Report 2013-119 Recommendation 26 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 #26 To: Health Care Services, Department of

To prevent the certification of ineligible providers, Health Care Services should immediately complete its program recertification on or before March 24, 2016, as federal regulations require.

Annual Follow-Up Agency Response From August 2017

DHCS completed its certification efforts in December 2016.

  • Completion Date: December 2016

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

Although Health Care Services asserts that it fully implemented this recommendation, it did not provide any documentation to support its assertion.

  • Auditee did not substantiate its claim of full implementation

Annual Follow-Up Agency Response From October 2016

DHCS is 95.6% completed with the continued certification efforts. There are 16 applications that need to be finalized before the project is completed. DHCS is in process of completing the final adjudication of 15 applications and one application was returned for a post onsite review and should be finalized by January 2017.

  • Estimated Completion Date: January 2017

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented


1-Year Agency Response

DHCS is on track to complete all DMC recertifications on or before the federally required date of March 24, 2016. On July 15, 2013, DHCS initiated the continued certification process by noticing certified Drug Medi-Cal (DMC) providers of the requirement to recertify. The continued certification process is occurring in phases and requires the submission of a complete application package with supporting documentation for review by DHCS. DHCS terminated the certifications of DMC providers that failed to respond timely to the request for continued certification.

  • Estimated Completion Date: March 2016
  • Response Date: August 2015

California State Auditor's Assessment of 1-Year Status: Pending

Date of implementation is set for March 2016.


6-Month Agency Response

DHCS is on track to complete all DMC recertifications on or before the federally required date of March 24, 2016. On July 15, 2013, DHCS initiated the continued certification process by noticing certified Drug Medi-Cal (DMC) providers of the requirement to re certify. The continued certification process is occurring in phases and requires the submission of a complete application package with supporting documentation for review by the Department.

DHCS terminated the certifications of DMC providers that failed to respond timely to the request for continue certification.

  • Estimated Completion Date: March 2016
  • Response Date: February 2015

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


60-Day Agency Response

No update.

  • Estimated Completion Date: March 2016
  • Response Date: October 2014

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

Based on its response, the department has not yet implemented this recommendation. In addition, 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.


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