​​​​Archived

Medical Review Audit and Corrective Action Plan  

Issued in 2022

​​Health Plan of San Mateo

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

Report​ (Medical Audit and Cal MediConnect) (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)

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 06/01/29 - 03/31/21]

Report (Corrective Action Plan in progress)

​[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)

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 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​

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

Contra Costa Health Plan

[Review Period 05/01/19 - 04/30/20]
Report (Corrective Action Plan in progress)

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

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 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.