IMMIGRANT HEALTH: Medi-Cal Fraud Program Owes $3M to Wronged Families
Under terms of a class-action suit settled last fall in federal court, the state Department of Health Services is "scrambling to return at least $3 million to immigrants" who were "improperly ordered to return Medi-Cal benefits" under a fraud detection program at border crossings. The San Diego Union-Tribune reports that in a "scathing report" released last week that urged the program's end, state auditors cited an "intimidating and poorly managed program" that "inaccurately" told immigrants they had illegally received Medi-Cal benefits and "failed to draw the line between the need to crack down on public assistance abuses and the legal rights of people entitled to benefits." Among the abuses the state audit found were intimidations of jail time or lowered chances for citizenship and demands of payments higher than the cost of actual Medi-Cal services. About 1,500 families are eligible for refunds of amounts "wrongly recouped by the state since 1996."
Grantland Johnson, secretary of the state Health and Human Services Department, said, "We will ... be looking into a redirection that involves an increased effort to combat provider fraud" without "direct contact with the Immigration and Naturalization Services on specific beneficiaries." The Union-Tribune reports that state health officials said they started withdrawing health investigators from INS checkpoints earlier this month. Ben Seeley, director of the Border Solutions Task Force, said the state pulling the Medi-Cal investigators off border duty "has dismayed those who favor a hard-line stance against illegal immigration and public assistance abuses." He said, "We're going to push to get the (Medi-Cal fraud) unit back at the border crossing. Anytime there is fraud, that affects taxpayers." Seeley said the fraud detection program has "thwarted" nearly $15 million in Medi-Cal fraud and helped prevent millions more, but state auditors said "authorities exaggerated the program's overall financial benefits by disregarding other expenses" (Cantlupe, 4/10).