California Welfare and Institutions Code

§ 14184.80

WIC § 14184.80 Effective Jan 1, 2018Div. 9 · Part 3 · Ch. 7 · Art. 5.5

Statute text

(a)Within 90 days of the effective date of the act that added this section, the department shall amend its contract with the external quality review organization (EQRO) currently under contract with the department and approved by the federal Centers for Medicare and Medicaid Services to complete an access assessment. This one-time assessment is intended to do all of the following:

(1)Evaluate primary, core specialty, and facility access to care for managed care beneficiaries based on the current health plan network adequacy requirements set forth in the Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2 (commencing with Section 1340) of Division 2 of the Health and Safety Code) and Medicaid managed care contracts, as applicable.

(2)Consider State Fair Hearing and Independent Medical Review (IMR) decisions, and grievances and appeals or complaints data.

…

Legislative history

Amended by Stats. 2017, Ch. 561, Sec. 288. (AB 1516) Effective January 1, 2018.