To ensure that the providers receive reimbursement for only valid services, Health Care Services should immediately ensure that each county has a process in place to follow up on their providers' implementation of corrective action plans aimed at resolving program deficiencies.
The statement, "Describe the County's process for ensuring that provider's corrective action plans are submitted and implemented as required. Please provide documentation that demonstrates the County's monitoring process for provider corrective action plans." (pg. 40, question 9 & 9a) was added to the 14/15 County Monitoring Instrument. Fifty-seven county reviews to the State-County contract were completed by June 30, 2015. Twenty-five counties had effective CAP monitoring systems in place while all remaining counties were provided technical assistance to strengthen their system or create one. DHCS staff created a form available on the Department's website for county staff to complete and submit to DHCS via email certifying Drug Medi-Cal CAPs have been implemented by their programs.
DHCS provided documentation showing that it updated its County Monitoring Instrument with instructions for counties to demonstrate their process for monitoring corrective action plans. In addition, DHCS now requires counties to certify that Drug Medi-Cal providers have fully implemented all corrective actions designed to resolve program deficiencies.
All counties will be reviewed by June 30, 2015.
See Attachment A
The statement "Describe the County's process for ensuring that provider's corrective action plans are submitted and implemented as required. Please provide documentation that demonstrates the County's monitoring process for provider corrective action plans." (pg. 40, question 9) has been added to the 14/15 County Monitoring Instrument (attached). Reviews of county compliance with ensuring their DMC providers' CAPs are implemented will begin in September 2014
We agree that it has adjusted the county monitoring instrument as indicated; however, Health Care Services has not yet implemented this recommendation.
†Response Type refers to the interval in which the auditee is providing the State Auditor with their status in implementing recommendations made in an audit report. Auditees must submit a response regarding their progress in implementing recommendations from our reports at three intervals from the release of the report: 60 days, six months, and one year or subsequent to one year.
*Agency responses received after June 2013 are posted verbatim.