Report 2006-110 Recommendation 7 Responses
Report 2006-110: Department of Health Services: It Needs to Improve Its Application and Referral Processes When Enrolling Medi-Cal Providers (Release Date: April 2007)
Recommendation #7 To: Health Services, Department of
The department should seek legislation to revise state law to eliminate preferred provider status. However, if it chooses to keep this status and to increase the number of applicants that could benefit from the shorter processing period that preferred provider status offers, the department should increase its efforts to notify applicants of the reasons it denies applications during the prescreening for preferred provider status.
6-Month Agency Response
The department asserts that while the majority of physicians have elected not to enroll under preferred provider status, the California Medical Association?s intent for introducing the status under Senate Bill 857 remains valid. Thus, the department recommends allowing physicians to weigh the cost/benefit of enrolling as preferred providers. To promote awareness of preferred provider status, the branch posted a bulletin to its Web site describing how physicians can request, and provide documentation and verification for, consideration for enrollment in the Medi-Cal program as a preferred provider. Additionally, the branch indicates that it plans to update the Top Reasons Provider Enrollment Applications are Denied on its Web site to include the reasons preferred provider applications are denied in the prescreening process. Further, Chapter 693, Statutes of 2007 reduces from 90 days to 60 days the time within which the branch must notify applicants of the reasons it denies applications during the prescreening for preferred provider status. The branch reports that the shorter processing period may encourage qualified providers to apply for preferred provider status. (See 2008-406 p. 208)
- Response Date: October 2007
California State Auditor's Assessment of 6-Month Status: Fully Implemented
Agency responses received after June 2013 are posted verbatim.