Report 2011-104 Recommendations and Responses in 2015-041

Report 2011-104: Medi-Cal Managed Care Program: The Departments of Managed Health Care and Health Care Services Could Improve Their Oversight of Local Initiatives Participating in the Medi-Cal Two-Plan Model

Department Number of Years Reported As Not Fully Implemented Total Recommendations to Department Not Implemented After One Year Not Implemented as of 2014-041 Response Not Implemented as of Most Recent Response
Department of Health Care Services 3 4 2 1 1

Recommendation To: Health Care Services, Department of

Health Care Services should ensure that it performs annual medical audits of local initiatives as required by law.

Response

MRB has fully implemented the annual medical audits for each of the previously existing 21 Medi-Cal managed care plans. A 22nd plan opened and will be audited in the subsequent year as well. DHCS is fully integrated with the Department of Managed Health Care (DMHC) to coordinate and conduct joint audits. As the DMHC is on a triennial cycle, approximately every third MRB audit is a joint endeavor. DHCS has published the reports on the Managed Care Quality and Monitoring Division's website.

  • California State Auditor's Assessment of Status: Partially Implemented
  • Estimated Completion Date: March 2015
  • Response Date: October 2015

Current Status of Recommendations

All Recommendations in 2015-041