State Medicaid Managed Care Advisory Committee Network Adequacy and Access to Care Subcommittee

1. Welcome, roll call, and introductions. The meeting was convened by Arron Dead. A quorum was present. Members present: Arron Head, Ramsey Long Bothom, Lindsey Vasquez, Jennifer Vincent. 2. Network adequacy measures and report. UMCM 5.28.1 Access to Network Providers Performance Standards and Specifications UMCM 5.28.1 Access to Network Providers Performance Standards and Specifications outlines the performance standards and specifications for the Provider Categories monitored by HHSC for network adequacy. MCCO Monitoring: Network Adequacy Performance Report Network Adequacy Performance Reports are shared with the MCOs on a quarterly basis. Performance Reports for Q1-Q3 are used as a baseline to determine if an MCO should be placed on an action plan or Corrective Action Plan (CAP). Performance Reports for Q4 assess MCO compliance for Time or Distance. Based on MCO performance, a Network Adequacy Action Plan and/or CAP is requested in Q4. Network Adequacy