State's mistake on Medi-Cal letter misinforms a quarter-million low-income people

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The California Department of Health Care Services mistakenly sent nearly a quarter-million low-income people notice that they may have to find new doctors once they enroll in Medi-Cal next year. DHCS says it sent out correction notices as soon as it discovered the error.

The people who received the letter earlier this month are enrolled in the state’s Bridge to Reform program. Under the program, counties and the federal government are splitting the cost of insuring low-income people until they are eligible for Medicaid -- known in California as Medi-Cal -- on January 1.

The Bridge program launched in 2011; the idea was to make the rollout of the Medi-Cal expansion as smooth as possible by getting people insured and signed up with primary care physicians well before 2014. 

Earlier this month the Department of Health Care Services sent letters to nearly a half million of those patients with information on how their transition to Medi-Cal will work. But because of a processing error, more than 246,000 of those letters incorrectly told patients they may have to switch doctors because their current physicians were not part of the Medi-Cal network. A lot of worried people started calling or showing up at their doctors’ offices. 

"If you got this notice, it was an incorrect notice and you will be able to keep your provider," said DHCS spokesman Norman Williams said. "Once we learned of this situation, we began working to mail a retraction notice, and the correct version." He said the corrected version started going out last week.

Sean South, associate director of policy at the California Primary Care Association, said it will be important for the state to avoid future errors that could cause confusion for patients looking to enroll in insurance programs offered under the Affordable Care Act. Nationwide, the rollout of the health care law has been plagued by glitches that have made enrollment difficult or impossible for many people.

South said that because roughly 1.3 million residents are eligible for Medicaid expansion in California, if enrolling them goes well,  "it would probably be the biggest success story for the Affordable Care Act so far."