To prevent the certification of ineligible providers, Health Care Services should immediately train its staff regularly on the program requirements, including the certification standards and the federal Medicaid provider enrollment requirements.
DHCS will continue to regularly train staff on program requirements, including certification standards and federal Medicaid provider enrollment requirements. Prior to beginning application review, all new PED staffs are trained on state and federal requirements for program participation. Further, effective July 2013, all staff that process DMC applications for continued certification or certification have been trained on the program requirements. Copies of the DMC certification standards, regulations, and federal requirements are provided to staff to use continually during application review. The PED managers for DMC enrollment meet each morning for a half hour, and the staff and managers meet three time a week to address issues and changes as a group. PED also conducts ongoing trainings as new issues are identified by the Total Quality Management Unit.
Health Care Services provided a copy of its training schedule for Drug Medi-Cal and a powerpoint presentation describing the relevant requirements.
Although Health Care Services indicated that it has fully implemented this recommendation, it has not provided any information to indicate that it has taken any action on this recommendation.
Agency responses received are posted verbatim.