Common use of Million Californians Clause in Contracts

Million Californians. Contact the DMHC Help Center at 0-000-000-0000 or xxx.XxxxxxXxxx.xx.xxx Upon receipt, of the Plan’s annual PAAS submission the Department is required to review the information submitted regarding a plan’s compliance with the timely access standards, make recommendations for changes that further protect enrollees, and post findings from the review on its Web site on or before December 31st of each year. On February 13, 2017, the Department issued All Plan Letter (APL) 17-002 requiring that each plan contract with an external vendor to conduct a quality assurance review of the plan’s data prior to submission. Once an issue is identified by the plan’s External Vendor Validation Report, the APL requires that plan either correct the issue or explain why it cannot be fixed and implement corrective action to ensure that the issue does not recur in future reporting years. The Department contracts with an outside vendor to complete review of all plan PAAS submissions. After the Department’s vendor completes its review of the plan’s submission, the Department sends each health plan a feedback letter requesting a response. In its response, the health plan may include additional information for the Department to take into account in assessing compliance or actions the health plan is taking to ensure compliance in future reporting years. For MY 2017, the Department sent the Plan a feedback letter on October 23, 2018. The letter provided the Plan the opportunity to submit a response to the Department’s feedback no later than December 13, 2018. The Plan failed to report an accurate rate of compliance in the Plan’s MY 2017 PAAS submission, in violation of Health and Safety Code, section 1367.03, subdivision (f)(3); 3 Rule 1300.67.2.2, subdivision (g)(2)(B). Section 1367.03, subdivision (f)(2), requires plans to submit annual reports demonstrating compliance with timely access standards. Pursuant to Section 1367.03, subdivision (f)(3), the Department has adopted standardized methodologies which plans are required to follow when conducting and preparing the PAAS submission. As part of the MY 2017 PAAS Methodology plans were required to submit a rate of compliance with the time-elapsed standards set forth in Rule 1300.67.2.2, subdivision (c)(5) separately for each required provider type. (Cal. Code Regs., tit. 28, § 1300.67.2.2, subd. (g)(2)(B).)

Million Californians. Contact the DMHC Help Center at 0-000-000-0000 or xxx.XxxxxxXxxx.xx.xxx Upon receipt, of the Plan’s annual PAAS submission the Department is required to review the information submitted regarding a plan’s compliance with the timely access standards, make recommendations for changes that further protect enrollees, and post findings from the review on its Web site on or before December 31st of each year. On February 13, 2017, the Department issued All Plan Letter (APL) 17-002 requiring that each plan contract with an external vendor to conduct a quality assurance review of the plan’s data prior to submission. Once an issue is identified by the plan’s External Vendor Validation Report, the APL requires that plan either correct the issue or explain why it cannot be fixed and implement corrective action to ensure that the issue does not recur in future reporting years. The Department contracts with an outside vendor to complete review of all plan PAAS submissions. After the Department’s vendor completes its review of the plan’s submission, the Department sends each health plan a feedback letter requesting a response. In its response, the health plan may include additional information for the Department to take into account in assessing compliance or actions the health plan is taking to ensure compliance in future reporting years. For MY 2017, the Department sent the Plan a feedback letter on October 23, 2018. The letter provided the Plan the opportunity to submit a response to the Department’s feedback no later than December 13, 2018. The Plan failed to report an accurate rate of compliance in the Plan’s MY 2017 PAAS submission, in violation of Health and Safety Code, section Code Section 1367.03, subdivision (f)(3); 3 , and Rule 1300.67.2.2, subdivision (g)(2)(B). Section Health and Safety Code section 1367.03, subdivision (f)(2), requires plans to submit annual reports demonstrating compliance with timely access standards. Pursuant to Section 1367.03, subdivision (f)(3), the Department has adopted standardized methodologies which plans are required to follow when conducting and preparing the PAAS submission. As part of the MY 2017 PAAS Methodology Methodology, plans were required to submit a rate of compliance with the time-elapsed standards set forth in Rule 1300.67.2.2, subdivision (c)(5) ), separately for each required provider type. (Cal. Code Regs., tit. 28, § 1300.67.2.2, subd. (g)(2)(B).)

