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Medical Surveys and Corrective Action Plans 

The Department of Health Care Services (DHCS) works with the Department of Managed Health Care (DMHC) to conduct routine medical surveys of Medi-Cal Managed Care Health Plans (MCPs) on selected populations. The medical survey is a comprehensive evaluation of the MCP's compliance with managed health care law (Knox-Keene Health Care Service Plan Act) in the following program areas:
  1. Utilization Management
  2. Continuity of Care
  3. Availability and Accessibility
  4. Member Rights
  5. Quality Management
MCPs are required to provide a Corrective Action Plan (CAP) upon the completion of a DMHC Survey or any other monitoring activity where findings are identified. DHCS conducts CAP evaluations, and provides technical assistance to ensure compliance. 

Medical Surveys and Corrective Action Plans: 

  1. Alameda Alliance for Health
    [Review Period 04/01/14 - 03/31/15]
    Report (Seniors and Persons with Disabilities) & Corrective Action Plan   
       
  2. Anthem Blue Cross Partnership Plan
    [Review Period 11/01/14 – 10/31/15]
    Report (Cal MediConnect) & Corrective Action Plan

    [Review Period 09/01/12 - 08/31/13]
    Report (Seniors and Persons with Disabilities) & Corrective Action Plan  
       
  3. California Health and Wellness Plan
    [Review Period 06/01/2014 - 05-31-2015]
    Report (Seniors and Persons with Disabilities) & Corrective Action Plan  

  4. CalOptima
    [Review Period 01/01/14 - 06/30/14]
    Report (Seniors and Persons with Disabilities) & Corrective Action Plan  
       
  5. CalViva Health
    [Review Period 04/01/15 – 03/31/16]
    Report (Seniors and Persons with Disabilities) & Corrective Action Plan
       
  6. Care 1st Partner Plan, LLC
    [Review Period 1/1/15 - 12/31/15]
    Report (Cal MediConnect) & Corrective Action Plan   

    [Review Period 10/01/12 - 09/30/13]
    Report (Seniors and Persons with Disabilities)Corrective Action Plan  
       
  7. CareMore Health Plan
    [Review Period 07/01/14 – 04/30/16]
    Report (Cal MediConnect) & Corrective Action Plan
       
  8. CenCal Health
    [Review Period 01/01/14 - 07/31/14]
    Report (Seniors and Persons with Disabilities) & Corrective Action Plan  
       
  9. Central California Alliance for Health
    [Review Period 01/01/14 - 05/31/14]
    Report (Seniors and Persons with Disabilities) & Corrective Action Plan    
       
  10. Community Health Group Partnership Plan
    [Review Period 04/01/14 - 03/31/15]
    Report (Cal MediConnect) & Corrective Action Plan  

    [Review Period 06/01/15 - 05/31/16]
    Report (Seniors and Persons with Disabilities) & Corrective Action Plan  
       
  11. Contra Costa Health Plan
    [Review Period 05/01/15 – 04/30/16]
    Report (Seniors and Persons with Disabilities) & Corrective Action Plan
       
  12. Gold Coast Health Plan
    [Review Period MM/DD/YY - MM/DD/YY]
    Medical Survey & Corrective Action Plan  
       
  13. Health Net Community Solutions, Inc.
    [Review Period 02/01/14 - 01/31/15]
    Report (Cal MediConnect) & Corrective Action Plan  

    Review Period 05/01/15 – 02/29/16
    Report (Seniors and Persons with Disabilities) & Corrective Action Plan
       
  14. Health Plan of San Joaquin
    [Review Period 07/01/14 - 06/30/15]
    Report (Seniors and Persons with Disabilities) & Corrective Action Plan  
       
  15. Health Plan of San Mateo
    [Review Period 11/01/14 - 9/30/15]
    Report (Cal MediConnect)Corrective Action Plan   

    [Review Period 01/01/14 - 07/31/14]
    Report (Seniors and Persons with Disabilities) & Corrective Action Plan
     
  16. Inland Empire Health Plan
    [Review Period 10/01/14 - 08/17/15]
    Report (Seniors and Persons with Disabilities) & Corrective Action Plan  

    [Review Period 10/01/14 - 09/20/15]
    Report (Cal MediConnect) & Corrective Action Plan  
       
  17. Kern Health Systems
    [Review Period 08/01/15 – 07/31/16]
    Report (Seniors and Persons with Disabilities) & Corrective Action Plan  
       
  18. KP Cal LLC (NorCal)
    [Review Period MM/DD/YY - MM/DD/YY]
    Report & Corrective Action Plan  
       
  19. L.A. Care Health Plan
    [Review Period 07/01/14 - 06/30/15]
    Report (Cal MediConnect) & Corrective Action Plan

    [Review Period 07/01/14 - 06/30/15]
    Report (Seniors and Persons with Disabilities) & Corrective Action Plan
       
  20. Molina Healthcare of California Partner Plan, Inc.
    [Review Period 08/01/14 - 07/31/15]
    Report (Rural Expansion) & Corrective Action Plan  

    [Review Period 08/01/14 - 07/31/15]
    Report (Cal MediConnect) & Corrective Action Plan  
  21. Partnership Health Plan of California
    [Review Period 12/01/13 - 11/30/14]
    Report (Seniors and Persons with Disabilities/Rural Expansion) & Corrective Action Plan     
       
  22. San Francisco Health Plan
    [Review Period 01/01/14 - 12/31/14]
    Report (Seniors and Persons with Disabilities) & Corrective Action Plan  
       
  23. Santa Clara Family Health Plan
    [Review Period 04/01/15 - 03/31/16]
    Report (Cal MediConnect) & Corrective Action Plan

[Review Period 01/01/13 - 12/31/13]
Report (Seniors and Persons with Disabilities) & Corrective Action Plan 
   

 
Last modified on: 10/18/2017 3:00 PM