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Counties must reinstate and cease termination of ABD-eligible Medi-Cal cases where RFTHIs were not returned
DHCS issued a letter directing counties to stop terminating cases for specific aged, blind and disabled cases where the beneficiary did not return the Request for Tax Household Information form associated with MAGI rules. Counties will also be…
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Non-COHS Medi-Cal managed care plans must treat medical exemption requests and denials as continuity of care requests
DHCS is directing managed care plans to treat Medical Exemption Requests as automatic requests for continuity of care for those Medi-Cal beneficiaries transitioning into managed care. MCPs must treat every exemption listed in data reports as an automatic…
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Clarification for using personal care services to meet Medi-Cal share of cost
DHCS recently clarified the process for using out-of-pocket expenses from personal care services to meet current or future share of cost amounts. Previously, IHSS needed to assess and approve the need for personal care services, and the out-of-pocket…
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Guidance on transitioning Covered California cases to Medi-Cal
DHCS issued a letter to guide counties on how to handle Covered California cases transitioning to Medi-Cal after Covered California’s annual redetermination process, which will always run at the same time each year. When Covered California determines that…
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Directions for issuing refunds for premiums from Optional Targeted Low Income Children Program
DHCS issued a letter with directions on how the county should deal with refunds of TLICP premiums or waivers due to beneficiary request or retroactive eligibility for non-premium aid codes. When a beneficiary requests prospective discontinuance in writing,…
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Plans must ensure continuity of care for Medi-Cal beneficiaries transitioning into managed care
DHCS issued an All-Plan Letter providing requirements for continuity of care for Medi-Cal beneficiaries that are transitioning into managed care plans from fee-for-service Medi-Cal. The requirements allow for the option to continue treatment for up to 12 months…
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The State will provide Accelerated Enrollment to Medi-Cal applicants when eligibility has not been determined within 45 days
DHCS issued a letter explaining a new state policy to grant accelerated enrollment (AE) to Medi-Cal applicants who have not had an eligibility determination within the statutory 45-day timeline. During Covered California’s 2015 open enrollment period, DHCS will…
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New Job Aid issued to explain 90-day cure period
DHCS issued a MEDIL providing the counties a job aid to outline the requirements for the 90-day cure period for the Medi-Cal renewal process. The cure period begins from the date of a NOA for discontinuance. The job…
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Change in treatment of work expenses for disability-linked Medi-Cal beneficiaries
DHCS has issued instruction to the counties regarding the retroactive exclusion of impairment-related and blind work expenses for all disability-linked Medi-Cal cases going back to 12/1/90. Counties are to make these changes when a case comes to its…
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New instructions on Medi-Cal enrollment for former foster care children
DHCS issued a letter outlining the handling of former foster care youth in the Mandatory Coverage Group (MCG) and Optional Coverage Group (OCG) for Medi-Cal applications and enrollment. Applicants in these categories are supposed to be provided with…