CHA News

Managed Care Plans to Face Sanctions from DHCS for Poor Performance

This post has been archived and contains information that may be out of date.

What’s happening: Medi-Cal managed care plans (MCPs) will face sanctions from the Department of Health Care Services (DHCS) for failing to meet quality performance standards. 

What else to know: DHCS has issued All Plan Letter (APL) 23-012, which updates and clarifies the policy on the imposition of administrative and monetary sanctions to plans that fail to meet minimum performance for required quality performance measures. 

APL 23-012 describes how the monetary penalties will be calculated, taking into consideration the nature, scope, and gravity of the violation, the degree to which the MCP is below the required minimum performance level, and whether the identified issue has improved over time.