California Healthline: State Has Paid More Than $1 Million in Penalties for Late Hearings; Total Will Rise

by David GornMonday, July 29, 2013
 

The Department of Health Care Services has sent more than $1 million in penalty checks to some beneficiaries in the Community Based Adult Services program due to long delays in appeal hearings over beneficiaries’ eligibility status, according to DHCS officials.

About $1.2 million in penalties has been paid to 486 appellants and there are another 670 checks waiting in the queue.

DHCS officials did not have an estimate of how much money those additional 670 checks represent. They are “still being processed,” according to Norman Williams, deputy director of communications at DHCS.

The average amount of the checks sent so far is $2,430 per person.

“That’s a lot of money to be spending because you couldn’t get your hearings out on time,” said Elizabeth Zirker, staff attorney at Disability Rights California.

The state has 90 days to process fair hearings for CBAS eligibility appeals. If  the ruling finds the appellant eligible for the program, the state must pay $100 a day for each day past the 90-day limit.

Of the 2,370 CBAS hearings held last year, 1,235 of the appellants were found to be CBAS-eligible and 1,156 of the decisions went longer than 90 days, according to Williams.

Williams said the lawsuit settlement that created the new CBAS Medi-Cal benefit “resulted in a large volume of fair hearings requiring new processes that called for the State Hearings Division to gear up to handle the hearings in a short period of time,” Williams said.

 

Continue reading here: http://www.californiahealthline.org/capitol-desk/2013/7/state-has-paid-more-than-$1-million-in-penalties-for-late-hearings

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