Report 2007-122 Recommendation 1 Responses

Report 2007-122: Department of Health Care Services: Although Notified of Changes in Billing Requirements, Providers of Durable Medical Equipment Frequently Overcharged Medi-Cal (Release Date: June 2008)

Recommendation #1 To: Health Care Services, Department of

To maintain control over the cost of reimbursements, Health Care Services should develop an administratively feasible means of monitoring and enforcing current Medi-Cal billing and reimbursement procedures for medical equipment. If unsuccessful, Health Care Services should consider developing reimbursement caps for medical equipment that are more easily administered.

Annual Follow-Up Agency Response From October 2012

The California Department of Health Care Services (DHCS) continues to maintain control over the cost of reimbursement through the application of edits and audits to claims for payment submitted to the fiscal intermediary consistent with Medi-Cal policy. Additionally, DHCS conducts a variety of post-payment audits to monitor and enforce Medi-Cal billing and reimbursement procedures for medical equipment. As a result of these efforts it is not necessary to implement reimbursement caps for medical equipment.

  • Completion Date: October 2012

California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented

All Recommendations in 2007-122

Agency responses received after June 2013 are posted verbatim.

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