Child's $21M medical bill underscores Medi-Cal challenges

California Department of Health Care Services Director Jennifer Kent mentioned in recent social media posts that there is a child in the state whose medical expenses totaled $21 million in 2014, according to the Los Angeles Times.

Those costs were covered by Medi-Cal, California's Medicaid program, which is run by the Department of Health Care Services.

Ms. Kent declined to offer any additional details about the patient, but said patients with the highest costs tend to have severe genetic disorders.

"They are very expensive people with really expensive needs," she told the Los Angeles Times. "Your disease defines the treatment you require, and the costs are joined to that diagnosis … That's just the nature of the beast."

Medi-Cal isn't the only payer challenged to cover the costs of treating these conditions. In 2016, Des Moines, Iowa-based Wellmark Blue Cross and Blue Shield sent letters to its customers telling them it was raising premiums for 2017 by about 38 to 43 percent. The insurer said the higher rates were partially due to a single member who receives $1 million of care per month. Earlier this year, Wellmark Executive Vice President Laura Jackson said the high-cost member is a teenage boy who suffers from hemophilia, a genetic disorder that keeps blood from clotting.

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