Report 2006-110 Recommendation 9 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 #9 To: Health Services, Department of

To ensure that it is referring those applicants at greatest risk of committing fraud and not preventing eligible Medi-Cal providers from providing services to beneficiaries, the branch and the Medical Review Branch, with direction from the department, should reevaluate the appropriateness of the branch's high-risk fraud indicators periodically by consistently communicating and collaborating with one another.

1-Year Agency Response

The branch states that it established a workgroup, consisting of branch and Medical Review Branch staff, which has reviewed the current list of high-risk indicators and identified changes that need to be made to PETS. (2009-406, p. 191)

  • Response Date: April 2008

California State Auditor's Assessment of 1-Year Status: Fully Implemented

All Recommendations in 2006-110

Agency responses received after June 2013 are posted verbatim.