To prevent the certification of ineligible providers, Health Care Services should immediately use a risk-based approach for recertifying program providers.
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.
Health Care Services has implemented a risk-based approach for recertifying program providers.
Agency responses received are posted verbatim.