All PCP sites participating in the Medi-Cal Managed Care Program and the Medicare-Medicaid Plans are required by California Code of Regulations (22 CCR § 56230) and California Department of Health Care Services (DHCS) All Plan Letter 20-006 to 1) complete an initial FSR and subsequent periodic full scope reviews and 2) complete corrective action plans (CAPs) within DHCS-specified timelines for cited deficiencies.
Full scope reviews consist of completion of the DHCS Facility Site and Medical Record Review (FSR/MRR) and the Physical Accessibility Review Survey (PARS). FSRs are conducted to ensure that all contracted PCP sites have sufficient capacity to provide appropriate primary healthcare services and can maintain patient safety standards and practices. The FSR confirms the PCP site operates in compliance with all applicable local, state, and federal laws and regulations. MRRs are conducted to review medical records for format, legal protocols, and documented evidence of the provision of preventive care and coordination and continuity of care services. The medical record provides legal proof that the patient received care. PARS are conducted to assess the physical adequacy of provider sites that provide services to seniors and persons with disabilities.
Anthem Blue Cross (Anthem) has compiled a library of resources under the FSR, MRR, and PARS sections to help providers achieve a safe and effective provision of primary care services, to ensure and support the quality of care and documentation of appropriate clinical services, and to improve overall member health outcomes. Many documents were produced and developed by Anthem while others are sample or generic documents offered by external best practice sources that providers may customize to their needs. Resources also include links to public or government entity websites that offer further guidance and other valuable resources.