Report 2018-124 Recommendation 1 Responses

Report 2018-124: Gold Coast Health Plan: Its Reimbursements to Pharmacies Are Reasonable, but Its Pharmacy Benefits Manager Did Not Always Process Claims Correctly (Release Date: August 2019)

Recommendation #1 To: Gold Coast Health Plan

To ensure that the public clearly understands the commission's decisions, the commission should report its reasoning for awarding contracts with adequate detail or the legal basis, if any, for choosing not to do so.

6-Month Agency Response

On October 28, 2019, GCHP's Commission adopted a policy entitled Required Findings for Awards of Contract. Under this policy, GCHP Staff will include in staff reports recommending a contract award a statement of the rationale for awarding the contract to the recommended recipient. Pursuant to the policy, any motion to award the contract to the recommended recipient shall include the rationale from the staff report, unless a motion is made to change the rationale for the award, in which case the policy will require that the motion set forth the different rationale. If the Commission decides to award the contract to a different recipient than recommended in the staff report, the proposed policy will require that the Commission include in the motion for the award the rationale for choosing a different recipient. The policy does not require any individual Commissioner to disclose the basis for his or her vote to the extent that doing so constitutes inquiry into his or her individual deliberative process.

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

60-Day Agency Response

GCHP general counsel developed a policy which will be taken to the October 28, 2019 meeting for commission adoption.

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

All Recommendations in 2018-124

Agency responses received are posted verbatim.