Million Californians. Contact the DMHC Help Center at 0-000-000-0000 or xxx.XxxxxxXxxx.xx.xxx Upon receipt, of the Plan’s annual PAAS submission the Department is required to review the information submitted regarding a plan’s compliance with the timely access standards, make recommendations for changes that further protect enrollees, and post findings from the review on its Web site website on or before December 31st 31 of each year. On February 13, 2017, the Department issued All Plan Letter (APL) 17-002 requiring that each plan contract with an external vendor to conduct a quality assurance review of the plan’s data prior to submission. Once an issue is identified by the plan’s External Vendor Validation Report, the APL requires that plan either correct the issue or explain why it cannot be fixed and implement corrective action to ensure that the issue does not recur in future reporting years. The Department contracts with an outside vendor to complete review of all plan PAAS submissions. After the Department’s vendor completes its review of the plan’s submission, the Department sends each health plan a feedback letter requesting a response. In its response, the health plan may include additional information for the Department to take into account in assessing compliance or actions the health plan is taking to ensure compliance in future reporting years. For MY 2017, the Department sent the Plan a feedback letter on October 23, 2018. The letter provided the Plan the opportunity to submit a response to the Department’s feedback no later than December 13, 2018. The Plan failed to report an accurate rate of compliance in the Plan’s MY 2017 PAAS submission, in violation of Health and Safety Code, section Code Section 1367.03, subdivision (f)(3); 3 , and Rule 1300.67.2.2, subdivision (g)(2)(B). Section Health and Safety Code section 1367.03, subdivision (f)(2), requires plans to submit annual reports demonstrating compliance with timely access standards. Pursuant to Section 1367.03, subdivision (f)(3), the Department has adopted standardized methodologies which plans are required to follow when conducting and preparing the PAAS submission. As part of the MY 2017 PAAS Methodology Methodology, plans were required to submit a rate of compliance with the time-elapsed standards set forth in Rule 1300.67.2.2, subdivision (c)(5) ), separately for each required provider type. (Cal. Code Regs., tit. 28, § 1300.67.2.2, subd. (g)(2)(B).)) Here, the Plan failed to meet the required sample sizes which resulted in reporting an accurate rate of compliance.

Million Californians. Contact the DMHC Help Center at 0-000-000-0000 or xxx.XxxxxxXxxx.xx.xxx Upon receipt, receipt of the Plan’s annual PAAS submission submission, the Department is required to review the information submitted regarding a plan’s compliance with the timely access standards, make recommendations for changes that further protect enrollees, and post findings from the review on its Web site on or before December 31st 31 of each year. On February 13, 2017, the Department issued All Plan Letter (APL) 17-002 requiring that each plan contract with an external vendor to conduct a quality assurance review of the plan’s data prior to submission. Once an issue is identified by the plan’s External Vendor Validation Report, the APL requires that the plan either correct the issue or explain why it cannot be fixed and implement corrective action to ensure that the issue does not recur in future reporting years. The Department contracts with an outside vendor to complete review of all plan PAAS submissions. After the Department’s vendor completes its review of the plan’s submission, the Department sends each health plan a feedback letter requesting a response. In its response, the health plan may include additional information for the Department to take into account in assessing compliance or actions the health plan is taking to ensure compliance in future reporting years. For MY 2017, the Department sent the Plan a feedback letter on October 23, 2018. The letter provided the Plan the opportunity to submit a response to the Department’s feedback no later than December 13, 2018. The Plan failed In addition to report an accurate rate of compliance the violations prosecuted below, the Department’s October 23, 2018, comment letter noted the following errors in the Plan’s MY 2017 PAAS submission, : • Incorrect Rate of Compliance for Each Product Type • Failed to Correctly Calculate Target Sample Size • Failed to Conduct Survey Waves 6 Weeks Apart • Failed to Submit Narrative Information for Plan-to-Plan Arrangement • Failed to Submit all Requirements for the Language Assistance Program Assessment • Failed to Identify Corrective Actions in violation of Health and Safety Code, section 1367.03, subdivision (f)(3); 3 Rule 1300.67.2.2, subdivision (g)(2)(B)Vendor Validation Report The Department issued a notice admonishing the Plan for the errors above. Section 1367.03, subdivision (f)(2), requires plans to submit annual reports demonstrating compliance with timely access standards. Pursuant to Section 1367.03, subdivision (f)(3)As such, the Department has adopted standardized methodologies which plans are required to follow when conducting and preparing Plan is on notice that the PAAS submission. As part of the errors were identified in its MY 2017 PAAS Methodology plans were required submission, and the Department expects that the Plan takes steps to submit a rate of compliance with ensure that the time-elapsed standards set forth same errors do not occur in Rule 1300.67.2.2, subdivision (c)(5) separately for each required provider type. (Cal. Code Regsfuture PAAS submissions., tit. 28, § 1300.67.2.2, subd. (g)(2)(B).)

