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Report File
Date Issued
Submitting OIG
Department of Health & Human Services OIG
Other Participating OIGs
Department of Health & Human Services OIG
Agencies Reviewed/Investigated
Department of Health & Human Services
Components
Centers for Medicare and Medicaid Services
Report Number
A-09-20-02009
Report Type
Audit
Location

CA,
United States

Number of Recommendations
9
Questioned Costs
$23,139,767
Funds for Better Use
$0
External Entity
California Department of Health Care Ser

Open Recommendations

This report has 8 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
22-A-09-051.02 No $0 $0

We recommend that the California Department of Health Care Services verify that deficiencies identified during annual provider-licensing inspections were corrected and that OTPs implemented their corrective action plans

22-A-09-051.03 No $0 $0

We recommend that the California Department of Health Care Services consider performing additional postservice prepayment monitoring and postservice postpayment utilization reviews.

22-A-09-051.04 No $0 $0

We recommend that the California Department of Health Care Services implement a system edit for identifying claims with an unreasonable number of counseling service units in 1 day and take appropriate action for the claims identified

22-A-09-051.05 No $0 $0

We recommend that the California Department of Health Care Services revise the Drug Medi-Cal Billing Manual or provide additional guidance to OTPs regarding the allowable number of counseling service units and work with counties to ensure that their OTP billing manuals do not conflict with State regulations

22-A-09-051.06 No $0 $0

We recommend that the California Department of Health Care Services take actions to ensure that OTPs comply with Federal and State requirements for providing and claiming reimbursement for OTP services.

22-A-09-051.07 No $0 $0

We recommend that the California Department of Health Care Services take actions to ensure that OTPs provide the number of counseling services specified in a beneficiary’s treatment plan or document the reasons that counseling services were not provided as specified in the treatment plan.

22-A-09-051.08 No $0 $0

We recommend that the California Department of Health Care Services take actions to ensure that OTPs maintain documentation supporting that a complete physical evaluation of a patient was performed, including the results of drug use, tuberculosis, and syphilis tests and the identity of the person who performed the physical evaluation.

22-A-09-051.09 No $0 $0

We recommend that the California Department of Health Care Services take actions to ensure that OTPs have their physicians review and countersign beneficiaries’ treatment plans within the 14-day period as required.

Department of Health & Human Services OIG

United States