MedicaidAdministrativeMedium impact
23-1463m Keep with Behavior Access Standards Performance Targets to Align with Plan Goals
Health Net·CA · Psychiatry·Prior Authorization
We identified it
Jun 20, 2026
Summary
CalViva Health has updated behavioral health appointment access standards to align with DMHC requirements, establishing specific performance targets for urgent care (48 hours), non-urgent psychiatrist appointments (15 business days), and non-physician behavioral health provider appointments (10 business days). The policy sets compliance rates of 70-90% for various appointment types and applies to Medi-Cal plans in Fresno, Kings, and Madera counties.
Action Required
Immediately: Behavioral health providers must ensure appointment scheduling meets new access standards - urgent appointments within 48 hours (70% compliance), non-urgent psychiatrist appointments within 15 business days (70% compliance), and non-physician provider appointments within 10 business days (70% compliance). Update scheduling systems and staff training to track and meet these performance targets. Monitor compliance rates as they will be assessed through annual Provider Appointment Availability Survey (PAAS).