Report 2013-119 Recommendation 22 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 #22 To: Health Care Services, Department of

To prevent the certification of ineligible providers, Health Care Services should immediately use a risk-based approach for recertifying program providers.

60-Day Agency Response

DHCS issued a provider bulletin on August 22, 2014 which designated all newly certifying DMC applicants and providers that submit applications for revalidation with the exception of DMC providers operated by governmental entities as high risk. All other DMC providers have been designated as moderate risk. The provider bulleting will become effective September 22, 2014.

California State Auditor's Assessment of 60-Day Status: Fully Implemented

Health Care Services has implemented a risk-based approach for recertifying program providers.

All Recommendations in 2013-119

Agency responses received are posted verbatim.