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​​​​​​​​​Archived - Medical Review Audit and Corrective Action Plans  

Issued in 2024

AIDS Healthcare Foundation

[Review Period 10/01/22 - 09/30/23]

Report (Corrective Action Plan in progress)​

Contra Costa Health Plan

[Review Period 07/01/22 - 06/30/23]

Report & Corrective Action Plan​

Inland Empire Health Plan

[Review Period 08/01/22 - 07/31/23]

Report & Corrective Action Plan​

Issued in 2023

Alameda Alliance for Health

​[Review Period 04/01/22 - 03/31/23]

Report & Corrective Action Plan​

Anthem Blue Cross Partnership Plan

[Review Period 10/01/21 - 09/30/22]

Report & Corrective Action Plan​​​​

Blue Shield of CA Promise Health Plan

[Review Period 04/01/22 - 03/31/23]

Report & Corrective Action Plan​

California Health and Wellness

[Review Period 07/01/22 - 06/30/23]

Repo​rt & Corrective Action Plan

[Review Period 05/01/21 - 06/30/22]

Report & Corrective Action Plan

CalOptima

[Review Period 02/01/22 - 01/31/23]

Report & Corrective Action Plan​

CalViva Health

[Review Period 04/01/22 - 03/31/23]

Report & Corrective Action Plan​

CenCal Health

[Review Period 10/01/22 - 09/30/23]

Report & (Corrective Action Plan N/A)

[Review Period 10/01/21 - 09/30/22]

Report​ & Corrective Action Plan

Central California Alliance for Health

[Review Period 11/01/21 - 10/31/22]

Report & (Corrective Action Plan N/A)​

Community Health Group Partnership Plan

[Review Period 06/01/22 - 05/31/23]

Report & Corrective Action Plan

[Review Period 06/01/21 - 05/31/22]

Report​ (Corrective Action Plan in progress)

​​​​​Contra Costa Health Plan

[Review Period 07/01/21 - 05/31/22]

Report​ (Corrective Action Plan in progress)

​Gold Coast Health Plan

[Review Period 07/01/22 - 06/30/23]

Report & Corrective Action Plan

[Review Period 06/01/21 - 05/31/22]

Report & Corrective Action Plan​​​

Health Plan of San Joaquin

[Review Period 07/01/21 - 09/30/22]

Report & Corrective Action Plan

Inland Empire Health Plan

[Review Period 08/01/21 - 07/31/22]

Report & Corrective Action Plan

Kaiser

[Review Period 11/01/21 - 10/31/22]

Report & C​orrective Action Plan

Kern Health Systems

[Review Period 11/01/21 - 10/31/22]

Report (Corrective Action Plan in progress)

​​L.A. Care Health Plan

[Review Period 07/01/21 - 01/31/23]

Report​ (Corrective Action Plan in progress)

Molina Healthcare of California Partner Plan, Inc.

[Review Period 05/01/22 - 04/30/23]

Report & (Corrective Action Plan N/A)

[Review Period 08/01/19 - 04/30/22]

Report​ & Corrective Action Plan

Partnership Health Plan of California

[Review Period 07/01/21 - 06/30/22]

Report & Corrective Action Plan​

San Francisco Health Plan

[Review Period 03/01/22 - 02/28/23]

Report​ & Corrective Action Plan

Santa Clara Family Health Plan

[Review Period 03/01/22 - 02/28/23]

Report​ & Corrective Action Plan

[Review Period 03/01/21 - 02/28/22]

Report & Corrective Action Plan​

​​Senior Care Action Network Health Plan

​[Review Period 03/01/22 - 02/28/23]

Report & Corrective Action Plan​​

Issued in 2022

Aetna Better Health of California

[Review Period 04/01/21 - 03/31/22]

Report​ & Corrective Action Plan​

AIDS Healthcare Foundation

[Review Period 01/01/21 - 12/31/21]

Report & Corrective Action Plan​

Alameda Alliance for Health

[Review Period 04/01/21 - 03/31/22]

Report​ & Corrective Action Plan 

Anthem Blue Cross Partnership Plan

[Review Period 10/01/19 - 07/31/21]

Report​ (Corrective Action Plan in progress)

​​​Blue Shield of CA Promise Health Plan

[Review Period 01/01/21 - 12/31/21]

Report & Corrective Action Plan

Report (Cal MediConnect) & Corrective Action Plan (Cal MediConnect)

CalOptima

[Review Period 02/01/20 - 12/31/21]

Report & Corrective Action Plan​

CalViva Health

[Review Period 04/01/20 - 03/31/22]

Report & Corrective Action Plan

CenCal Health

[Review Period 11/01/19 - 09/30/21]

Report & Corrective Action Plan

Central California Alliance for Health

[Review Period 11/01/19 - 10/31/21]

Report & Corrective Action Plan

Health Net Community Solutions, Inc.

