Measurement Year 2018

Timely Access All Plan Letters

Health Plans are required to submit a Timely Access Compliance Report by March 31 of each year. The DMHC will issue the standardized methodology, survey tool, submission instructions and templates for measuring and submitting the rates of compliance with appointment time-elapsed standards, in accordance with Health and Safety Code section 1367.03, subd. (f)(3) and Rule 1300.67.2.2, subd. (g)(2).

All Plan Letter - January 19, 2018 (Issued on 01/19/18)

All Plan Letter - April 7, 2017 (Supersedes APL issued on 02/13/17)

MY 2018 Annual Timely Access Compliance Report Submission Methodology, Templates and Tools

Health Plans are required to submit a Timely Access Compliance Report by March 31 of each year. The items required to be submitted as part of this annual report are set forth in the Timely Access Compliance Report Instructions below.

For measuring and reporting rates of compliance with appointment time-elasped standards, pursuant to Health and Safety Code section 1367.03, subd. (f)(3), the DMHC published a standardized methodology, the Provider Appointment Availability Survey (PAAS) Methodology.

Steps for submitting Timely Access Compliance Report (Sections A-F):

1. Read the MY 2018 Timely Access Compliance Report Instructions. (Issued 03/09/18)

2. Read the MY 2018 PAAS Methodology. (Rev. 04/16/18)

3. Read the MY 2018 PAAS Survey Tool and PAAS Template Instructions:

MY 2018 PAAS - Survey Tool

MY 2018 PAAS - Provider Contact List Templates

MY 2018 PAAS - Raw Data Templates

MY 2018 PAAS - Results Templates

4. Conduct the survey utilizing the DMHC's PAAS Templates and Survey Tool, set forth above.

5. Complete the PAAS Templates, which are available and must be submitted in a "locked" Excel format. (All health plans submitting a Timely Access Compliance Report must utilize the PAAS Methodology and submit a Provider Contact List, Raw Data, and Results Templates for each provider type in section B of the DMHC's Timely Access Web Portal.)

6. Conduct the Quality Assurance Review and draft the Quality Assurance Report, Health Plan Response to items identified in the Quality Assurance Report, and Addendum(s).

7. Submit all Timely Access Compliance Report documents in accordance with the MY 2018 Timely Access Compliance Report Instructions via the DMHC's Timely Access Web Portal. (See Health and Safety Code section 1367.03, subds. (f)(2)-(3) and California Code of Regulations, title 28, section 1300.67.2.2, subds. (g)(2)(A)-(F).)

Measurement Year 2017

MY 2017 Annual Timely Access Compliance Report Submission Methodology,Templates and Tools

Health Plans are required to submit a Timely Access Compliance Report by March 31 of each year. The items required to be submitted as part of this annual report are set forth in the Timely Access Compliance Report Instructions below. The DMHC has two standardized methodologies, the Provider Appointment Availability Survey Methodology and the Audit Methodology, for measuring and reporting rates of compliance with appointment time-elapsed standards, pursuant to Health and Safety Code section 1367.03, subd. (f)(3).

Steps for Submitting Timely Access Compliance Reports (Sections A-F):

  1. Read the MY 2017 Timely Access Compliance Report Instructions. (Rev. 09/15/17)
  2. Read the MY 2017 Provider Appointment Availability Survey Methodology. (Issued 04/04/17)
  3. Conduct the survey utilizing the DMHC's tools and reporting templates for MY 2017. The following reporting templates are in a "locked" Excel format. All health plans utilizing the survey methodology must submit Raw Data and Provider Contact List for each provider type using these templates in section B.2: "Raw Data and Provider Contact List" in the DMHC's web portal.

MY 2017 Provider Appointment Availability Survey - Survey Tool:

MY 2017 Provider Appointment Availability Survey - Provider Contact List Templates:

MY 2017 Provider Appointment Availability Survey - Raw Data Templates:

  1. Use the MY 2017 Results Templates by relevant provider type when reporting results for section B.3: "Rate of Compliance with the Time-Elapsed Standards" in the DMHC's web portal.
  1. Submit documents per instructions via the DMHC's Timely Access web portal. (You may download the optional MY 2017 D. Advanced Access Form to report provider groups.)

