Report 2013-125 Recommendation 16 Responses

Report 2013-125: California Department of Health Care Services: Weaknesses in Its Medi-Cal Dental Program Limit Children's Access to Dental Care (Release Date: December 2014)

Recommendation #16 To: Health Care Services, Department of

To ensure that the State pays only for deliverables performed by Delta Dental under the terms of its contract, Health Care Services should immediately take these steps: ensure that the financial manual and invoices are consistent with contract language.

6-Month Agency Response

The Department of Health Care Services (DHCS) upheld its commitment to ensure that its financial manual and invoices are consistent with contract language. On April 21, 2015, DHCS issued an instruction letter to its fiscal intermediary to include the beneficiary and provider outreach plans as precedent to payment conditions to the Financial Manual. DHCS will monitor the implementation of the provider and beneficiary outreach plans through this mechanism.

  • Completion Date: May 2015
  • Response Date: July 2015

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

Health Care Services provided its letter dated April 21, 2015, directing Delta Dental to amend the financial manual to include the beneficiary and provider outreach and education plans as precedent to payment. It also provided copies of the 2015 beneficiary and provider outreach and education plans.


60-Day Agency Response

DHCS is in the process of evaluating existing financial manual provisions and invoice payment mechanisms with the requirements delineated in the contract with Delta Dental. DHCS will process the necessary documents to align manuals and invoices with the contract. The DHCS will implement this recommendation by May 1, 2015.

  • Estimated Completion Date: May 2015
  • Response Date: February 2015

California State Auditor's Assessment of 60-Day Status: Pending


All Recommendations in 2013-125

Agency responses received are posted verbatim.