Report 2013-119 Recommendation 25 Responses
Report 2013-119: California Department of Health Care Services: Its Failure to Properly Administer the Drug Medi-Cal Treatment Program Created Opportunities for Fraud (Release Date: August 2014)
Recommendation #25 To: Health Care Services, Department of
To prevent the certification of ineligible providers, Health Care Services should immediately continue its implementation of an automated provider enrollment system.
Annual Follow-Up Agency Response From November 2018
DHCS has implemented Provider Application and Validation for Enrollment (PAVE) version 3.0, to prevent the certification of ineligible providers. https://www.dhcs.ca.gov/provgovpart/Pages/PAVE.aspx. PAVE allows Drug Medi-Cal providers to use the portal for enrollment needs. Through PAVE, DHCS is able to identify providers when their continued enrollment is due in accordance with federal requirements.
- Completion Date: September 2018
California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented
Health Care Services provided a link to its automated provider enrollment system's website, which notes that implementation of the current system was rolled out to Drug Medi-Cal providers.
Annual Follow-Up Agency Response From August 2017
DMC providers will be able to use PAVE phase/version 3.0 for their enrollment needs. This has been moved up from the original plan to include DMC providers in phase/version 3.5. PAVE phase/version 3.0 is expected to go live on January 23, 2018.
- Estimated Completion Date: 1/23/18
California State Auditor's Assessment of Annual Follow-Up Status: Pending
Date of implementation is set for January 23, 2018.
Annual Follow-Up Agency Response From October 2016
DHCS will continue its implementation of the automated provider enrollment system. The web-based enrollment system Provide Application and Validation for Enrollment (PAVE) system will be rolled out in phases. The initial implementation date is October 2016 with DMC providers added in the phase that is expected to go live in Fall of 2017.
- Estimated Completion Date: October 2017
California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented
1-Year Agency Response
DHCS will continue its implementation of the automated provider enrollment system. The projected final implementation date is December 2015; however, the automated monthly database checks began in the fall of 2014 for all providers enrolled in the PED PMF.
- Estimated Completion Date: December 2015
- Response Date: August 2015
California State Auditor's Assessment of 1-Year Status: Pending
Date of implementation is set for December 2015.
6-Month Agency Response
DHCS will continue its implementation of the automated provider enrollment system. The projected final implementation date is Summer 2015; however, the automated monthly database checks will begin in Fall 2014 for all providers enrolled in the PED PMF.
- Estimated Completion Date: Summer 2015
- Response Date: February 2015
California State Auditor's Assessment of 6-Month Status: Pending
60-Day Agency Response
No update.
- Estimated Completion Date: Spring 2015
- Response Date: October 2014
California State Auditor's Assessment of 60-Day Status: No Action Taken
Based on its response, the department has not yet implemented this recommendation. In addition, it has not provided any information to indicate that it has taken any action on this recommendation.
All Recommendations in 2013-119
Agency responses received are posted verbatim.