Report 2018-111 Recommendation 7 Responses
Report 2018-111: Department of Health Care Services: Millions of Children in Medi-Cal Are Not Receiving Preventive Health Services (Release Date: March 2019)
Recommendation #7 To: Health Care Services, Department of
To ensure that children in Medi-Cal have access to all of the preventive services for which they are eligible, DHCS should modify by May 2019 its contracts to make it clear to plans and providers that they are required to provide services according to Bright Futures.
Annual Follow-Up Agency Response From October 2021
DHCS submitted contract updates to CMS on December 30, 2020. DHCS is working on obtaining signatures from MCPs to submit to CMS. The revised language focused on the importance of providing preventive care services according to Bright Futures schedules. Language was added to specifically include the periodicity timeline/schedule established by AAP Bright Futures. Additional contract language was added to clarify requirements for medically necessary services.
- Completion Date: December 2020
California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented
Annual Follow-Up Agency Response From November 2020
As previously reported, DHCS has drafted contract language which addresses EPSDT. DHCS agrees to provide confirmation to CSA in the next update to confirm the Managed Care Plan (MCP) contract has been submitted to CMS with updates to address EPSDT. The target date for submission is December 2020.
- Estimated Completion Date: December 2020
California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented
We are continuing to assess this recommendation as partially implemented, given the steps taken by DHCS as reported in its six-month response. We will review the updated contract language when DHCS has finalized it.
1-Year Agency Response
DHCS has drafted contract language which addresses EPSDT. This language will be submitted to CMS by the end of 2020.
- Estimated Completion Date: December 2020
- Response Date: March 2020
California State Auditor's Assessment of 1-Year Status: Partially Implemented
We are continuing to assess this recommendation as partially implemented, given the steps taken by DHCS as reported in its six-month response. We will review the updated contract language when DHCS has finalized it.
6-Month Agency Response
DHCS released an updated EPSDT APL with enhanced language regarding Bright Futures for MCP, stakeholder, and advocate feedback. DHCS has reviewed all stakeholder feedback and made appropriate changes to the APL. The APL was published in August 2019 and has been posted under the following link: https://www.dhcs.ca.gov/formsandpubs/Pages/AllPlanLetters.aspx
- Completion Date: August 2019
- Response Date: September 2019
California State Auditor's Assessment of 6-Month Status: Partially Implemented
Although DHCS has released its All-Plan Letter (APL), it has not updated the contracts to eliminate the unclear language in the contracts that we discuss on page 29 of our report. DHCS informed us that it intends to update the contracts in November 2019.
- Auditee did not address all aspects of the recommendation
60-Day Agency Response
DHCS released an updated EPSDT APL with enhanced language regarding Bright Futures for MCP, stakeholder, and advocate feedback. DHCS is currently incorporating feedback and anticipates publishing the APL no later than June 1, 2019.
- Estimated Completion Date: June 2019
- Response Date: May 2019
California State Auditor's Assessment of 60-Day Status: Pending
We look forward to reviewing the updated all-plan letter with DHCS' 6-month response.
All Recommendations in 2018-111
Agency responses received are posted verbatim.