California’s Schwarzenegger Calls for More Scrutiny of Medi-Cal Claims

SACRAMENTO, Calif.–Gov. Arnold Schwarzenegger has ordered the
California Department of Health Services to take a closer look at
Medi-Cal claims to root out fraud.

The governor also directed the department to carry out onsite
reviews of some 2,000 pharmacies for compliance, and to create a
plan with provider associations and regulatory boards to address
claims errors. The state also will use new, customized anti-fraud
technology to identify potential fraud schemes.

Schwarzenegger’s directives came as the DHS issued its second
annual report of payment error in Medi-Cal, the state’s Medicaid
program.

“This study, which is the only one of its kind in the nation, is
a very valuable tool that helps guide our anti-fraud efforts,” said
Kimberly Belshé, secretary of the California Health and Human
Services Agency. “If you want to eliminate fraud and abuse in
taxpayer-funded health care programs, you must first identify where
these problems exist, measure them and then take action.”