Report 2013-125 Recommendation 23 Responses

Report 2013-125: California Department of Health Care Services: Weaknesses in Its Medi-Cal Dental Program Limit Children's Access to Dental Care (Release Date: December 2014)

Recommendation #23 To: Health Care Services, Department of

To ensure that Health Care Services and its fiscal intermediaries reimburse providers only for services rendered to eligible beneficiaries, Health Care Services should obtain Social Security's Death Master File and update monthly its beneficiary eligibility system with death information.

Annual Follow-Up Agency Response From September 2017

DHCS issued a letter on January 12, 2017 to all counties reaffirming the instruction to check MEDS alerts for SSN verifications that failed to match. The county must take appropriate steps to verify the accuracy of the SSN should it fail an electronic verification.

  • Completion Date: January 2017

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Health Care Services' response does not address obtaining Social Security's Death Master File. When we followed up with Health Care Services' staff, they asserted that Health Care Services now obtains a monthly update of the Death Master File, but it has not yet implemented a process to match its eligibility system against these updates.

  • Auditee did not substantiate its claim of full implementation
  • Auditee did not address all aspects of the recommendation

Annual Follow-Up Agency Response From November 2016

DHCS-Eligibility Division is actively working towards the implementation of a monthly update from the SSA Death Master File. We believe the audit finding was caused by applicants using fraudulent or erroneous SSNs not the frequency of the death file from SSA. DHCS will issue a policy letter to counties reminding them to follow-up on MEDS alerts when SSNs fail verification. The anticipated completion date of this letter is December 19, 2016.

  • Estimated Completion Date: December 2016

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented


1-Year Agency Response

DHCS maintains its forecast that the improvements will be in place on or before April 30, 2016.

  • Estimated Completion Date: April 2016
  • Response Date: December 2015

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


6-Month Agency Response

The Department of Health Care Services (DHCS) is continuing to work on improving the ability to detect unreported beneficiary deaths. Over the last 60 days, DHCS has identified and evaluated numerous federal, state, private, and direct reporting sources. Based on this evaluation, DHCS maintains its forecast that the improvements will be in place on or before April 30, 2016. These improvements include the acquisition, testing, and roll out of new sources and the improvement of existing sources.

  • Estimated Completion Date: April 2016
  • Response Date: July 2015

California State Auditor's Assessment of 6-Month Status: Pending


60-Day Agency Response

DHCS intends to increase the frequency of updates to the Medi-Cal Eligibility Data System (MEDS) with the Social Security Administration's Death Master File from quarterly to monthly. The request to increase the frequency to monthly was already in progress and will most likely require an amendment to the existing DHCS/SSA information sharing agreement. The implementation date of April 30, 2016 accounts for the development and testing needed to complete this request.

  • Estimated Completion Date: April 2016
  • Response Date: February 2015

California State Auditor's Assessment of 60-Day Status: Pending


All Recommendations in 2013-125

Agency responses received are posted verbatim.


Report type

Report type
















© 2013, California State Auditor | Privacy Policy | Conditions of Use | Download Adobe PDF Reader