Report 2014-134 Recommendation 9 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 #9 To: Health Care Services, Department of
To make certain that Health Care Services complies with state law requiring it to conduct annual medical audits, it should finish developing and begin adhering to its schedule for auditing all health plans in fiscal year 2015-16.
Annual Follow-Up Agency Response From November 2018
DHCS has developed and adheres to its schedule for auditing all MCP's annually. During SFY 2017-18, DHCS has audited 24 out of 24 MCPs. 5 of the 24 MCPs audited are still in progress. DHCS will continue to audit MCPs annually.
- Completion Date: July 2016
California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented
1-Year Agency Response
DHCS audited 21 of the 22 MCPs during State Fiscal Year 15-16. One MCP will be audited in the beginning of SFY 16-17. Moving forward all MCPs will be audited annually.
- Estimated Completion Date: On-going audits
- Response Date: June 2016
California State Auditor's Assessment of 1-Year Status: Pending
6-Month Agency Response
All Medi-Cal managed care health plans will be audited during State Fiscal Year 15-16 and annually thereafter.
- Estimated Completion Date: End of 2016
- Response Date: December 2015
California State Auditor's Assessment of 6-Month Status: Pending
60-Day Agency Response
DHCS has expanded audit resources and all Medi-Cal managed care health plans are scheduled for audit during Fiscal Year 15-16.
- Estimated Completion Date: July 2016
- Response Date: August 2015
California State Auditor's Assessment of 60-Day Status: Pending
Health Care Services did not provide any documentation to support its response.
All Recommendations in 2014-134
Agency responses received are posted verbatim.