To ensure that the State pays only for deliverables performed by Delta Dental under the terms of its contract, Health Care Services should immediately take these steps: ensure that the financial manual and invoices are consistent with contract language.
The Department of Health Care Services (DHCS) upheld its commitment to ensure that its financial manual and invoices are consistent with contract language. On April 21, 2015, DHCS issued an instruction letter to its fiscal intermediary to include the beneficiary and provider outreach plans as precedent to payment conditions to the Financial Manual. DHCS will monitor the implementation of the provider and beneficiary outreach plans through this mechanism.
Health Care Services provided its letter dated April 21, 2015, directing Delta Dental to amend the financial manual to include the beneficiary and provider outreach and education plans as precedent to payment. It also provided copies of the 2015 beneficiary and provider outreach and education plans.
DHCS is in the process of evaluating existing financial manual provisions and invoice payment mechanisms with the requirements delineated in the contract with Delta Dental. DHCS will process the necessary documents to align manuals and invoices with the contract. The DHCS will implement this recommendation by May 1, 2015.
†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.