Million Californians. Contact the DMHC Help Center at 0-000-000-0000 or xxx.XxxxxxXxxx.xx.xxx Upon receipt, of the Plan’s annual PAAS submission the Department is required to review the information submitted regarding a plan’s compliance with the timely access standards, make recommendations for changes that further protect enrollees, and post findings from the review on its Web site on or before December 31st of each year. On February 13, 2017, the Department issued All Plan Letter (APL) 17-002 requiring that each plan contract with an external vendor to conduct a quality assurance review of the plan’s data prior to submission. Once an issue is identified by the plan’s External Vendor Validation Report, the APL requires that plan either correct the issue or explain why it cannot be fixed and implement corrective action to ensure that the issue does not recur in future reporting years. The Department contracts with an outside vendor to complete review of all plan PAAS submissions. After the Department’s vendor completes its review of the plan’s submission, the Department sends each health plan a feedback letter requesting a response. In its response, the health plan may include additional information for the Department to take into account in assessing compliance or actions the health plan is taking to ensure compliance in future reporting years. For MY 2017, the Department sent the Plan a feedback letter on October 23, 2018. The letter provided the Plan the opportunity to submit a response to the Department’s feedback no later than December 13, 2018. The Plan failed to report an accurate rate of compliance in the Plan’s MY 2017 PAAS submission, in violation of Health and Safety Code, section Code Section 1367.03, subdivision (f)(3); 3 , and Rule 1300.67.2.2, subdivision (g)(2)(B). Section 1367.03, subdivision (f)(2), requires plans to submit annual reports demonstrating compliance with timely access standards. Pursuant to Section 1367.03, subdivision (f)(3), the Department has adopted standardized methodologies which plans are required to follow when conducting and preparing the PAAS submission. As part of the MY 2017 PAAS Methodology Methodology, plans were required to submit a rate of compliance with the time-elapsed standards set forth in Rule 1300.67.2.2, subdivision (c)(5) ), separately for each required provider type. (Cal. Code Regs., tit. 28, § 1300.67.2.2, subd. (g)(2)(B).)) Here, the Plan failed to provide a rate of compliance for a required provider type.

