Trang chủ Nhà cung cấp & Đánh giá quyền truy cập đối tác

Đánh giá khả năng tiếp cận

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.

Báo cáo cuối cùng đánh giá tiếp cận CA 2017-2018

Sự tham gia của các bên liên quan

The state established an Advisory Committee to provide input into the structure of the Access Assessment. The Advisory Committee include representatives from consumer advocacy organizations, providers, provider associations, health plans, health plan associations, and legislative staff. The Committee provided input into the assessment structure including network adequacy requirements and metrics, as well as feedback on the initial draft and final report.

Cuộc họp cuối cùng của Ủy ban cố vấn

Vào thứ năm, ngày 20 tháng 6, 2019, HSAG đã tổ chức Cuộc họp Ủy ban cố vấn đánh giá quyền truy cập để xem xét kết quả đánh giá quyền truy cập và cung cấp hướng dẫn cho ủy ban để gửi phản hồi của mình cho HSAG.