Report 2014-134 Recommendation 12 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 #12 To: Managed Health Care, Department of

To make certain that Managed Health Care complies with its contractual obligations, it should monitor workload closely, and it should justify and request additional staff if it determines it does not have adequate staffing to perform quarterly reviews.

60-Day Agency Response

The DMHC has improved its network review tools and technologies to allow for more efficient review of these Medi-Cal networks. The DMHC has also established two new positions in its Office of Licensing, Division of Provider Networks: an Associate Health Program Advisor and a Health Program Specialist. These positions will, among other duties, assist in the quarterly review of the Medi-Cal networks in the 28 rural counties.

• Completion Date: July 2015
• Response Date: August 2015

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

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All Recommendations in 2014-134

Agency responses received are posted verbatim.