Tahanan Mga Tagapagbigay ng Serbisyo at Kasosyo Pagtatasa ng Pag-access

I-access ang Pagsusuri

Return to the Medi-Cal 2020 Waiver Homepage

The Centers for Medicare and Medicaid Services (CMS) approved California’s Section 1115(a) Medicaid Waiver Renewal, titled California Medi-Cal 2020 Demonstration (Medi-Cal 2020) on December 30, 2015. The Special Terms and Conditions (STCs) set forth by CMS and DHCS established the conditions and limitations on the waiver and expenditure authorities. In accordance with the Medi-Cal 2020 STCs, California was required to conduct a one-time assessment (Access Assessment) of Medi-Cal Managed Care (MCMC) beneficiaries’ access based on current Medi-Cal managed care health plan (MCP) network adequacy requirements.

This Access Assessment evaluated MCMC beneficiaries’ access to primary, core specialty, and facility services, as well as compliance with MCP network adequacy and timely access requirements and standards. Following the State’s approval to move forward with the Access Assessment on July 25, 2016, DHCS coordinated with Health Services Advisory Group, Inc. (HSAG), the State’s external quality review organization (EQRO), to design and conduct the required Access Assessment. The final report has been prepared for the period of March 1, 2017 – December 30, 2017.

CA 2017-2018 Access Assessment Final Report

Pakikipag-ugnayan sa Stakeholder

Ang estado ay nagtatag ng isang Advisory Committee upang magbigay ng input sa istruktura ng Access Assessment. Kasama sa Advisory Committee ang mga kinatawan mula sa mga organisasyon ng adbokasiya ng consumer, provider, asosasyon ng provider, planong pangkalusugan, asosasyon ng planong pangkalusugan, at kawani ng pambatas. Ang Komite ay nagbigay ng input sa istraktura ng pagtatasa kabilang ang mga kinakailangan at sukatan ng kasapatan ng network, pati na rin ang feedback sa paunang draft at huling ulat.

Pangwakas na Pagpupulong ng Komite sa Pagpapayo

Noong Huwebes, Hunyo 20, 2019, nag-host ang HSAG ng Access Assessment Advisory Committee Meeting upang suriin ang mga resulta ng pagtatasa ng access at magbigay ng gabay sa komite para sa pagsusumite ng feedback nito sa HSAG.