Report 2006-110 Recommendation 10 Responses

Report 2006-110: Department of Health Services: It Needs to Improve Its Application and Referral Processes When Enrolling Medi-Cal Providers (Release Date: April 2007)

Recommendation #10 To: Health Services, Department of

The branch and the Medical Review Branch, with direction from the department, should place increased emphasis on processing those applications referred for further review within a reasonable time period, to ensure that some eligible Medi-Cal providers are not unreasonably delayed from providing services to beneficiaries.

1-Year Agency Response

The branch reports that it updated the reasons applications are referred in the PETS to accurately reflect the referral indicators, which it asserts was completed in March 2008. Further, the branch asserts that it implemented new procedures in June 2007 to ensure that applications referred for comprehensive review are processed within 60 days of receipt of the onsite report from the Medical Review Branch. Finally, the branch claims that it will contact the Medical Review Branch within six months after a referral has been made to obtain status of any outstanding issues and perform a quarterly reconciliation of outstanding cases between the branch and the Medical Review Branch. (2009-406, p. 191)

California State Auditor's Assessment of 1-Year Status: Fully Implemented

All Recommendations in 2006-110

Agency responses received after June 2013 are posted verbatim.