State Controller’s Office Says Medi-Cal Overpays for Hearing Aids
Medi-Cal has overpaid hearing aid providers by millions of dollars, a recent inquiry by State Controller John Chiang (D) found, the Orange County Register's "OC Watchdog" reports.
Medi-Cal is California's Medicaid program.
Paying Wholesale Cost
Current rules require Medi-Cal to reimburse hearing aid providers for the wholesale cost of the devices.
However, state auditors have found that hearing aid providers pay only a portion of the wholesale cost because of various discounts and rebates.
In one case, a hearing aid provider paid $436 for a hearing aid and was reimbursed by Medi-Cal for the wholesale cost of $1,218 (Joseph, "OC Watchdog," Orange County Register, 2/29).
According to Chiang's office, if the Department of Health Care Services changed its policy to reimburse for the acquisition cost of hearing aids instead of the wholesale cost, the state could save up to $27.3 million over a three-year period (State Controller letter, 2/27).
New Policy
The Department of Health Care Services recently changed the definition of wholesale cost as it applies to hearing aid reimbursement.
However, hearing aid providers and legislators have criticized the change because they believe the new policy will have a negative effect on beneficiaries ("OC Watchdog," Orange County Register, 2/29).
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