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Technical Assistance Guides

In accordance with California Welfare and Institutions Code §14456, the Department of Health Care Services (DHCS) conducts medical audits of Medi-Cal managed care plans (MCPs) on an annual basis.  Medical audits evaluate MCPs’ compliance with the DHCS contractual requirements and applicable laws and regulations.  DHCS’ Managed Care Quality and Monitoring Division (MCQMD) is responsible for ensuring overall monitoring and oversight of MCPs.  MCQMD designates the Medical Review Branch (MRB) of DHCS’ Audits and Investigations Division (A&I) to perform the mandated audits. 
MCQMD and A&I have partnered together to create Technical Assistance Guides (TAG) for each of the following six audit categories of review.  The TAGs are designed to identify key elements that will be commonly evaluated to inform MCPs of the audit process and increase transparency.   
Last modified on: 4/12/2018 8:47 AM