Million Californians. Contact the DMHC Help Center at 0-000-000-0000 or xxx.XxxxxxXxxx.xx.xxx Upon receipt, of the Plan’s annual PAAS submission the Department is required to review the information submitted regarding a plan’s compliance with the timely access standards, make recommendations for changes that further protect enrollees, and post findings from the review on its Web web site on or before December 31st of each year. On February 13, 2017, the Department issued All Plan Letter (APL) 17-002 requiring that each plan contract with an external vendor to conduct a quality assurance review of the plan’s data prior to submission. Once an issue is identified by the plan’s External Vendor Validation Report, the APL requires that the plan either correct the issue or explain why it cannot be fixed and implement corrective action to ensure that the issue does not recur in future reporting years. The Department contracts with an outside vendor to complete review of all plan PAAS submissions. After the Department’s vendor completes its review of the plan’s submission, the Department sends each health plan a feedback letter requesting a response. In its response, the health plan may include additional information for the Department to take into account in assessing compliance or actions the health plan is taking to ensure compliance in future reporting years. For MY 2017, the Department sent the Plan a feedback letter on October 23, 2018. The letter provided the Plan the opportunity to submit a response to the Department’s feedback no later than December 13, 2018. The Plan failed to report an accurate rate of compliance in the Plan’s MY 2017 PAAS submission, in violation of Health and Safety Code, section Code Section 1367.03, subdivision (f)(3); 3 , and Rule 1300.67.2.2, subdivision (g)(2)(B). Section Health and Safety Code section 1367.03, subdivision (f)(2), f)(2),3 requires plans to submit annual reports demonstrating compliance with timely access standards. Pursuant to Section 1367.03, subdivision (f)(3), the Department has adopted standardized methodologies which plans are required to follow when conducting and preparing the PAAS submission. As part of the MY 2017 PAAS Methodology Methodology, plans were required to submit a rate of compliance with the time-elapsed standards set forth in Rule 1300.67.2.2, subdivision (c)(5) ), separately for each required provider type. (Cal. Code Regs., tit. 28, § 1300.67.2.2, subd. (g)(2)(B).)) The Plan did not submit a rate of compliance and PAAS data for non-physician mental health providers in its Timely Access Compliance Report Submission. This issue was identified by the Department and in the Plan’s External Vendor Validation Report. The Plan’s External Vendor Validation Report indicated that the Plan did not include the compliance data because the survey was overlooked due to staff turnover.

Million Californians. Contact the DMHC Help Center at 0-000-000-0000 or xxx.XxxxxxXxxx.xx.xxx Upon receipt, of the Plan’s annual PAAS submission the Department is required to review the information submitted regarding a plan’s compliance with the timely access standards, make recommendations for changes that further protect enrollees, and post findings from the review on its Web site on or before December 31st of each year. On February 13, 2017, the Department issued All Plan Letter (APL) 17-002 requiring that each plan contract with an external vendor to conduct a quality assurance review of the plan’s data prior to submission. Once an issue is identified by the plan’s External Vendor Validation Report, the APL requires that plan either correct the issue or explain why it cannot be fixed and implement corrective action to ensure that the issue does not recur in future reporting years. The Department contracts with an outside vendor to complete review of all plan PAAS submissions. After the Department’s vendor completes its review of the plan’s submission, the Department sends each health plan a feedback letter requesting a response. In its response, the health plan may include additional information for the Department to take into account in assessing compliance or actions the health plan is taking to ensure compliance in future reporting years. For MY 2017, the Department sent the Plan a feedback letter on October 23, 2018. The letter provided the Plan the opportunity to submit a response to the Department’s feedback no later than December 13, 2018. The Plan failed to report an accurate rate of compliance in the Plan’s MY 2017 PAAS submission, in violation of Health and Safety Code, section Code Section 1367.03, subdivision (f)(3); 3 f)(3)3, and Rule 1300.67.2.2, subdivision (g)(2)(B). Section Health and Safety Code section 1367.03, subdivision (f)(2), requires plans to submit annual reports demonstrating compliance with timely access standards. Pursuant to Section 1367.03, subdivision (f)(3), the Department has adopted standardized methodologies which plans are required to follow when conducting and preparing the PAAS submission. As part of the MY 2017 PAAS Methodology Methodology, plans were required to submit a rate of compliance with the time-elapsed standards set forth in Rule 1300.67.2.2, subdivision (c)(5) ), separately for each required provider type. (Cal. Code Regs., tit. 28, § 1300.67.2.2, subd. (g)(2)(B).)) Here, the Plan failed to report an accurate rate of compliance.