CHA News Article

DHCS Clarifies Guidance on Network Certification for Medi-Cal Managed Care Plans
Changes impact network provider requirements under Hospital Fee Program

The Department of Health Care Services (DHCS) has released All Plan Letter 19-002, which details reporting requirements for Medi-Cal managed care health plans (MCPs) during the annual network certification process.

Each MCP must provide DHCS with supporting documentation demonstrating its capacity to serve the anticipated membership in its service area; DHCS then provides evidence of compliance to the Centers for Medicare & Medicaid Services.

As previously reported in CHA News, the network adequacy filings are one of the required characteristics to be considered a network provider. APL 19-002 supersedes 18-005, which was referenced in the final network provider guidance released in APL 19-001.   

All required information must be submitted to DHCS by March 19.

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