Report 2013-119 Recommendation 28 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 #28 To: Health Care Services, Department of

To ensure that it appropriately and consistently reviews provider applications and conducts site visits, Health Care Services should update its program checklists to reflect the current federal and state laws and regulations.

6-Month Agency Response

As part of PED's existing process, reviews are conducted with the aid of a set of checklists designed to ensure review is completed in adherence to current federal and state laws and regulations. Effective July 2013 for all DMC providers targeted for continued certification, and effective January 2014 for new and backlogged certification applicants, staff review applications with the aid of checklists that were developed specifically for DMC applicants and, where appropriate, mirror requirements for all other FFS providers. DHCS will continue to update these checklists periodically as necessary to reflect any future changes in law or regulation.

  • 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 updated analyst review guide that, if followed, would address this recommendation.

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.