Local leaders demand action after state regulators cite L.A. County's public health system, which treats poor residents, for long delays in care.
In mid-December, a woman in her early 40s with severe abdominal pain and unexplained weight loss was referred to a gastroenterologist at Los Angeles County-USC Medical Center.
Mitchell, who is also on the Board of Governors for L.A. Care, said the panel agreed with her suggestion to “immediately hire” outside consultants to determine why the problems occur and how they can be prevented.Supervisor Hilda Solis, whose district includes County-USC in Boyle Heights, said she would ask county health officials, and the county counsel, to address the issue.
The time limit, which went into effect more than a decade ago, appears to have been openly ignored by county health officials for years. That failure, and allegations of the hospital system’s poor communication with patients about the reasons for delays and denials for specialty care,Regulators found that L.A. Care does not take into account the date on which a primary care provider first requests a specialist for their patient. More than 300,000 L.A. Care enrollees get care at county hospitals, according to the health plan.
Itzcalli pointed to the regulators’ use of the word “suggests” and argued the “judicious phrasing only proves that they are unsure what the documents actually say and, more importantly, are unsure how eConsult actually works.” In their formal accusation this month, state investigators echoed that concern. They said documents they reviewed suggest, “there are no built-in timeframes for the various stages of the eConsult process” and no notification for the patients of the status of an appointment request.
Because the 15-day limit applies to insurers and not doctors and hospitals directly, they said they viewed it as “guidance” as opposed to a hard-and-fast rule.
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