DHCS Proposes Network Adequacy Standards

Last Spring, the Centers for Medicare and Medicaid Services (CMS) issued the Medicaid and CHIP Managed Care Final Rule, which addressed beneficiary rights and protections, program integrity, care coordination and network adequacy. In the Final Rule, states were required to implement state-specific standards for network adequacy in regards to time and distance.

This week, DHCS released their proposed network adequacy standards which would apply to:

  • Medi-Cal managed care;
  • County Mental Health;
  • Drug Medi-Cal; and
  • Dental Managed Care Plans.

DHCS also presented an update on their proposal at the Stakeholder Advisory Committee Meeting yesterday, February 16.

Public comment on the proposed standards are due to DHCS by February 28, 2017, and can be submitted to dhcsmcqmdnau@dhcs.ca.gov.