Medi-Cal Certification Backlog Reduces Number of Physicians Available To Treat Beneficiaries
Forty percent more physicians would be available to treat Medi-Cal beneficiaries if the state eliminated a backlog of 10,500 applications from physicians seeking to participate in the program, the Orange County Register reports. State officials say that the process takes an average of 111 days, but some physicians say it can extend beyond a year. Medi-Cal certification is necessary for physicians to receive reimbursement from the state for services provided for the program's beneficiaries. Without it, physicians turn away Medi-Cal patients, have them pay cash or provide free care. Currently, only about 26,000 of the state's 90,000 licensed physicians are approved to participate in Medi-Cal. "The No. 1 complaint is how hard it is to find a doctor on Medi-Cal. Many (doctors) don't even want to be in the system," Dr. Kevin Grumbach, a physician and indigent care researcher at the University of California-San Francisco, said, adding, "Given that situation, it's curious that the state isn't more eager to sign up doctors for Medi-Cal."
An unknown number of the 27,700 applications that the Department of Health Services has termed "closed" were rejected because they contained errors and remain in "bureaucratic limbo," the Register reports. To become certified for Medi-Cal, physicians must submit as many as five applications. If the applications contain any errors, they are returned to the physicians, which can "add months to the process," according to the Register. The Register reports that in 2001, certification took just a few months, but state budget cuts that prompted a hiring freeze at DHS, an increase in applications and more stringent anti-fraud measures have since "conspired to create a large backlog," according to Stan Rosenstein, DHS deputy director of medical care services (Kim Quach, Orange County Register, 3/10).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.