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.

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.