Audit Templates

Pursuant to Health and Safety Code section 1367.03, subd. (f)(3), DMHC has adopted two standardized methodologies that health plans may use to report compliance with the required appointment wait time standards for Measurement Year 2017. Health plans have not elected to use the manual audit methodology for MY 2017. As a result, the DMHC has not selected the dates in each calendar quarter to collect the data. The Provider Appointment Audit Methodology for MY 2017 will be published in June of 2017.

Measurement Year 2016

Timely Access Report

The Measurement Year 2016 ("MY 2016") Timely Access Report, published by the DMHC pursuant to Health and Safety Code 1367.03, subd. (i), the corresponding MY 2016 Timely Access Data and Timely Access Data and Timely Access to Care Fact Sheet are posted below.

MY 2016 Timely Access Report

NOTE: As reported in the MY 2016 Timely Access Report, to ensure the reliability of the Timely Access Data submitted by plans, the report displays data with sampling errors of 5% or less. Some charts combine information for more than one provider tye or appointment wait time standard in order to remain at or below the 5% sampling error. In some cases, the Timely Access Data shown in the report was adjusted by the DMHC's statisticians to remove data inconsistencies to allow DMHC to compare survey results across health plans. For more information on the statistical adjustments to the Timely Access Data see Appendix A in the Timely Access Report.

MY 2016 Timely Access Data

NOTE: The MY 2016 Timely Access Data is as reported by the plans and does not reflect adjustments by the DMHC's statisticians. For more information on the statistical adjustments to the Timely Access Data see Appendix A in the Timely Access Report.

Survey Tools

Survey Templates

Audit Templates

Measurement Year 2015

Timely Access Report

The Measurement Year 2015 ("MY 2015") Timely Access Report, published by the DMHC pursuant to Health and Safety Code 1367.03, subd. (i), the corresponding MY 2015 Timely Access Data, the Timely Access Fact Sheet and the All Plan Letter, issued February 14, 2017, are posted below.

MY 2015 Timely Access Report

MY 2015 Timely Access Data (NOTE: As reported in the MY 2015 Timely Access Report, 90 percent of health plans' 2015 Timely Access Compliance Reports submitted to the DMHC contained one or more significant errors or data inaccuracies, making it virtually impossible for the DMHC to measure individual health plan compliance and compare health plans across the industry.)

Survey Tools

Steps for submitting Timely Access Compliance Report (A-F data):

1.  Read the MY 2015 Timely Access Compliance Report Instructions

2.  Please use the MY 2015 templates by relevant provider type when reporting results for section B.3 Data Source: Appointment Availability Audit/Survey in the DMHC's web portal.

3.  Submit documents per instructions via the DMHC's web portal (You may download the D. Advanced Access Form (optional) to report provider groups).

Audit Templates

Provider Appointment Manual Audit Dates

Rule 1300.67.2.2, subd (g)(2)(B) requires health plans to report a rate of compliance with several appointment wait time standards. Pursuant to SB 964 and Section 1367.03, subd (f)(3), DMHC has adopted two standardized methodologies that plans may use to report compliance with the required appointment wait time standards for Measurement Year 2015 (“MY2015”).

Plans conducting a manual audit using the DMHC MY2015 Provider Appointment Audit Methodology will perform appointment availability audits on four days during MY2015, one day in each calendar quarter of the year. After the close of each calendar quarter, DMHC will post on its website a notification of one date from the quarter for which data shall be collected. Data should be collected for each date soon after it is posted on DMHC’s website to allow plans to use the data for ongoing monitoring and to ensure that data systems are not purged before collection is accomplished.

For MY2015, the first two audit dates are:

First quarter: Wednesday, February 11, 2015

Second quarter: Tuesday