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Medi-Cal Application Backlog Will Be ‘Down Significantly’ Within Six Weeks

At an Assembly Committee on Health hearing yesterday, Department of Health Care Services Director Toby Douglas said the backlog of Medi-Cal applications — at one point in March topping 900,000 unprocessed eligibility claims — now is down to about 250,000 applications and will be “down significantly” from that by the start of November.

Douglas answered a number of concerns at the hearing, including announcing a shift in DHCS policy regarding asthma and allergy testing, as well as Denti-Cal and special-needs dental care issues.

The counties and DHCS, Douglas said, reduced the Medi-Cal application backlog by 650,000 over six months — more than 100,000 a month. A similar pace in the next month-and-a-half would get it down to about 100,000 applications.

“If you look at the trajectory, I hope to take this down significantly over the next six weeks,” Douglas said.

That wasn’t really good enough at the hearing for Assembly member Jim Patterson (R-Fresno).

“I don’t think I heard an answer to this,” Patterson said. “When do we anticipate ending the backlog?”

“We are going to continue to work through it,” Douglas said. “We want to get to that as soon as possible.”

Patterson wanted to know specifically when the department would be done going through all the backlogged applications. “I have to go back and tell my constituents about this,” he said. “What do I tell them? That it will never be zero?”

Douglas said it wasn’t only about clearing the older claims, but making sure the newer claims don’t end up contributing in even greater numbers to the backlog.

“It gets back to getting the defects out of the [computer] system, so we’re in a stable state,” Douglas said.

Douglas also announced at the hearing that DHCS will change its Medi-Cal policy stance on ordering certain types of allergy tests. It was a shift to national standards that Assembly health committee chair Richard Pan (D-Sacramento) has lobbied DHCS to change for more than two years.

“For patients waiting months and months to get tested, this is an important victory,” Pan said in a written statement after the hearing. “Now a doctor can order tests to identify a patient’s allergy and asthma triggers so they can avoid getting sick.”

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