State Hopes To Cut Medi-Cal Enrollment Backlog Nearly in Half by August

by David Gorn

State officials yesterday released a letter to CMS outlining a rough plan of action and a detailed explanation for a backlog of 600,000 unprocessed Medi-Cal applications.

The letter, sent Monday by Toby Douglas, director of the Department of Health Care Services, was in time to make the 10-business-day deadline set by CMS officials.

"Our … efforts to address pending applications have resulted in a decline in the number of pending applicants from 900,000 in March to 600,000 at the end of June," the letter to CMS said.

"We anticipate that the combination of efforts detailed in the attached plan will result in a further reduction of pending applicants to approximately 350,000 within six weeks," the letter said.

According to Douglas, the number of pending applications is always changing as new applications come in and pending applications get processed.

Douglas said in the letter that he expects the 350,000 applications that are still outstanding at the start of September mostly will be comprised of recently submitted applications -- those submitted in the previous 45 days.

There still will be a small number of cases, he said, "that require intensive manual work due to data errors or missing information on the application," and those could take longer to resolve.

Part of the reason for the backlog, Douglas said, was due to the success of Medi-Cal expansion. In March and April alone there were about a million applications, almost twice as many as usual, he said.

Douglas estimated 2.2 million Californians have enrolled in Medi-Cal since the start of the year. The total enrollment in Medi-Cal through the end of June is projected to be 10.9 million, he said.

That's almost 28% of California's estimated population of 39.3 million people.

That's a huge jump from the 7.9 million Medi-Cal beneficiaries in the 2012-13 fiscal year. Douglas said that number is expected to jump to 11.5 million in 2015.


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