FSRs are conducted to ensure that all contracted primary care provider (PCP) sites have sufficient capacity to provide appropriate primary health care services and can maintain patient safety standards and practices. The FSR also confirms the PCP site operates in compliance with all local, state, and federal laws and regulations. FSRs are conducted by DHCS-Certified Nurse Reviewers.
Physical Accessibility Review Survey Audit
PARS is a physical evaluation of a healthcare facility (“site”) that provides care to Medi-Cal members who are seniors and/or persons with disabilities (SPDs). These sites are Primary Care Provider sites, Community Based Adult Services sites, High Volume Specialist sites, or other Ancillary sites (as appropriate). PARS are conducted by DHCS Certified Auditors and other designated staff.
The onsite evaluation includes six areas: Parking; Exterior Building; Interior Building; Restroom; Exam Room; and Exam Table/Scale. The review establishes if the facility has Basic Access or Limited Access for members with disabilities.
PARS Standards and Tool and APL 12-006
Medi-Cal Managed Care Letters
Medi-Cal Managed Care communicates with Medi-Cal managed care plans (MCPs) by means of All Plan and Policy Letters.
All Plan Letters (APLs) are the means by which Medi-Cal Managed Care conveys information or interpretation of changes in policy or procedure at the Federal or State levels, and provides instruction to contractors, if applicable on how to implement these changes on an operational basis.
Policy Letters (PLs) provide guidance to MCPs about changes in Federal or State law and Regulation that affect the way in which they operate or deliver services to Medi-Cal beneficiaries.
Below are APLs and PLs that pertain to the Facility site review process and/or DHCS standards for FSR/MRR/PARS audit.
APL
|
Title
|
APL 16-014
|
Comprehensive Tobacco Prevention and Cessation Services for Medi-Cal Beneficiaries (Supersedes PL 14-006)
|
APL 18-016
|
Readability and Suitability of Written Health Education Materials (Supersedes APL 11-018)
|
APL 18-004
|
Immunization Requirements (Supersedes PL 96-013 and APL 07-015)
|
APL 18-018
|
Diabetes Prevention Program
|
APL 20-016
|
Blood Lead Screening of Young Children (Supersedes APL18-017)
|
APL 21-004
|
Standards for Determining Threshold Languages, Nondiscrimination Requirements, and Language Assistance Services
|
APL 21-009
|
Collecting Social Determinants of Health Data
|
APL 21-014
|
Alcohol and Drug Screening, Assessment, Brief Interventions and Referral to Treatment (Supersedes APL 18-014)
|
APL 22-017
|
Primary Care Provider Site Reviews: Facility Site Review and Medical Record Review (Supersedes APL 20-006)
|
APL 22-025
|
Responsibilities for Annual Cognitive Health Assessment for Eligible Members 65 Years of Age or Older
|
APL 22-030
|
Initial Health Appointment (Supersedes APL 13-017and Policy Letters 13-001 and 08-003)
|
APL 23-005
|
Requirements For Coverage of Early and Periodic Screening, Diagnostic, and Treatment Services for Medi-Cal Members Under the Age of 21 (Supersedes APL 19-010)
|
APL 23-017
|
Directed Payments for Adverse Childhood Experiences Screening Services (Supersedes APL 19-018)
|
APL 24-001
|
Street Medicine Provider: Definitions and Participation in Managed Care (Supersedes APL 22-023)
|