To make certain that Health Care Services complies with state law requiring it to conduct annual medical audits, it should finish developing and begin adhering to its schedule for auditing all health plans in fiscal year 2015-16.
DHCS audited 21 of the 22 MCPs during State Fiscal Year 15-16. One MCP will be audited in the beginning of SFY 16-17. Moving forward all MCPs will be audited annually.
All Medi-Cal managed care health plans will be audited during State Fiscal Year 15-16 and annually thereafter.
DHCS has expanded audit resources and all Medi-Cal managed care health plans are scheduled for audit during Fiscal Year 15-16.
Health Care Services did not provide any documentation to support its response.
Agency responses received are posted verbatim.