Morning Briefing
Summaries of health policy coverage from major news organizations
California, Massachusetts Medicaid Programs Blasted
Since signing up for Medi-Cal more than a year ago, Kevin Hill hasn鈥檛 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鈥檚 provider directory. But either the phone numbers didn鈥檛 work or the doctors weren鈥檛 accepting new patients, he said. He's given up. 鈥淣ow I just go to an emergency center to pay cash even though I can barely afford it,鈥 the 58-year-old said. (Karlamangla, 6/16)
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)
Thousands of calls to California鈥檚 Medi-Cal complaint lines don鈥檛 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鈥檚 office rejected up to 45,000 calls in a month, State Auditor Elaine Howle said in her report to lawmakers. (Ortiz, 6/16)
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鈥檚 office 鈥 but thousands went unanswered every month. (Feder Ostrov, 6/16)
Meanwhile, Massachusetts' Medicaid program is also under the microscope -
The state鈥檚 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 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)
