Advocates suing CA over Medi-Cal payments

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A nonprofit group is suing the state of California, alleging that low Medi-Cal reimbursements are denying quality health care to millions of Californians. (KABC)

It was hard enough for Medi-Cal patient Saul Perea to grow up with cerebral palsy. But making it worse was having to wait a year and a half to see a specialist.

Implementation of the Affordable Care Act covered more people than ever, but Medi-Cal's reimbursement to doctors is now so low many have dropped their Medi-Cal patients.

Demand is overwhelming nonprofits such as St. John Well Child and Family Center in South Los Angeles.

The civil rights group MALDEF on Wednesday announced it is suing the California Health and Human Services Agency and the Department of Health Services. The group claims that the state is failing to pay doctors enough, thereby lowering the quality of health care for the 13 million patients on Medi-Cal, more than half of them Latino.

The state's response: "The Department of Health Care Services has an established plan to monitor patient access to care. DHCS has not identified any systemic problems with patient access to services in the Medi-Cal program nor has the federal Centers for Medicare and Medicaid Services identified any issues."

Yet providers say there is an issue. Medi-Cal reimbursement rates rank 48th in the continental United States.

Civil rights advocates say this claim is about more than money. It is about cutting red tape.

MALDEF wants measures ensuring timely payments to doctors, and to adequately monitor and enforce the existing network.

Pressure is growing as the number of Medi-Cal patients has doubled since 2011 to 13.5 million.

Related Topics:
healthhealth careaffordable care actlawsuit
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