Report 2023-103 Recommendation 2 Responses

Report 2023-103: The Comprehensive Perinatal Services Program: The Lack of Usage Data Prevents the State From Knowing How Often Medi‑Cal Members Receive Perinatal Care (Release Date: February 2024)

Recommendation #2 To: Health Care Services, Department of

To ensure effective program oversight and to acknowledge that nearly all Medi-Cal members use managed care plans, Public Health and Health Care Services should, by January 2025, collaborate to update regulations related to the perinatal program. The regulations should include, at a minimum, a clarification of the roles and responsibilities of each department and adjustments to the current monitoring and oversight systems as described individually below to ensure that the departments provide sufficient oversight of the perinatal program.

6-Month Agency Response

Over the past six months, DHCS and CDPH have met monthly to collaborate and identify specific Title 22 changes each department believes are necessary to be responsive to the audit recommendation. Continuing through the end of the year, DHCS and CDPH will collaborate to ensure Medi-Cal members have access to a comprehensive suite of pregnancy and pregnancy-related services and supports, inclusive of those covered under the Comprehensive Perinatal Services Program (CPSP). By January 2025, DHCS and CDPH will identify and finalize the recommended approach for any necessary changes to the Title 22 CPSP regulations and the timing by which the regulation package can be promulgated.

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

60-Day Agency Response

Following the release of the audit and in alignment with the ongoing birthing care pathways work, DHCS and CDPH are actively discussing the future role of Comprehensive Perinatal Services Program (CPSP) as a component part of Medi-Cal's suite of comprehensive pregnancy and pregnancy-related benefits. DHCS and CDPH have regularly scheduled monthly meetings, and the recommendation is a standing agenda item. Over the coming months, DHCS and CDPH will continue to collaborate to ensure Medi-Cal members have access to a comprehensive suite of pregnancy and pregnancy-related services and supports, inclusive of those covered under CPSP. Ultimately, by January 2025, DHCS and CDPH will collaborate to identify any necessary changes to the Title 22 CPSP regulations and the timing by which the regulation package can be promulgated. DHCS and CDPH will continue to provide updates.

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

All Recommendations in 2023-103

Agency responses received are posted verbatim.