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.
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.
Health Care Services provided a copy of its updated analyst review guide that, if followed, would address this recommendation.
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.
Agency responses received are posted verbatim.