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Medi-Cal Pregnancy Services Available Regardless of Gender Identity
DHCS issued an All County Letter to update counties about eligibility for pregnancy services. Based on Section 1557 of the Affordable Care Act, SAWS will change its language for Medi-Cal NOAs about coverage of pregnancy services. The programming…
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Resources for Denti-Cal Adult Dental Benefit Restoration
As of January 1, 2018, the Department of Health Care Services has restored all optional adult dental benefits that had been eliminated in 2009. DHCS issued an All Plan Letter to dental managed care plans with a benefits…
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Medi-Cal Asset Verification
Starting this month, DHCS will be sending counties new asset verification reports for screening specific Aged, Blind and Disabled Medi-Cal beneficiaries and applicants. After a three-month pilot, counties will use these reports to detect any unreported assets from…
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Outpatient Mental Health Services through Medi-Cal Managed Care Plans
A recent DHCS All-Plan Letter restated the responsibilities of managed care plan for providing medically necessary outpatient mental health services for those with mild to moderate impairments. The APL also states the plans’ responsibilities to members with severe…
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Coordination of Long Term Care and Medi-Cal Managed Care
All Medi-Cal managed care plans are required to coordinate the care and placement of beneficiaries who need long term care services. Plans in non-COHS counties are responsible for all medically necessary long term care services provided from the…
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Medi-Cal Coverage of Palliative Care
Under Welfare and Institutions Code section 14132.75, the Medi-Cal program covers palliative care for non-dual eligible beneficiaries. Palliative care is defined as patient- and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. The…
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SAWS Soft Pause Removal
Currently, the Soft Pause feature of SAWS protects consumers from losing MAGI-based Medi-Cal eligibility when personal circumstances change. The soft pause allows the county to run eligibility determinations for other programs while keeping the beneficiary on a MAGI…
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Extension of Presumptive Eligibility Period for Pregnant Women
DHCS has reminded counties that women on Presumptive Eligibility for Pregnant Women should have their PE period extended when they submit the required application. Currently, PE benefits last for up to two months beginning on the day of…
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Medi-Cal Applications and Services for Disaster-Affected Individuals
In the wake of recent hurricanes and fires, counties have been reminded that they may accept written attestations from applicants to prove California residency. DHCS has issued talking points to help applicants and providers navigate issues of eligibility,…
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Medi-Cal System Treatment of New Medicare Beneficiary Identifiers
The Centers for Medicare and Medicaid Services (CMS) is planning to phase in Medicare Beneficiary Identifiers (MBIs) between April 2018 and April 2019 to replace the current Medicare Health Insurance Claim Number (HICN) based on beneficiary Social Security…