California Health Report: State Agency Running Medi-Cal Didn’t Know How Many Docs Took its Insurance

July 17, 2014

 

The state’s Medi-Cal provider list had a higher number of physicians than were even licensed to practice in California last year.

By Hannah Guzik

The California agency that oversees the state’s low-income health plan vastly overstated the number of doctors who accepted patients through the state program last year, even as the number of people enrolled in the program was set to skyrocket under the federal Affordable Care Act, the California Health Report has found.

The state’s Medi-Cal provider list had more physicians than were even licensed to practice in California last year.

The list had some duplicated names and may have also included doctors who were deceased or retired, Department of Health Care Services spokesman Anthony Cava conceded Tuesday.

“DHCS tracks enrolled physicians in Medi-Cal, but providers are not required to notify us if they stop seeing Medi-Cal members,” he said. “The list you reference could have also included doctors who were deceased and retired, and we are working diligently to continue improving the list to ensure only providers who should be listed are included.”

The accuracy of the list is important because it is one of the tools the state can use to determine if there are enough doctors to serve those in Medi-Cal’s fee-for-service program, which about 9 percent of California residents are enrolled in. Many of the doctors listed are also enrolled in Medi-Cal managed-care plans, which serve about 20 percent of the state’s population.

About 2.2 million people have signed up for Medi-Cal, the state’s low-income health plan, since the program was expanded under the Affordable Care Act. In total, 10.9 million people are enrolled.

Continue reading here: http://www.healthycal.org/archives/16258

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