Morning Briefing
Summaries of health policy coverage from major news organizations
California, Massachusetts Medicaid Programs Blasted
Los Angeles Times: Medi-Cal Patients May Not Have Adequate Access To Doctors, Audit Finds
Since signing up for Medi-Cal more than a year ago, Kevin Hill hasn’t been able to find a doctor. He said he called at least 15 physicians near his home in Long Beach who were listed in his health plan’s provider directory. But either the phone numbers didn’t work or the doctors weren’t accepting new patients, he said. He's given up. “Now I just go to an emergency center to pay cash even though I can barely afford it,” the 58-year-old said. (Karlamangla, 6/16)
The San Jose Mercury News: California State Auditor Blasts Medi-Cal Program For Inadequate Provider Networks
A scathing state review of California's strained Medi-Cal program confirms what thousands of the health plan's exasperated enrollees have long complained about: The department tasked with overseeing health care for almost one third of the state's residents cannot ensure it has enough doctors to serve its 12.3 million patients. (Seipel, 6/16)
The Sacramento Bee: Audit: California’s Medi-Cal Phone Lines Overwhelmed
Thousands of calls to California’s Medi-Cal complaint lines don’t get through, and thousands more that manage to ring the call center go unanswered, according to a new state audit. For the year that ended in January 2015, the phone system to the Medi-Cal ombudsman’s office rejected up to 45,000 calls in a month, State Auditor Elaine Howle said in her report to lawmakers. (Ortiz, 6/16)
Kaiser Health News: State Auditor Slams California’s Oversight Of Medi-Cal Plans Used By 9 Million
California health officials failed to ensure that more than 9 million residents enrolled in Medi-Cal managed care plans had access to doctors when they needed them, the state auditor said in a stinging report Tuesday. Health officials might have learned about those problems from calls to an ombudsman’s office – but thousands went unanswered every month. (Feder Ostrov, 6/16)
Meanwhile, Massachusetts' Medicaid program is also under the microscope -
The Boston Globe: MassHealth Overspent $500M, Audit Finds
The state’s Medicaid program spent more than $500 million over five years on improper or unnecessary payments, according to a state audit released Tuesday. State Auditor Suzanne M. Bump asserts that the state paid for services that should have been covered by the health insurers it contracts with to manage care. (Freyer, 6/16)
The Associated Press: Audit: Medicaid Program Squandered More Than $500M
The state Medicaid program squandered more than $500 million through unnecessary payments or missed savings opportunities in its managed care program, according to an audit released Tuesday. The review by State Auditor Suzanne Bump found MassHealth, the state Medicaid program, made $233 million in unnecessary payments for medical services that should have been covered by managed care organizations between October 2009 and September 2014. The audit also says the state could have saved $288 million more through more detailed structuring of managed care contracts. (LeBlanc, 6/16)
