To ensure that it appropriately and consistently reviews provider applications and conducts site visits, Health Care Services should retain the documentation, such as checklists, that it uses to support its certification decisions in accordance with its retention policy.
DHCS currently retains, in accordance with its retention policy, the documentation that it uses to support certification decisions. The PED Document Management System (DMS) is a computer program developed in 2001 and was designed for the purpose of maintaining a complete electronic record of all documents received by PED. All applicant-submitted documents, PED working papers, correspondence to and from providers, Special Claims Review action letters, A&I findings, and other miscellaneous documents are scanned into DMS to maintain a permanent record. Additionally, PETS and PETSII are programs that maintain dates, notes, and all action items made on an application. All application review requires extensive usage of at least two of these programs. Any documents associated with approved applications for DMC continued certification or new certification will also be maintained in DMS.
Since the time of our audit, Health Care Services has taken over the certification of Drug Medi-Cal providers and it retains those applications electronically. Previously, these applications were stored in hardcopy and Health Care Services was unable to locate the applications for our audit. If Health Care Services continues to use its Document Management System to store these records electronically, it 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.