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California passes up millions for prison healthcare, report says

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California’s court-run prison healthcare program is missing out on tens of millions of dollars a year in federal funds because of disagreement with counties and software problems, a new legislative report states.

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The legislative analyst’s office found increasing numbers of prison inmates who, because of their low income status, are eligible for the state’s Medicaid program. That program, delivered through counties, draws matching federal reimbursements. The LAO notes that federal policy has allowed states to collect federal Medicaid reimbursement for eligible state prison inmates since 1997.

The agency states that California has only recently developed a process to obtain this funding, and is not yet seeking the full amount possible.

The LAO report, released Tuesday, notes that the court-appointed prison healthcare receiver has agreements with 12 counties, covering nearly three-fourths of the inmates in the state prison system, and the state pays those counties a $10 administrative fee per covered inmate. However, other counties have not signed agreements, including a consortium of 35 rural counties that have balked at the amount of overhead funding the state offers.

[Updated at 1:30 p.m., Feb. 5: The legislative analyist estimates California would save $13 million if agreements with all counties were reached. In addition, the agency says the Department of Health Care Services has been unable to process two-thirds of the prison claims submitted for reimbursement, many because of software problems. The LAO calculates that solving those and other such problems, as well as expanding the state Medicaid program to qualify for 100% federal funding, would mean an additional $40 million in reimbursements for inmate healthcare.]

The legislative agency is calling for budget hearings on the matter.

A spokeswoman for court-appointed healthcare receiver J. Clark Kelso said that his office concurs with the LAO report. ‘We appreciate their in-depth review,’ said Joyce Hayhoe, who is Kelso’s legislative affairs liaison. Hayhoe said the office is in continuing negotiations with counties to secure more Medicaid coverage agreements.

Gov. Jerry Brown contends California spends too much on prison medical services. The court-appointed receiver’s office reports spending $1.6 billion on inmate healthcare this year, a decline from the program’s $2 billion budget several years ago.

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