if the amendments modify or remove any of the mandatory requirements from their negotiated MOU that were set forth in the applicable MOU Template. Upon execution, MCPs are required to submit all amendments to MOUs to the MCOD-MCP Submissions Portal on SharePoint.
3. What is submission process for completed Behavioral Health MOUs?
MCPs and Mental Health Plans (MHPs), Drug Medi-Cal Organizaed Delivery System (DMC-ODS) and Drug Medi-Cal (DMC) counties must each demonstrate a good faith effort to meet the MOU requirements of
APL 23-029 and Behaviorial Health Information Notices (BHINs)
23-056,
23-057, and
24-016.
MCPs are required to submit all executed and redline MOUs, including Behavioral Health MOUs as described above.
4. What are the applicable Subcontractor requirements for MCPs and do all Subcontractors need to be signatories to the MOU? What does being an "express party" to the MOU mean?
The MCP Contract sets forth what functions can and cannot be delegated by the MCPs. Only when an MCP has a Subcontractor or Downstream Subcontractor arrangement delegating part or all of the responsibilities related to effectuating the MOU to a Knox-Keene licensed health care service plan(s), the MOU must be signed by the MCP, that Subcontractor or Downstream Subcontractor, and the Third-Party Entity. In such instance, the Subcontractor or Downstream Subcontractor would be considered an “express party” in this scenario and would also be required to acknowledge and agree to the terms of the MOU between the Third-Party Entity and MCP. For avoidance of doubt, the Subcontractor or Downstream Subcontractor are not going to enter into a separate MOU with the Third-Party Entity, but also become a signatory to the MOU between the MCP and Third-Party Entity. The reason for requiring Subcontractors and/or Downstream Subcontractors that are Knox-Keene licensed health care service plans to sign the MOU is because they provide Member care services and should participate in care coordination and referral processes outlined in the MOU, as compared to other Subcontractors and/or Downstream Subcontractors that provide purely administrative functions.
5. Why are MCPs required to publish the executed MOUs and Annual Report?
MCPs must publish executed MOUs and Annual Report on its website within 30 Calendar Days of MOU execution and report due date, respectively. The requirement for MCPs to post executed MOUs and the annual report to its website is intended to provide transparency of compliance to stakeholders and ensure annual reviews of the executed MOU are completed. DHCS only has authority to require certain Third-Party Entities to post the MOUs on their websites. At this time, DHCS will not be housing all executed MOUs in a centralized location or website.
6. What is the MOU Annual Report?
The MOU Annual report is a report that includes updates from the quarterly meetings with Third-Party Entities and the results of their annual MOU reviews. MCPs must submit this report annually via the MCOD-MCP Submission Portal. DHCS developed and released an MOU Annual Report Template, which assists in organizing the information required for the report. The elements required can be found in APL
23-029.
7. What is the due date for the MOU Annual Report?
The MOU Annual Report will be due on the last business day of January each year. MCPs must report on all MOUs that were in effect during the reporting year. For MOUs that become effective during the reporting year, MCPs must report on MOU-related activities during the period that the MOU was effective. For example, if an MOU is executed on July 1, 2024, the MCP must report from July 1, 2024, to December 31, 2024. For any additional questions regarding the MOU Annual Report, please email
MCPMOUS@dhcs.ca.gov.
8. How will DHCS oversee and hold MCPs accountable for executing and meeting the obligations set forth in the MOUs?
MCPs are required under the MCP Contract, Exhibit A, Attachment III, to make good faith efforts to enter into MOUs with Third-Party Entities, to ensure Members ability to access and/or receive services in a coordinated manner from MCPs and Third-Party Entities. DHCS is monitoring MCPs’ progress toward this goal through the MOU Quarterly Reports on the status of execution of each required MOU and in annual reports describing the collaboration among the parties.
In addition, MCPs are responsible for ensuring that their Subcontractors, Downstream Subcontractors, and Network Providers comply with all applicable State and federal laws and regulations, contract requirements, and other DHCS guidance, including APLs and Policy Letters. For more information on Subcontractors and Network Providers, including the definition and applicable requirements, see
APL 19-001, and any subsequent APLs on this topic.
9. What is the submission process for the quarterly reports to DHCS?
DHCS is aware that engaging in negotiations to execute MOUs will take some time and that the Third-Party Entities have certain processes that need to be followed. MCPs must demonstrate a good faith effort to meet the MOU requirements of the MCP Contract and
APL 23-029. MCPs that are unable to execute the required MOUs by the required execution date must submit quarterly progress to DHCS demonstrating evidence of their good faith effort to execute the MOUs using DHCS’s MOU Quarterly Reporting Template for MCPs. Third-Party Entities are not required to submit or sign the quarterly reports, as the quarterly reports are specific to the MCPs compliance with the MOU requirements.
MHPs and DMC-ODS, and DMC counties must demonstrate a good faith effort to meet the MOU requirements of BHINs
24-016, 23-056, and
23-057 respectively. For more information about the submission process for these MOUs by the MHP, DMC-ODS and DMC counties, please see the section for the bespoke MOUs. MCPs are encouraged to collaborate with Third-Party Entities and cooperate with Third-Party Entities review and approval processes for executing MOUs in order to achieve MOU execution in a respectful, meaningful and mutually agreeable way.
