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22-1093 Facility Site Review and Medical Record Review Changes

Health Net·CA · Family Medicine, Internal Medicine, Pediatrics·Prior Authorization
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

DHCS updated facility site review (FSR) and medical record review (MRR) policies with new criteria and timelines. Key changes include expanded screening requirements for initial health assessments, blood lead screening, autism screening, and maternal depression screening, plus new corrective action plan deadlines.

Action Required

Action needed
Immediately: Review updated FSR/MRR criteria in Provider Library > Provider Manual > Quality Improvement. Ensure initial health assessments are completed within 120 days of member enrollment. Update screening protocols for blood lead, autism disorder, and maternal depression. For any cited deficiencies: Submit corrective action plans (CAPs) within 30 calendar days of review and close non-critical CAPs within 90 calendar days. Contact Pam Carpenter or Plan FSR representative with questions.