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State High-Risk Program Assessment of Department of Health Care Services Oversight of Medi-Cal Provider Payments

The California State Auditor concludes that Health Care Services’ oversight of Medi-Cal provider payments is at substantial risk of fraud, waste, or abuse due to inadequate follow-up on high-risk providers, ongoing participation of ineligible providers, and significant ground-transportation related overpayments; the assessment justifies updating Health Care Services’ inclusion on the state high-risk list and infor…

Findings

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Recommendations

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