A new form for annual Medi-Cal renewals scheduled to be sent to about eight million Californians is confusing and misleading and could cause many beneficiaries to fall out of coverage, according to health care advocates.
“The renewal form is really a mess,” said Elizabeth Landsberg, director of legislative advocacy for the Western Center on Law and Poverty. “It’s just not very clear, it’s confusing. It’s a terrible form.”
Landsberg said Californians could lose Medi-Cal coverage by not dealing correctly with the forms and with millions of beneficiairies needing to file them, the repercussions are potentially huge. County health departments will begin mailing the renewal form and a supplemental form April 1.
“Everyone is required to do a renewal once a year,” Landsberg said. “There have always been some people who have lost coverage [during the renewal process].” But in this case, she said, the complicated nature of the process and the new information required to renew coverage could raise those numbers dramatically. “We think [the damage] could be significant,” she said.
The form is actually two separate forms that both need to be filled out, said Norman Williams, deputy director of public affairs at the Department of Health Care Services.
“DHCS worked closely with stakeholders and counties to develop these Medi-Cal eligibility renewal materials,” Williams said in a written statement. “We will continue working with our partners on revisions for future renewal materials. In the meantime, counties will include a cover letter with the forms that will explain the two-form process to our members. And we will be working closely with the counties to address member questions and concerns related to the new renewal process.”
The Western Center on Law and Poverty and the National Health Law Program wrote to CMS, detailing some of their concerns, which include:
- Two forms replacing one form is unnecessary and causes confusion;
- One page says that if the form is not returned by mail, the recipient will lose coverage. But that’s not accurate, advocates said, noting that recipients also can fill out the forms in-person or on the phone;
- One of the check boxes under race determination is “Spanish;”
- One check box asks if a recipient’s income arrives twice a month and another choice is every two weeks. Advocates point out they are the same and
- If there are any questions or problems, the recipient is asked to call the Covered California hotline, rather than county services. The wait time at Covered California currently is about an hour.
According to advocates, DHCS officials told them “the form has already been programmed into the various county systems and could not be changed because it would take too long.”
In a written statement, advocates said “Therefore none of our comments were accepted. Despite recognizing the flaws with the … form, instead of fixing that form the state created yet another form … to collect additional information. That form is also going out to these families at the same time.”
“The former form was so much more understandable,” Landsberg said. “It is a sea change over to tax-based rules and getting new information for families, but they shouldn’t have badly designed forms on top of the new information.”
The odd errors and sometimes misleading information, she said, make the effort seem rushed.
“It is a draft,” Landsberg said. “It shouldn’t have been programmed into the system. Advocates have been abundantly clear, we’ve urged the department to postpone for a couple of months now to fix it. We think it’s a wrong choice to send out these forms.”