California Falls Short on Medi-Cal Fraud, State Report Says
The state auditor flags Medi-Cal fraud oversight concerns in a report released Thursday by Grant Parks. The Department of Health Care Services is ill-equipped to stop pervasive abuse in Medi-Cal, a program serving about 14 million Californians with annual payouts of $200 billion.
Key Findings:
- Two medical providers billed almost $1.6 million in Medi-Cal services in 2024-25 despite being deemed ineligible years earlier.
- One transportation provider claimed to have driven 35 people in a single day, nine traveling over 340 miles each. The provider took in over $11 million in 2024-25.
- Of the 28,000 highest-risk Medi-Cal providers, the Department had not begun investigations into 26,000.
The Department disagreed with the auditor's findings, arguing that the report lacks context and highlights "isolated anecdotes."
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