Advocacy Organizations File Lawsuit Over Medi-Cal Backlog
On Wednesday, a coalition of advocacy groups filed a lawsuit in Alameda County Superior Court over a backlog of Medi-Cal applications, the AP/Sacramento Bee reports.
Medi-Cal is California's Medicaid program (Lin, AP/Sacramento Bee, 9/17).
About 2.2 million additional Californians signed up for Medi-Cal under the Affordable Care Act's expansion of the program. A total of about 11 million state residents now are covered by the program, according to the Los Angeles Times' "L.A. Now."
California Department of Health Care Services spokesperson Norman Williams said that about 350,000 applications for the program had not yet been processed as of Sept. 1 -- down from 900,000 backlogged applications earlier this year (Brown, "L.A. Now," Los Angeles Times, 9/17).
Details of Lawsuit
The lawsuit was filed by several groups, including:
- Bay Area Legal Aid;
- Central California Legal Services;
- Multiforum Advocacy Solutions;
- National Health Law Program;
- Neighborhood Legal Services of Los Angeles County; and
- Western Center on Law and Poverty (NHLP release, 9/17).
The suit calls for the court to require DHCS to:
- Determine Medi-Cal eligibility within 45 days of submission;
- Notify applicants who are affected by the backlog that they can request a hearing on their application; and
- Provide benefits to eligible applicants while their applications are being processed.
Katie Murphy with Neighborhood Legal Services said the advocacy groups hope that the court will address the lawsuit before Nov. 15, when Covered California's second open enrollment period begins. Covered California is the state's health insurance exchange under the ACA.
Murphy said, "There will be another wave" of applications for Medi-Cal and more people will have to wait for coverage if the current backlog is not fixed by then ("L.A. Now," Los Angeles Times, 9/17).
Williams said the department does not comment on litigation. However, Williams noted that many of the applications that were backlogged as of mid-August have been processed and that DHCS is "currently developing an updated set of numbers to reflect that activity" (Florido, "KPCC News," KPCC, 9/17).
In addition, DHCS officials say that many of the applications are backlogged because applicants provided incomplete or incorrect information.
Department spokesperson Tony Cava said that enrollees can receive coverage for their medical care when their applications were pending. He added that those in need of immediate treatment can seek in-person enrollment assistance through county social services agencies (Gorman, "Capsules," Kaiser Health News, 9/18).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.