Report 2014-134 Recommendation 11 Responses

Report 2014-134: California Department of Health Care Services: Improved Monitoring of Medi-Cal Managed Care Health Plans Is Necessary to Better Ensure Access to Care (Release Date: June 2015)

Recommendation #11 To: Managed Health Care, Department of

To make certain that Managed Health Care complies with its contractual obligations, it should continue its plan to perform quarterly reviews of the adequacy of provider networks beginning with the first quarter of 2015.

60-Day Agency Response

In response to the State Auditor's recommendation, the DMHC has taken steps to ensure the quarterly review of Medi-Cal networks in the 28 rural counties. This review is in addition to the quarterly Medi-Cal network reviews for the 30 original counties it has conducted since 2011.

At this time, the DMHC has completed its review of the Medi-Cal networks in all 58 counties for the first quarter of 2015. These network assessments were submitted to the Department of Health Care Services on July 31, 2015. Given the process and staffing improvements, the DMHC is well positioned to continue conducting quarterly reviews of the Medi-Cal networks in all 58 counties on an ongoing basis.

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

All Recommendations in 2014-134

Agency responses received are posted verbatim.