Audit: California Paid $4B In Questionable Medi-Cal Claims

SACRAMENTO, Calif. (AP) – An audit finds California paid at least $4 billion over four years in questionable Medi-Cal premiums and claims because it failed to follow up on eligibility discrepancies. The California auditor’s office says Tuesday that from 2014 through 2017 more than 450,000 people marked as eligible for Medi-Cal in the state’s system were listed as ineligible in county systems. Half of those discrepancies persisted for more than two years. Auditors also found some eligible individuals may have encountered unnecessary hardship and been inappropriately denied services. An email seeking comment from the Department of Health Care Services, which administers California’s Medicaid program, was not immediately returned. The report recommends the department resolve the discrepancies and recover erroneous payments when possible. The department is also urged to assist counties in addressing the problems.


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