California Dual Eligible Enrollees Lose Medi-Cal Coverage Due to Administrative Errors
Administrative and paperwork errors are causing dually eligible beneficiaries in California to lose Medi-Cal coverage, disrupting their access to care. These coverage losses affect beneficiaries who qualify for both Medicare and Medicaid, creating gaps in services and undermining trust in the health care system. The issue highlights ongoing challenges in eligibility redeterminations and enrollment processes for vulnerable populations. State agencies and health plans serving dual eligibles must address procedural barriers that lead to inappropriate disenrollment.
Procedural disenrollment of dual eligibles creates network disruption, discontinuity of care coordination services, and potential financial liability for health plans when members lose Medi-Cal coverage but remain enrolled in D-SNPs.
Managed Care · LTSS
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