When the California Department of Health Care Services (DHCS) received complaints about abuse and fraud in the Drug Medi-Cal (DMC) program, our California Statewide Law Enforcement Association (CSLEA) members in DHCS's Audits & Investigations Division went to work. Their investigations uncovered suspected fraud and as a result, the state suspended Medi-Cal payments to 16 alcohol and drug treatment centers.
Investigators checked out 22 treatment centers and found suspected violations at 16 of them. The allegations include hiring felons and/or people convicted of abusing patients to billing Medi-Cal for services that were not needed or that were never performed.
"Unfortunately, there is no shortage of fraud where people stand to make a buck," said CSLEA President Alan Barcelona. "DHCS investigators devote their skills to, not only exposing the fraud and abuse, but to also building a case against those individuals breaking the law. They do a great job of protecting taxpayers' money and making sure the program is doing what it was designed to do."
The investigation is on-going. The case has been referred to the state Department of Justice (DOJ) for further investigation.