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Patients sue over application backlog
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SACRAMENTO  (AP) — Medi-Cal patients and health care advocates filed a lawsuit against the state Wednesday for leaving hundreds of thousands of low-income and disabled people waiting months for care.

The suit filed in Alameda County Superior Court aims to get the California Department of Health Care Services to process applications within a required 45-day time frame.

One plaintiff, 68-year old Frances Rivera of Visalia, said she lost her adult son, Robert, who died from a pulmonary embolism while waiting to hear back about his Medi-Cal application. The application was approved two months after he died.

“It’s not easy watching someone you love go through this, and there’s nothing you can do,” Rivera said in a statement. “I just want to cry when I think about all the times we said, ‘He has this problem,’ and nobody did anything.”

The health care services department does not comment about pending litigation, spokesman Norman Williams said.

Medi-Cal is the state’s version of Medicaid, the state-federal health insurance program for poor, disabled and low-income people. The program’s ranks have swelled nationwide under President Barack Obama’s Affordable Care Act, which allows more people to qualify in the states that decided to expand it.

California was among the states that opted to expand Medicaid but also has the largest application backlog. It stood at 900,000 in May, out of 1.9 million people who enrolled. The state Department of Health Care Services reported the backlog had been reduced to 350,000 as of Sept. 1.

“We will continue our joint work with the counties to process these cases, and we expect more progress in the coming weeks,” Williams said.

California is among a handful of states that received letters from the federal Centers for Medicare & Medicaid Services in June asking states to address gaps in their eligibility and enrollment systems that have delayed access to Medicaid coverage.

Some applicants in the backlog have been waiting for a response since October, far longer than the 45-day time limit required by state and federal law.

“These are not just numbers. These are real people, and they are suffering,” said Lucy Quacinella, an attorney representing Maternal and Child Health Access, which is a plaintiff in the suit.