Our thoughts on all things electronic case management.
In California, TCM, a Medicaid benefit program, is administered by the California Department of Health Care Services (DHCS). The TCM program started in 1995 after the Medi-Cal Administrative Claiming Program split in two: TCM and Medi-Cal Administrative Activities (MAA).
In this final part, Part III, to our TCM audits blog, we will address the TCM program audits as conducted by the TCM program at the Department of Health Care Services (DHCS). As written in our previous blogs on this topic, the Targeted Case Management (TCM) program cost reports are audited in California every year. For the program audit (or non-financial), DHCS strives to be on a 3-year. That means that your program may be audited once every 3 years.
As promised, here’s our follow up blog on TCM audits and appeals. Previously in Part I of this series, we noted that every year the Targeted Case Management (TCM) programs and their cost reports are audited in California. The appeals process begins with the informal hearing. If the county does not prevail at this level, it can appeal at the formal level.
Every year the Targeted Case Management (TCM) programs and their cost reports are audited in California. State Department of Health Services (DHCS) auditors communicate with local governmental agencies (LGA) to obtain financial and other documents for their review. Many LGAs have been taken aback by extensive documentation requests and surprised by the audit findings.