Report 2013-119 Recommendation 13 Responses

Report 2013-119: California Department of Health Care Services: Its Failure to Properly Administer the Drug Medi-Cal Treatment Program Created Opportunities for Fraud (Release Date: August 2014)

Recommendation #13 To: Health Care Services, Department of

To prevent the certification of ineligible providers, Health Care Services should immediately train its staff regularly on the program requirements, including the certification standards and the federal Medicaid provider enrollment requirements.

6-Month Agency Response

DHCS will continue to regularly train staff on program requirements, including certification standards and federal Medicaid provider enrollment requirements. Prior to beginning application review, all new PED staffs are trained on state and federal requirements for program participation. Further, effective July 2013, all staff that process DMC applications for continued certification or certification have been trained on the program requirements. Copies of the DMC certification standards, regulations, and federal requirements are provided to staff to use continually during application review. The PED managers for DMC enrollment meet each morning for a half hour, and the staff and managers meet three time a week to address issues and changes as a group. PED also conducts ongoing trainings as new issues are identified by the Total Quality Management Unit.

  • Completion Date: July 2013
  • Response Date: February 2015

California State Auditor's Assessment of 6-Month Status: Fully Implemented

Health Care Services provided a copy of its training schedule for Drug Medi-Cal and a powerpoint presentation describing the relevant requirements.

60-Day Agency Response

No update.

  • Completion Date: July 2013
  • Response Date: October 2014

California State Auditor's Assessment of 60-Day Status: No Action Taken

Although Health Care Services indicated that it has fully implemented this recommendation, it has not provided any information to indicate that it has taken any action on this recommendation.

All Recommendations in 2013-119

Agency responses received are posted verbatim.