Advance Notice of Possible Site Reviews – 2025 DHCS Audit
| Date: | December 10, 2025 |
| From: | Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) |
| To: | Health Plan Providers |
| Type: | Regulatory |
| Subject: | Advance Notice of Possible Site Reviews – 2025 DHCS Audit |
| Business: | Medi-Cal Managed Care |
The California Department of Health Care Services (DHCS) has scheduled a routine annual medical audit of Health Plan. The medical audit will consist of an evaluation of Health Plan’s compliance with its contract and regulations.
Auditors will be virtually on-site at Health Plan from January 12, 2026 – January 23, 2026. As a courtesy, we want to let you know that you may be contacted by DHCS for a virtual site visit.
Helpful information:
- The audit will involve facility site visits and medical records review by DHCS.
- DHCS auditors will conduct interviews with some of our Health Plan providers at their practice locations.
- Providers selected by DHCS for a site visit will be contacted directly by a DHCS Nurse Evaluator to schedule the on-site visit.
If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan and our services is always available on our website www.hpsj-mvhp.org
