In September 2019, the California Department of Health Care Services (DHCS) will be releasing Timely Access survey results that include measures on provider and call center staff awareness of Medi-Cal managed care health plan (MCP) members’ right to access interpretation services when seeing a doctor or receiving other services.
Annual Assessments for Medi-Cal Managed Care Plans
DHCS’ External Quality Review Organization (EQRO) conducts an annual survey of MCP compliance to timely access to appointments. DHCS provides the results of the survey to MCPs on a quarterly basis.
The Timely Access survey calls made are statistically significant (28,000 participating providers across the state and every MCP Member Services Department). Providers included in the survey are primary care physicians, specialists, mental health providers, and ancillary providers.
While the oversight process is targeted at MCPs and not specifically CMC plans, the plan-level overlap in member services representative training and policy and procedures as well as the large volume of providers included in the survey suggest that the Medi-Cal findings are applicable to the Cal MediConnect products.
Interpretation Services Requirements
Per contractual requirements, MCPs are required to provide a qualified interpreter or provider that speaks the native language to members with limited proficiency in English. DHCS worked with advocates from the Medi-Cal Managed Care Advisory Group to develop the survey questions.
In August 2019, DHCS incorporated the following language measures specific to access to interpretation services in the Timely Access study:
- MCP member services representatives’ knowledge of interpretation service requirements; and
- Participating provider office’s knowledge of interpretation service requirements.
Follow-up from Assessment Results
Through DHCS’ quarterly monitoring process, DHCS will provide each MCP with their plan-specific results, including the language assistance measures. DHCS provides each MCP the raw data derived from the survey, which includes the National Provider Number of every provider the EQRO called so MCPs can review which specific providers require extra education and training around interpretation services.
MCPs have a few weeks from receipt of the data to communicate steps they will take to ensure compliance with the measures, including the timeline in which they will make any necessary corrections.
2019 Quarter 2 Timely Access – Language Measures Results