Report 2018-122 Recommendation 2 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 #2 To: Health Care Services, Department of

To obtain assurance that health plans throughout the State exhaust all of their reasonable options to meet the access requirements before requesting alternative access standards, DHCS should immediately develop written guidance that specifies the conditions under which staff should approve, deny, or contact health plans for clarification regarding their alternative access standard requests.

60-Day Agency Response

DHCS continues to improve the Alternate Access Standards (AAS) review process, which includes adding more specific criteria to determine reasonability of AAS requests, such as zip codes identified as Health Professional Shortage Designation Areas. DHCS is currently creating a standardized review process for staff and will be providing in-person training to ensure compliance.

  • Estimated Completion Date: July 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.