[Review Period 04/01/21 - 03/31/22]

Report​ (Corrective Action Plan in progress)

Health Plan of San Joaquin

[Review Period 07/01/19 - 06/30/21]

Report & Corrective Action Plan​​

Health Plan of San Mateo

[Review Period 11/01/19 - 07/31/21]

Report​ (Medical Audit and Cal MediConnect) 

Corrective Action Plan​ (Medical Audit)

Corrective Action Plan (Cal MediConnect)

[Review Period 08/01/21 - 06/30/22]

Report​ (Corrective Action Plan in progress) 

​​​​Inland Empire Health Plan

[Review Period 10/01/19 - 07/31/21]

Report & Corrective Action Plan

Report (Cal MediConnect) & Corrective Action Plan (Cal MediConnect)

Kaiser

[Review Period 09/01/19 - 10/31/21]

Report & Corrective Action Plan

Kern Health Systems

[Review Period 08/01/19 - 07/31/21]

Report & Corrective Action Plan​

L.A. Care Health Plan

[Review Period 07/01/19 - 06/30/21]

Report (Corrective Action Plan in progress)

[Review Period 07/01/20 - 06/30/21]

Report (Cal MediConnect) (Corrective Action Plan in progress)

Partnership Health Plan of California

[Review Period 01/01/20 - 06/30/21]

Report​ & (Corrective Action Plan N/A)

​​San Francisco Health Plan

[Review Period 03/01/21 - 02/28/22]

Report​ & Corrective Action Plan

Senior Care Action Network Health Plan

[Review Period 03/01/21 - 02/28/22]

Report & Corrective Action Plan

Issued in 2​​021

​Aetna Better Health of California

[Review Period 04/01/19 - 03/31/21]

Report​ (Corrective Action Plan in progress)

​​AIDS Healthcare Foundation

[Review Period 01/01/20 - 12/31/20]​

Report​ & Corrective Action Plan​

Alameda Alliance for Health

[Review Period 06/01/19 - 03/31/21]

Report & Corrective Action Plan

​[Review Period 10/01/18 - 09/30/20]
Corrective Action Plan (Focused)

​​Blue Shield of CA Promise Health Plan

[Review Period 01/01/20 - 12/31/20]

Report & Corrective Action Plan​

California Health and Wellness

[Review Period 12/01/19 - 04/30/21]

Report & Corrective Action Plan​

Community Health Group Partnership Plan

[Review Period 06/01/19 - 05/31/21] (Medical Audit)

[Review Period 06/01/20 - 05/31/21] (Cal MediConnect)

Report (Medical Audit and Cal MediConnect) & Corrective Action Plan (Medical Audit)

Corrective Action Plan (Cal MediConnect)

Contra Costa Health Plan

[Review Period 07/01/20 - 06/30/21]

Report​ & Corrective Action Plan

Gold Coast Health Plan

[Review Period 04/01/19 - 05/31/21]​

Report & Corrective Action Plan​​

​​Health Net Community Solutions, Inc.

[Review Period 05/01/19 - 03/31/21]
Report (Corrective Action Plan in progress)

[Review Period 04/01/20 - 03/31/21]

Report (Cal MediConnect) & Corrective Action Plan​ (Cal MediConnect)

[Review Period 01/01/19 - 12/31/20]
Report​ (Focused) (Corrective Action Plan in progress)

​​​​L.A. Care Health Plan

[Review Period 01/01/19 - 12/31/20]

Report​ (Focused) (Corrective Action Plan in progress)

Rady Children's Hospital-San Diego

[Review Period 09/01/19 - 08/31/20]
Report & Corrective Action Plan

​San Francisco Health Plan

[Review Period 03/01/20 - 02/28/21]

Report​ (Corrective Action Plan in progress)

​Santa Clara Family Health Plan

Review Period 03/01/20 - 02/28/21]​
Report & Corrective Action Plan​

​​​​​​​​​Senior Care Action Network Health Plan

[Review Period 03/01/20 - 02/28/21]

Report & Corrective Action Plan​

​​United Healthcare Community Plan of California, Inc.

