State audit finds DHCS may have paid $93.7 million for fraudulent Medi-Cal drug treatment A California State Auditor’s report issued today found the Department of Health Care Services (DHCS) failed to properly administer the Medi-Cal Drug Treatment Program and may have paid at least $93.7 million for fraudulent drug treatment. The program provides substance abuse services to Medi-Cal beneficiaries when physicians determine they are medically necessary. The focus of the report was on outpatient drug-free services. The audit was requested by Assemblyman Ted Lieu after stories appeared in the media revealing that substance abuse clinics were fraudulently billing for patients who did not use ... August 21, 2014 Medi-Cal DHCS, Drug Abuse, Medi-Cal, Insurance/Reimbursement 0 0 Comment Read More »
DHCS to automate Medi-Cal provider enrollment The California Department of Health Care Services (DHCS) will soon be automating its Medi-Cal provider enrollment processes. The hope is that the new system, expected to go live this fall, will improve the provider enrollment experience by minimizing errors in the application process and significantly reducing the time required to process provider enrollments. The new enrollment system, called the Provider Application and Validation for Enrollment (PAVE) system, will be a web-based portal that providers can use to submit application and verifications and report changes. Initially, PAVE will only be available for ... March 27, 2014 Medi-Cal Medi-Cal, DHCS, Medi-Cal Provider Enrollment 0 0 Comment Read More »
State delays duals pilot project until April 1 The California Department of Health Care Services (DHCS) announced today that it would delay by three months implementation of the state's "pilot project" to redesign care for Medicare/Medi-Cal dual eligibles. The program, called CalMediConnect, is now expected to begin no earlier than April 2014. The project was authorized by the Assembly in July 2012 in an effort to save money and better coordinate care for the state’s low-income seniors and persons with disabilities. The program begins with a three-year demonstration project that would see a large portion of the state's ... August 15, 2013 Managed Care, Medi-Cal, Medicare DHCS, Medi-Cal, Medicare, Dual Eligible, Insurance/Reimbursement 0 0 Comment Read More »
