Report 2022-502 Recommendation 3 Responses
Report 2022-502: Follow-Up: Children in Medi‑Cal: The Department of Health Care Services Is Still Not Doing Enough to Ensure That Children in Medi‑Cal Receive Preventive Health Services (Release Date: September 2022)
Recommendation #3 To: Health Care Services, Department of
To better ensure the accuracy of its data and ensure that California receives all available federal Medicaid funding, DHCS should require its External Quality Review Organization (external reviewer) to perform its encounter data validation studies annually using the most recent set of data available, and it should implement recommendations from its external reviewer studies.
Annual Follow-Up Agency Response From December 2023
The EDV report has been published and DHCS will continue to report annually. In response to some of the recommendations in the report, DHCS is directing more efforts into developing more robust monitoring programs to improve data completeness and accuracy; however, DHCS continues to conduct the report with the most recent data.
- Completion Date: August 2023
California State Auditor's Assessment of Annual Follow-Up Status: Pending
DHCS did not provide evidence to substantiate that it had fully implemented this recommendation.
- Auditee did not substantiate its claim of full implementation
1-Year Agency Response
The Encounter Data Validation report has been published, and DHCS is now working on developing a more robust monitoring program to assess encounter data and improve data completeness as recommended in the report.
- Completion Date: August 2023
- Response Date: November 2023
California State Auditor's Assessment of 1-Year Status: Pending
DHCS did not provide evidence to substantiate that it had fully implemented this recommendation.
- Auditee did not substantiate its claim of full implementation
6-Month Agency Response
Full implementation date is extended due to finalization efforts to the Encounter Data Validation report with the EQRO, which is in the final approval processes. Once complete, DHCS will work closely with MCPs to implement the recommendations and monitor improvement.
- Estimated Completion Date: 06/30/2023
- Response Date: April 2023
California State Auditor's Assessment of 6-Month Status: Pending
Per DHCS's response, it will not implement this recommendation until June 2023.
60-Day Agency Response
On January 1, 2023, the EQRO will publish EDV results, and DHCS will work with MCPs to implement recommendations and monitor improvement through EDV.
- Estimated Completion Date: 01/03/2023
- Response Date: November 2022
California State Auditor's Assessment of 60-Day Status: Pending
Per DHCS's response, it will not implement this recommendation until January 2023.
All Recommendations in 2022-502
Agency responses received are posted verbatim.