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.

Chris Paddock
So it comes down to this question? Is Toby Douglas INCOMPETENT? He would hope that you thought so as that perception would be the lessor of two evils. Honestly, it's much to the contrary, his department continues to advertise about the massive expansion of Medi-Cal and in many cases these ads pose this question: " If you were denied before, you may be eligible now for coverage due the the historic expansion of benefit coverage". These statements, the knowledge that changes of MediCal would expand enrollment would spark the inter departmental organization and resource allocation to meet the demands they created. Don't tell me you didn't expect this and pass the same lie onto the Feds when they intercede and want answers. If CA cant manage federal benefits they should be stripped of the choice and the programs administered by the FEDS.
Chris Paddock
C4yourself, the slick county website designed to streamline applications, submit verifications, report changes etc. Unfortunately, it is not being used by county workers fully and properly. Specifically, if the site allows me to upload my documents to the county, they should approve the link request so the county offices can view the information. I submitted my documents in this manner and was later given notice that my application was denied due to not providing the needed verifications. The verifications were there the whole time-even before they asked for them. I went down to the local office with copies and noticed they had one person designated to take each page, time stamp it then scan it. I had 27 pages. This took over 40 min. This is archaic, but what stinks the most is you are not told that one of the four submittal options isn't used or acknowledged, thus delaying or resulting in daniels.
Chris Paddock
My observations of the CA welfare system is that when the State Budget went south a new and borrowed tactic from the private insurance sector was adopted. The Federal Govt. Mandates these benefits so they cant be cut from the budget to save money or slow down the bleeding. So, a Delay, Deny & Frustrate policy has obviously been adopted. Regardless if its Cal-Fresh, Cal-Works or Medi-Cal, across the board the treatment of benefit seeker of need has become atrocious. THe level of frustration most commonly has one cost saving result; the benefit seeker disengages from the system and home, health & nutrition spiral downward. Shame on Toby Douglas who more often than not is never available for press questions or comments.
Chris Paddock
I was qualified categorically due to a permanent disability relating to a chronic disease since 2012. I experienced numerous administrative errors that abruptly; without notice cancelled my coverage. Normally, it took less than 30 days to get things corrected re-enrolled. In most cases I would have to fall back on Ryan White & ADAP coverage for that 30 days. Unfortunately, that stop-gap coverage does not cover hospital admissions nor does it cover anything not related to my chronic illness. I applied via Covered CA. on Feb. 2, 2014 and was denied marketplace coverage and referred to the county for medi-cal. As of today, six months later- I have been told my file hasn't been assigned to a case worker yet. There has been no communication as why the delay is occurring & where I should obtain my medical treatment and prescription drugs. This is my experience, it appears that if you are on Medi-cal you are not "equal" in terms of access to medical care.

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