State Officials Meet CMS Deadline for Explanation of Huge Medi-Cal Backlog

State officials yesterday said they met the July 14 deadline to respond to a CMS request for a detailed explanation about why California’s backlog of unprocessed Medi-Cal applications remains at roughly 600,000 applicants. The backlog previously surpassed 900,000.

The response, mailed to CMS yesterday, has not yet been approved for public release, according to Norman Williams, deputy director of public affairs for the Department of Health Care Services.

Williams said the high volume of enrollees in expanded Medi-Cal contributed to the backlog. 

“The response to the … expansion of Medi-Cal has been tremendous,” Williams said in an email.

He said more than 800,000 people have been enrolled in Medi-Cal since the end of March. “The number of pending individuals continues to be a rolling number as new applicants enter the system and those found eligible gain enrollment status,” Williams said.

In April, the backlog stood at 900,000 pending applications for Medi-Cal, and the backlog now stands at 600,000, Williams said. He said the department has been addressing the backlog in four ways:

  • Automation system stabilization and improvement;
  • New messaging for consumers on the online portal about how to enter data more carefully and accurately, to cut down on duplicate application submissions;
  • Review of the pending applications data and identification of batch processes, which has eased the workload at the county level, Williams said, by expediting eligibility — “thus helping more than 140,000 individual applicants in recent weeks,” Williams said; and
  • Allowance of self-attestation of residency in the state till Aug. 1.

“We also recently installed the electronic interface with the Medi-Cal eligibility data system and [the California] Franchise Tax Board to verify residency,” Williams said. “In addition, efforts are underway to address the DMV interface for residency purpose.”

Williams did not say when the DHCS response letter to CMS would be released.

“For a program of Medi-Cal’s size, there have always been pending individuals awaiting enrollment,” Williams said, “and, as has always been the case, it is our responsibility to work with the counties and other partners to process applications and enroll individuals into coverage.”

Related Topics

Capitol Desk Medi-Cal