CDLU’s Complaint Against Molina Healthcare Referred to California Fraud Investigators

WASHINGTON, May 23, 2017 -- Consejo de Latinos Unidos (CDLU), a consumer advocacy group and public charity, was told by the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services that CDLU’s complaint against Molina Healthcare of California for allegedly not paying Latino physicians their “enhanced payments” due to them from the Affordable Care Act, known as Obamacare, has been referred to fraud investigators in the State of California.

In a letter to the CDLU, Gary Cantrell, Deputy Inspector General for Investigations, wrote, “OIG is responsible for reducing fraud, waste, abuse, and mismanagement in the programs of HHS, such as Medicare and Medicaid. To fulfill this responsibility, the Office of Investigations works closely with the agencies that oversee these programs. In reviewing your complaint, we have determined that the California Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA) would have primary jurisdiction….[and] have referred your complaint.”

K.B. Forbes, the Executive Director of the CDLU, stated, “We are confident that the State of California will probe this matter justly and hold Molina Healthcare accountable for the alleged scheme.” The CDLU has been in contact with the BMFEA.

In January, whistleblower attorney Brian Mahany, filed a class-action lawsuit on behalf of Dr. Manuel I. Figueroa, a physician who has practiced for over 50-years in the barrios of East Los Angeles, and whose only “enhanced payment” before April of 2016 from Molina was a mere $80.18.

The Affordable Care Act allowed doctors performing certain medical services for low income patients under Medicaid (known as Medi-Cal in California) to be paid at same rate as those services if billed to Medicare. The two-year “enhanced payments” program operated between January 1, 2013 and December 31, 2014.

“CDLU has been investigating these allegations since 2015, we hope to obtain fair compensation with interest to these physicians,” Forbes added.

A decade ago, CDLU spurred three U.S. Congressional hearings and numerous state and local investigations on the issue of hospitals overcharging uninsured Latinos and others. After an appearance on CBS’ 60 Minutes, CDLU brought the issue of hospital price gouging to an end when the American Hospital Association raised the white flag.

CONTACT:  	
K.B. Forbes 202.320.1212 text or call
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