MEDI-CAL FRAUD: ‘Right Under the Noses of State Officials’
Calling recent state efforts to combat Medi-Cal fraud "after the fact," a Los Angeles Times editorial today notes that it is "probably too late to recoup the millions of dollars already lost." The editors write that as fraud investigators focused on abuse by Medi-Cal recipients, medical supply scams -- facilitated by "lax" state standards -- "multiplied right under the noses of state officials," prompting the question, "Why didn't some take action?" But state officials are not entirely to blame, the Times relents, noting that the "California situation mirrors a nationwide problem" caused largely by a "shortage of investigators, outdated and unreliable computer systems and the fact that states operate 50 different Medicaid systems, each with differing standards." In addition, California officials still have no idea who is allowed to audit Medi-Cal cases after a federal ruling that state Controller Kathleen Connell has no jurisdiction over the issue. Gov. Gray Davis' (D) recent authorization of funds for 40 additional investigators and a new law mandating that every medical suppler keep records and post a $25,000 collateral bond against potential fraud should improve the situation and help the state "ensure that nothing of such magnitude ever happens again," the editorial concludes (12/1).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.