Clinical Assurance and Administrative Support Division (CAASD) is comprised of five branches, two pharmacy sections and an appeals and litigation section. CAASD provides strong, cost-effective utilization controls by reviewing and adjudicating Treatment Authorization Requests (TARs) for certain medical procedures, services and drugs for fee-for-service Medi-Cal beneficiaries prior to payment for services. In 2011, CAASD processed more than 3.2 million TARs. CAASD also responds to all TAR appeals submitted by providers and offers program support to the Office of Legal Services for all litigation resulting from denied TAR appeals. In addition, CAASD is responsible for the Designated Public Hospital Project (DPHP), which allows public hospitals in California to use an evidence-based standardized tool to determine medical necessity for hospital days and services for Medi-Cal beneficiaries in lieu of submitting a TAR to the field office.
Last modified on:
12/12/2014 1:45 PM