California Health Director Apologizes for Lack of Oversight in Medi-Cal Program

Recent media investigations by the Center for Investigative Reporting and CNN brought to light questionable billing practices of dozens of clinics in Medi-Cal’s drug rehabilitation program.

They included stories of taxpayer funds being used for counseling sessions that never occurred, for people who, in some cases, were incarcerated or dead.

So state lawmakers called for a hearing.

Toby Douglas, Director of the California Department of Health Care Services, testified before them at the State Capitol.  

“What we are uncovering in terms of the fraud and the other issues with the drug Medi-Cal program is completely unacceptable. And I am here to tell you that we are sorry that we did not take action sooner,” Douglas said.  

Democratic State Assembly Health Committee Chair Dr. Richard Pan said he is frustrated to hear about the misuse of funds in the public health program that is meant to serve poor people. 

“As a legislator we’ve had to make cuts to the program, and yet here there are people defrauding the program," said Pan.  

"It seems like that even though there were indications that people were either aware or concerned about it, there didn’t seem to be follow through, ” Pan said about the Department of Health Care Services' dealing with the suspected fraud. 

The Department of Health Care Services has referred some clinics to the Department of Justice.

But Douglas says they’re working on stronger systematic oversight.

“This is not a quick fix,” Douglas said.

Dr. Pan says he’ll be working with the Department to prevent future fraud.