Report 2018-122 Recommendation 12 Responses

Report 2018-122: Department of Health Care Services: It Has Not Ensured That Medi-Cal Beneficiaries in Some Rural Counties Have Reasonable Access to Care (Release Date: August 2019)

Recommendation #12 To: Health Care Services, Department of

To ensure that beneficiaries in the Regional Model counties have reasonable access to care, DHCS should determine by June 2020 the specific causes of Anthem's and Health & Wellness's inabilities to provide reasonable access to care in the Regional Model counties.

1-Year Agency Response

DHCS has worked with the EQRO to finalize the report. The report includes a two-fold analysis to identify the specific Regional Model counties in which provider network coverage issues exist for each of the MCPs, and specific causes of provider network issues identified in the California State Auditor's report. The EQRO's final report was delivered to DHCS in July 2020.

  • Completion Date: July 2020
  • Response Date: August 2020

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

6-Month Agency Response

DHCS has engaged the External Quality Review Organization to conduct this analysis. The analysis will be completed by June 2020.

  • Estimated Completion Date: June 2020
  • Response Date: January 2020

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

60-Day Agency Response

DHCS continues to work towards the analysis of the Regional Model and is on track to meet the June 2020 date.

  • Estimated Completion Date: June 2020
  • Response Date: October 2019

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

All Recommendations in 2018-122

Agency responses received are posted verbatim.