行为健康网络充分性监督部门
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行为健康网络充足性监督处 (BHNAOB) 在结构上隶属于行为健康监督和监测部门 (BHOMD)，而行为健康监督和监测部门又是卫生保健服务部行为健康计划的一部分。有关 BHOMD 的信息可通过本文档顶部的行为健康服务主页链接找到。BHNAOB 负责 Medi-Cal 行为健康网络充足性计划、行为健康服务法案网络充足性计划，并且以前负责行为健康质量改进计划 (BHQIP) 的行政管理，该计划已于 6 月30 、 2024日终止。网络充足性监督部门负责监督和监测专科心理健康服务 (SMHS) 和加州药物医疗补助组织化服务系统 (DMC-ODS) 项目的所有行为健康组成部分，以及由于平价要求而导致的加州药物医疗补助州计划的及时获取服务。
网络适足性监督科
The Network Adequacy Oversight Section (NAOS) is found within the BHNAOB. BHNAOB is found within BHOMD and is a part of the Behavioral Health program of DHCS.
DHCS contracts with counties that either provide, or arrange for the provision of, specialty mental health services and substance use treatment services to eligible Medi-Cal members.
NAOS performs compliance oversight and monitoring of the MHPs and DMC-ODS programs to ensure compliance with the network adequacy requirements set forth in Title 42 of the Code of Federal Regulations (CFR) and the network adequacy requirements of the Behavioral Health Services Act. NAOS primarily assesses the compliance of MHPs and DMC-ODS programs through its reviews of required submissions from these entities as part of an annual network certification process. NAOS, as necessary to ensure the adequacy of each provider network, identifies any deficiencies with current standards, including timely access standards as prescribed by WIC 14197 and provides technical assistance to the MHPs and DMC-ODS programs to resolve compliance issues. Where technical assistance is not effective, NAOS implements corrective measures such as corrective action plans and administrative or monetary sanctions.
NAOS also performs oversight, technical assistance, and monitoring related to improving access to care, which includes timely access requirements as defined in Welfare and Institutions Code 14197. These requirements include an initial request for first appointment or first specialty mental health service for new members, non-urgent follow-up appointments, and ensuring language assistance services are coordinated with scheduled appointments for health care services.
此处确定的网络适当性合规和监测活动专门针对 MHP、DMC-ODS 计划和 DMC 州计划的及时访问要求。管理式医疗质量与监控部负责监控管理式医疗计划的网络适当性要求。有关网络适当性的更多信息，包括年度认证报告、已批准的替代访问标准和纠正行动计划，请参阅医疗服务部网络适当性网页。
Provided below are some federal and state laws applicable to NAOS. These laws are found within the CFR, and Welfare and Institutions Code (WIC).
适用法律
联邦：
- 42 CFR 438.206 服务可用性
- 42 CFR 438.207 保证充足的能力和服务
- 42 CFR 438.68 网络充足性标准
州（法规）：
- HSC 第 1367.03 节
- WIC 第 14197 条
国家（法规）：
- 28 CCR 第 1300.67.04 节
- 28 CCR 第 1300.67.2.2 节