[Review Period 06/01/19 - 05/31/21]

Repo​rt​ & Corrective Action Plan

Issued in 202​​0

AIDS Healthcare Foundation

[Review Period 01/01/19 - 12/31/19]
Report & Corrective Action Plan

Anthem Blue Cross Partnership Plan

[Review Period 10/01/18 - 09/30/19]
Report & Corrective Action Plan

Report (Cal MediConnect) & Corrective Action Plan​ (Cal MediConnect)​

California Health and Wellness

[Review Period 12/01/18 - 11/30/19]
Report & Corrective Action Plan

​​​CalOptima

​​[Review Period 02/01/19 - 01/31/20]
Report & Corrective Action Plan

​CalViva Health

[Review Period 02/01/19 - 01/31/20]
Report​ & Corrective Action Plan

CenCal Health

[Review Period 11/01/18 - 10/31/19]
Report & Corrective Action Plan

Central California Alliance for Health

[Review Period 11/01/18 - 10/31/19]
Report & Corrective Action Plan​

Contra Costa Health Plan

[Review Period 05/01/19 - 04/30/20]
Report & Corrective Action Plan

Health Plan of San Mateo

[Review Period 11/01/18 - 10/31/19]
Report & Corrective Action Plan

Inland Empire Health Plan

[Review Period 10/01/18 - 09/30/19]
Report & Corrective Action Plan

Kaiser

[Review Period 09/01/18 - 08/31/19]
Report & Corrective Action Plan

Molina Healthcare of California Partner Plan, Inc.

[Review Period 08/01/18 - 07/31/19]​
Report & Corrective Action Plan​

San Francisco Health Plan

[Review Period 03/01/19 - 02/29/20]​

Report & Corrective Action Plan​

Santa Clara Family Health Plan

[Review Period 03/01/19 - 02/29/20]​
Report & Corrective Action Plan

​ Senior Care Action Network Health Plan

[Review Period 03/01/19 - 02/29/20]
Report & Corrective Action Plan

Issued in 20​​19

Aetna Better Health of California

[Review Period 04/01/18 - 03/31/19]
Report & Corrective Action Plan

Community Health Group Partnership Plan

[Review Period 06/01/18 - 05/31/19]
Report & Corrective Action Plan

Contra Costa Health Plan

[Review Period 06/01/18 - 03/31/19]
Report & Corrective Action Plan

Health Net Community Solutions, Inc.

​​[Review Period 05/01/18 - 04/30/19]​

Report & Corrective Action Plan​

​Health Plan of San Joaquin​​​

[Review Period 07/01/18 - 06/30/19]

Report & (Corrective Action Plan N/A)

Health Plan of San Mateo

[Review Period 11/01/17 - 09/30/18]
Report (Cal MediConnect) & Corrective Action Plan (Cal MediConnect)

Kern Health Systems

[Review Period 08/01/18 - 07/31/19]
Report & Corrective Action Plan

L.A. Care Health Plan

[Review Period 07/01/18 - 06/30/19]
Report & Corrective Action Plan

Partnership Health Plan of ​​​​California

[Review Period 01/01/18 - 12/31/18]
Report & Corrective Action Plan

​​​​​San Francisco Health Plan​

​​[Review Period 03/01/18 - 02/28/19]
Corrective Action Plan​

Santa Clara Family Health Plan

[Review Period 04/01/18 - 02/28/19]

Report & Corrective Action Plan

Report (Cal MediConnect) & Corrective Action Plan (Cal MediConnect)

Senior Care Action Network Health Plan

[Review Period 03/01/18 - 02/28/19]
Report & Corrective Action Plan

United Healthcare Community Plan of California, Inc.

[Review Period 04/01/18 - 04/30/19]
Report & Corrective Action Plan

Issued in 201​8

Alameda Alliance for Health

[Review Period 06/01/17 - 05/31/18]
Report & (Corrective Action Plan N/A)​​

CalOptima

[Review Period 02/01/17 -01/31/18]
Report & Corrective Action Plan​

Central California Alliance for Health

[Review Period 11/01/16 – 10/31/17]
Report & Corrective Action Plan 

Community Health Group Partnership Plan

[Review Period 06/01/17 - 05/31/18]
Report & (Corrective Action Plan N/A)​​

​Contra Costa Health Plan

[Review Period 06/01/17 – 05/31/18]
Corrective Action Plan

Gold Coast Health Plan

[Review Period 04/01/17 – 03/31/18]
Report & Corrective Action Plan   ​

Health Net Community Solutions, Inc.

[Review Period 05/01/17 – 04/30/18]
Corrective Action Plan​

Health Plan of San Joaquin

​[Review Period 07/01/17 – 06/30/18]

Health Plan of San Mateo

[Review Period 11/01/16 – 09/30/17]
Report​ (Corrective Action Plan in progress)

Inland Empire Health Plan

[Review Period 10/01/16 – 09/30/17]
Report & Corrective Action Plan​​    

Kaiser

[Review Period 09/01/16 – 08/31/17]
Report​ (Corrective Action Plan​ N/A)     

Partnership Health Plan of California

[Review Period 01/01/17 - 12/31/17]
Report & Corrective Action Plan​

San Francisco Health Plan

[Review Period 03/01/17 - 02/28/18]
Report & Corrective Action Plan​

Santa Clara Family Health Plan

[Review Period 04/01/17 – 03/31/18]
Report & Corrective Action Plan​​​​​​​​​​​


Last modified date: 4/15/2025 8:40 AM