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 The report released Tuesday by the California State Auditor showed
that the state's Drug Medi-Cal program may have paid more than $3
million in claims for patients who were actually dead, and found
serious deficiencies in the agency's records for 30 drug treatment
program providers.
“It is a very troubling audit,” said State Senator Ted Lieu, a
Southern California Democrat who requested the audit along with
another lawmaker. “It shows that there is significant fraud in
California’s Drug Medi-Cal system, and that this fraud has been
ongoing for many years.”
The audit was spurred by a 2013 investigation by The Center For
Investigative Reporting and CNN, which found questionable billing
practices at drug-treatment clinics in Southern California. The
program is a division of the state's healthcare program for the
poor, known as Medi-Cal.
Norman Williams, a spokesman for the California Department of Health
Care Services, which administers the program, said 237 Drug Medi-Cal
clinics were suspended following an investigation that began last
year.
“We actually welcome and we appreciate this report,” Williams said.
The state has begun the process of re-certifying the roughly 650
clinics that participate in the program, requiring their owners to
undergo fingerprint and background checks, he said.
The audit found that the state did not follow proper certification
processes for substance abuse clinics, and only took corrective
action following federal government intervention.
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The audit’s review of the files of 30 program provider applicants
found that five files were completely missing, and identified
deficiencies in every one that was present, including 24 with
inadequate disclosure statements. The audit states that the files
"demonstrated the State’s certification process was woefully
inadequate."
It recommends that the California Department of Health Care Services
coordinate with county governments to recover inappropriate payments
and more thoroughly screen substance abuse care providers’
eligibility.
Lieu, who is running to replace Democrat Henry Waxman for Congress
in a district that includes parts of Los Angeles and Beverly Hills,
said that the audit showed “a phenomenal lack of leadership and
training.”
(Editing by Sharon Bernstein and Eric Walsh)
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