‘I’m running out of medicine.’ Paperwork backlog costs some their Medi-Cal coverage

Thaddeus Moncrief has gone for months without three medicines he takes to control his high blood pressure. He also stopped leaving his home in Lancaster because he’s running dangerously low on catheters he uses with his wheelchair. He’s afraid of having an accident in public.

“Like yesterday I needed these medical supplies,” said Moncrief, 48.

Moncrief is one of many Los Angeles County residents who say they were wrongly dropped from Medi-Cal, the state’s healthcare program for low-income and disabled Californians, and have struggled to regain coverage and see their doctors. The patients say they turned in their renewal paperwork on time to the county, but lost coverage anyway.

David Kane, an attorney at Neighborhood Legal Services of Los Angeles County, said his organization has heard from more than 200 people this year who believe their Medi-Cal coverage was improperly terminated. Kane said he thinks the total number of those affected could be in the thousands.

Officials from the Department of Public Social Services, which processes Medi-Cal applications and renewals, would not comment on whether people had been wrongly terminated from Medi-Cal, saying they had been threatened with a lawsuit.

“I am aware of the Medi-Cal coverage situation that resulted in some cancellations, and my office is conducting a review of the matter,” L.A. County Supervisor Mark Ridley-Thomas said in a statement. “We are working with DPSS to ensure that recipients are treated fairly and that their concerns are being addressed.”

A state official said the backlog grew between June 2015 and March 2016 while the county updated language in letters sent to people whose Medi-Cal eligibility was being discontinued. The change was made to address separate litigation.

Moncrief said he turned in his annual paperwork to renew his Medi-Cal coverage in May. He’s paraplegic, and Medi-Cal has been paying for his doctor’s visits and medicines for decades.

But in July his doctors told him that he was no longer covered by the program, he said. He began calling county and state Medi-Cal offices, but was unable to figure out what had happened.

Eventually he filled out another renewal packet and mailed it to the county. His coverage still wasn’t reinstated, he said.

In September he contacted Neighborhood Legal Services, whose lawyers filed a complaint with the county. His Medi-Cal was reinstated within a few days.

But Moncrief hasn’t been able to see his doctor yet because the office can’t accommodate more patients.

“I’m running out of medicine ... I can’t do anything without my doctor,” he said. “Here we are back to square one.”

Typically, Medi-Cal beneficiaries begin receiving notices 60 days before their official renewal date. Kane said he thinks the county is not processing applications within that window, and that as a result its computer systems are automatically terminating people from the program.

Documents obtained by Neighborhood Legal Services through a public records request show that as of September, 24,545 renewal packets had been turned in but not yet scanned into the county’s computer system to be processed. Some had been submitted as far back as January.

“It’s the common pattern in all the cases, where the consumer does everything right, submits the paperwork on time, and the county’s default is to cut off life-sustaining care,” Kane said.

Tony Cava, spokesman for the California Department of Health Care Services, which oversees Medi-Cal, said a “technical update” in the discontinuance letters had contributed to the backlog, but that the county had “implemented a plan to ensure timely processing of renewals.”

“I’m sorry we are unable to discuss certain issues because of potential litigation,” Sheryl L. Spiller, director of the public social services department, said in an email to The Times. “Be assured, we are constantly striving to improve, whether we’re drawing on lessons from our successes or from our challenges, including those surrounding the Medi-Cal renewals.”

Officials said they were confident future renewals would be processed without delays.

The Medi-Cal program was expanded in 2014 under the Affordable Care Act to cover all state residents who make less than $16,395 a year. More people than expected signed up and the now 13.6 million Californians receive coverage through Medi-Cal — one in three people in the state.

There are 4.2 million people on Medi-Cal in Los Angeles County, and the county processes more than 100,000 renewals a month.

Kane said that despite the county’s assurances, he’s continued to receive calls from people who believe their coverage was improperly terminated and doesn’t expect that to let up.

Carol Northern, who lives in Palmdale, had already turned in her renewal packet when she got a letter saying it was time to renew her Medi-Cal coverage. “I’m thinking, wait a minute, it’s supposed to be continuing,” she said.

Northern learned from her health plan that her coverage had been canceled. Between May and August, she called county and state offices to try to figure out what had happened, she said.

She’s on oxygen 24 hours a day, and has a blood disease that requires several medicines. She grew worried because she had doctors to see and medicines to buy and “no way to pay them,” she said.

“It’s hard enough when you’re disabled and then you have to fight the system,” Northern said.

Her coverage was eventually reinstated, but she still hasn’t quite recovered.

“Every time I go to the mailbox I go, ‘OK, I hope there’s nothing in here from Medi-Cal,’” she said.

soumya.karlamangla@latimes.com

Twitter: @skarlamangla

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