CHA News Article

DHCS Submits Managed Care Quality Strategy Report to CMS

The Department of Health Care Services has submitted its final Managed Care Quality Strategy Report to the Centers for Medicare & Medicaid Services. As previously reported in CHA News, DHCS developed this report as required under the federal Medicaid managed care final rule. The report addresses quality strategies across all of California’s Medicaid managed care delivery systems, including managed care plans, county mental health plans, Drug Medi-Cal Organized Delivery Systems and dental managed care plans. The report also discusses how California’s Medicaid quality strategy meets federal requirements related to:

  • The state-defined network adequacy standards
  • The state’s goals and objectives for continuous quality improvement, a description of the quality metrics, performance targets and performance improvement projects
  • Arrangements for annual, external independent reviews
  • A description of the state’s transition of care policy
  • The state’s plan to identify, evaluate and reduce health disparities
  • Policies regarding sanctions
  • The state’s definition of ‘‘significant change”

The final version incorporates feedback received during the public comment period and will be updated annually to reflect significant changes.