LAO: Calif. Prison System Could Draw Millions Through Medi-Cal
California's prison health care system could obtain tens of millions of dollars in federal funds annually if it reaches Medi-Cal agreements with several counties and fixes problems with reimbursement software, according to a report from the Legislative Analyst's Office, the Los Angeles Times' "PolitiCal" reports.
Medi-Cal is California's Medicaid program (St. John, "PolitiCal," Los Angeles Times, 2/5).
About six years ago, U.S. District Judge Thelton Henderson appointed federal receiver J. Clark Kelso to oversee the state's prison health care systemÂ after determining that an average of one inmate per week died as a result of malpractice or neglect (California Healthline, 1/30).
The report found increasing numbers of inmates who are eligible for Medi-Cal because of their low-income status. According to LAO, federal policy has allowed states to draw federal matching funds for inmates who qualify for Medicaid since 1997.
The report found that California only recently developed a process to obtain federal Medi-Cal funds for low-income inmates.
According to LAO, Kelso has agreements on Medi-Cal coverage for inmates with 12 counties, which cover nearly 75% of inmates in California's prison system. However, the report found that several counties have not signed agreements, such as a consortium of 35 rural counties.
LAO also found that the Department of Health Care Services has been unable to process about 66% of prison claims submitted to Medi-Cal because of problems with software.
According to LAO, California would save $13 million annually if Kelso reached agreements with all counties.
LAO estimates that solving all problems noted in the report and expanding Medi-Cal under the Affordable Care Act -- which would allow the program to qualify for 100% federal funding -- would draw an additional $40 million in federal reimbursements annually for inmate health care.
Response to Report
Joyce Hayhoe -- the legislative affairs liaison for Kelso -- said that Kelso's office appreciates LAO's "in-depth" review.She said the office continues to negotiate with counties to reach more agreements on Medi-Cal coverage for inmates ("PolitiCal," Los Angeles Times, 2/5). 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.