Nov 6, 2009 12:07 am US/Pacific
Cancer Patient Caught in Medi-Cal Backlog
MARTINEZ (CBS 5) ―
The phones are ringing but nobody's picking up at Medi-Cal's customer service office in Sacramento. That's because massive state budget cuts have shut down the lines, leaving people like Lorene Curry without the healthcare she needed.
"I have stage 4 cancer, and it's an aggressive cancer," said Curry, who lives in Martinez.
She says the cancer caused her to take too much time off work. Eventually she lost her job and the medical coverage that came with it. Unable to afford private insurance, Curry signed up for Medi-Cal, the state's health insurance program for the poor. But despite getting her eligibility in September, Medi-Cal's computer records continued to show Curry as a Kaiser patient, the health plan she had lost along with her job. That meant her Medi-Cal card was no good when she tried to get medicine at the local Walgreens. And she says she couldn't use the card to get a doctor either.
"It's very frustrating when you need your medication and you need to see a doctor, and you can't," said Curry, who called the Medi-Cal help line, only to hear a taped message saying the line had been shut down "due to recent budget cuts and proposed state layoffs." The only way to get through, said the message, was by email or fax.
"I've emailed them. No response," said Curry. "Faxed. No response. And I also said, you know, you're playing with my life here!"
So CBS 5 ConsumerWatch contacted Medi-Cal on Curry's behalf.
"There is a backlog," explained Medi-Cal spokesman Norman Williams. "And we're working to deal with that as quickly as possible."
Williams said a $400 million budget cut in July has left only four staffers to deal with the 800 faxes and emails pouring in each day. Nevertheless, he said, the law still requires doctors and pharmacies to take care of new Medi-Cal patients until the billing problems can be sorted out.
"And it requires that the providers provide the service, even if there is other health coverage," said Williams.
That was a surprise to Walgreens, which told CBS 5 ConsumerWatch that it can't possibly chase down the billing records for thousands of Medi-cal patients potentially caught in the backlog.
"It's very very stressful," said Curry. She said she was running out of cancer medicine and was forced to turn to her county health clinic for help.
And that's an issue for Contra Costa County Health Director Dr. William Walker, who said the state's Medi-Cal backlog is pushing more patients into county services already strained by their own budget cuts.
"We have a huge crisis," said Dr. Walker. "We take them in, try to get them qualified for insurance. But if not, the county ends up being the provider of last resort as a safety net."
After CBS 5 ConsumerWatch contacted Medi-Cal, Curry's records were quickly corrected. Medi-Cal also issued a bulletin to its healthcare providers to make sure patients with eligibility problems are getting care as Medi-Cal tries to clear up the backlog.
"I feel great right now!" Curry said, "Because I've had help."
She's grateful the system is now working for her, providing doctors and medicine she hopes will stop her cancer.
"It's a great system," she said, but then shook her head. "But you need people who know what they're doing."
(© MMIX, CBS Broadcasting Inc. All Rights Reserved.)
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