Report 2013-119 Recommendation 26 Responses

Report 2013-119: California Department of Health Care Services: Its Failure to Properly Administer the Drug Medi-Cal Treatment Program Created Opportunities for Fraud (Release Date: August 2014)

Recommendation #26 To: Health Care Services, Department of

To prevent the certification of ineligible providers, Health Care Services should immediately complete its program recertification on or before March 24, 2016, as federal regulations require.

Agency Response*

DHCS is 95.6% completed with the continued certification efforts. There are 16 applications that need to be finalized before the project is completed. DHCS is in process of completing the final adjudication of 15 applications and one application was returned for a post onsite review and should be finalized by January 2017.

  • Response Type†: Annual Follow Up
  • Estimated Completion Date: January 2017
  • Response Date: October 2016

California State Auditor's Assessment of Status: Not Fully Implemented


Agency Response*

DHCS is on track to complete all DMC recertifications on or before the federally required date of March 24, 2016. On July 15, 2013, DHCS initiated the continued certification process by noticing certified Drug Medi-Cal (DMC) providers of the requirement to recertify. The continued certification process is occurring in phases and requires the submission of a complete application package with supporting documentation for review by DHCS. DHCS terminated the certifications of DMC providers that failed to respond timely to the request for continued certification.

  • Response Type†: 1-Year
  • Estimated Completion Date: March 2016
  • Response Date: August 2015

California State Auditor's Assessment of Status: Pending

Date of implementation is set for March 2016.


Agency Response*

DHCS is on track to complete all DMC recertifications on or before the federally required date of March 24, 2016. On July 15, 2013, DHCS initiated the continued certification process by noticing certified Drug Medi-Cal (DMC) providers of the requirement to re certify. The continued certification process is occurring in phases and requires the submission of a complete application package with supporting documentation for review by the Department.

DHCS terminated the certifications of DMC providers that failed to respond timely to the request for continue certification.

  • Response Type†: 6-Month
  • Estimated Completion Date: March 2016
  • Response Date: February 2015

California State Auditor's Assessment of Status: Pending


Agency Response*

No update.

  • Response Type†: 60-Day
  • Estimated Completion Date: March 2016
  • Response Date: October 2014

California State Auditor's Assessment of Status: No Action Taken

Based on its response, the department has not yet implemented this recommendation. In addition, it has not provided any information to indicate that it has taken any action on this recommendation.


All Recommendations in 2013-119

†Response Type refers to the interval in which the auditee is providing the State Auditor with their status in implementing recommendations made in an audit report. Auditees must submit a response regarding their progress in implementing recommendations from our reports at three intervals from the release of the report: 60 days, six months, and one year or subsequent to one year.

*Agency responses received after June 2013 are posted verbatim.


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