Report 2014-134 Recommendation 2 Responses

Report 2014-134: California Department of Health Care Services: Improved Monitoring of Medi-Cal Managed Care Health Plans Is Necessary to Better Ensure Access to Care (Release Date: June 2015)

Recommendation #2 To: Health Care Services, Department of

To make certain that it can provide support for its review process related to the adequacy of provider networks, Health Care Services should maintain for three years all documentation that supports its provider network certifications.

6-Month Agency Response

DHCS has instituted a new certification and document storage process. A new "network certification" folder has been added to the DHCS internal drive where documents are archived. All pertinent readiness material, including network certification documents are being saved in this folder. This process will initially be used in the certifying health plan networks for transitioning the responsibility of behavioral health treatment services to managed care no sooner than February 1, 2016.

  • Completion Date: October 2015
  • Response Date: December 2015

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

60-Day Agency Response

DHCS is developing a formal process to store all documents used to certify Medi-Cal managed care health plan networks for at least three years. DHCS will next complete a network certification in the end of 2015. Documents will be stored for at least three years following the certification. This same process will be used for all certifications moving forward.

  • Estimated Completion Date: December 2015
  • Response Date: August 2015

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

All Recommendations in 2014-134

Agency responses received are posted verbatim.