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: develop and implement tangible measurements to evaluate Delta Dental's performance of all functions under the contract.
DHCS has fully implemented this recommendation. The identified areas requiring tangible measures, namely the provider and beneficiary outreach provisions of the contract, have been satisfied through the fiscal intermediary's submission of the outreach deliverables.
Based on documents that Health Care Services submitted to demonstrate its implementation of Recommendations 11 through 16 of this audit report, we consider Recommendation 17 fully implemented.
On May 1, 2015, the Department of Health Care Services (DHCS) completed the identification of contract provisions without tangible measurements for evaluating the Fiscal Intermediary's (FI) performance of all functions under the contract. However, implementation of the tangible measurements identified through this process will require an additional 90 days and will be implemented by August 2015.
DHCS is in the process of developing tangible measurements to evaluate Delta Dental's performance of all functions under the contract beyond the existing deliverable structure. The measurements can be developed by May 1, 2015, but will require an additional 90 days to implement. (Summer 2015)
Agency responses received are posted verbatim.