The California State Auditor on Tuesday is slated to release a report 10 months in the making that will analyze the efficacy of the Medi-Cal managed care program. Medi-Cal is California’s Medicaid program.
The report is billed as offering an independent assessment of a number of aspects of the Medi-Cal managed care program, including:
- Accuracy of provider directories;
- Adequacy of provider networks;
- Appropriateness of the regulatory oversight structure for the Department of Managed Health Care and the Department of Health Care Services, which oversee Medi-Cal managed care;
- Sufficiency of those departments’ policies, staffing and procedures to ensure accurate provider directories and adequate provider networks; and
- Determination of managed care plans’ verification of provider network data to those two departments.
To reach its conclusions, the state auditor looked at Medi-Cal managed care plans in three counties to see how they meet requirements for adequate access to providers and accuracy of directories.