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Doctors examine the x-ray of a patient.
(IStock)
An audit released Tuesday revealed that the state of California had spent $ 4 billion between 2014 and 2017 to pay Medi-Cal coverage to beneficiaries who may not have been eligible for the program, according to reports.
Discrepancies between state and county record keeping may be at least partly responsible for the problem, the Los Angeles Times reported.
In one case, according to the report, the state continued to pay benefits to a resident's health plan until August of this year, even though that resident died almost five years ago. Payments to this resident's plan totaled $ 383,000, the Times reported.
In a letter to the state legislature and accompanying the audit, state auditor Elaine Howle wrote: "Although health care services have put in place a the process of notifying the counties of beneficiary files requiring follow-up, gaps have allowed the identified problems to persist. . "
Elaine Howle, California Auditor
"Although the health services have put in place a process to notify the counties of beneficiary registrations that require follow-up, weaknesses in this process have allowed the problems we have identified to continue."
The audit revealed that 453,000 beneficiaries identified as eligible in state registers were not considered eligible at the county level, the report says, suggesting that these people may have died, displaced or started to earn too much. money to be eligible for the program.
An email from the Associated Press, soliciting comments from the Department of Health Services, which administers the Medi-Cal program, was not immediately returned.
The auditors recommended that the department recover erroneous payments where possible and "implement protocols to ensure early resolution of anomalies".
The department was also asked to help counties solve problems.
Medi-Cal provides more than 13 million low-income Californians with services such as general health care, emergency services, dental care and mental health and addiction treatment.
The Associated Press contributed to this story.
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