家行為健康網路充足性監督部門​​ 

行為健康網絡充足監督科​​ 

返回行為健康服務首頁。​​  

The Behavioral Health Network Adequacy Oversight Branch (BHNAOB) is structurally within the Behavioral Health Oversight and Monitoring Division (BHOMD), which is a part of the Behavioral Health program of the Department of Health Care Services. Information about BHOMD can be found via the Behavioral Health Services homepage link at the top of this document. BHNAOB is responsible for the Medi-Cal Behavioral Health network adequacy program, the Behavioral Health Services Act network adequacy program, and formerly had administrative responsibility for the Behavioral Health Quality Improvement Program (BHQIP), which was sunset on June 30, 2024. The Network Adequacy Oversight Sections are responsible for the oversight and monitoring all behavioral health components of the Specialty Mental Health Services (SMHS) and Drug Medi-Cal Organized Delivery System (DMC-ODS) program, as well as timely access requirements for Drug Medi-Cal state plans due to parity requirements​​ 

網絡充足監督組​​ 

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.​​  

此處指出的網絡充足性合規與監督活動，是針對 MHP、DMC-ODS 計畫和 DMC 州計畫特別針對及時存取要求而提出的。管理式保健品質與監督部門監督管理式保健計劃的網絡充足性要求。請參閱健康照護服務部網絡充足性網頁，以瞭解更多與網絡充足性相關的資訊，包括年度認證報告、核准的替代性使用標準和矯正行動計劃。​​  

Provided below are some federal and state laws applicable to NAOS. These laws are found within the CFR, and Welfare and Institutions Code (WIC).​​  

適用法律​​  

聯邦：​​  

  • 42 CFR 438.206 服務的可用性​​  
  • 42 CFR 438.207 保證足夠的能力和服務​​  
  • 42 CFR 438.68 網絡充足標準​​  

國家（法規）：​​  

  • 衞生防護理系統第一三七十七 /03​​  
  • 世界貿易委員會第十四 197 條​​  

國家（法規）：​​  

  • 第二十八條 CCR 第一百零零零一七 /七四年​​  
  • 第二十八條 CCR 第一百零零零 .67.2.2 條​​  

其他資源​​ 

加州推進與創新加州醫療補助健康保健計劃 (CalAIM)：​​ 

醫療補助和加州醫療補助健康保健計劃 一般：​​ 

聯絡資訊​​