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Medi-Cal Coverage for Services under End of Life Option Act
DHCS issued an All Plan Letter to guide managed care plans about the administration of the End of Life Option Act benefit. This benefit allows terminally ill beneficiaries over the age of 18 with the capacity to make…
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Expanded eligibility and services under CMSP
As of May 1, 2016, the County Medical Services Program (CMSP) is changing some of its eligibility requirements and benefits. CMSP provides limited-term health coverage for indigent residents in 35 mostly rural California counties. These changes should be…
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Implementation of SB 75 Health for All Children
DHCS has issued a letter to inform counties about the expansion of Medi-Cal to individuals under age 19 without satisfactory immigration status but who are otherwise eligible for the program. CalHEERS changes should be effective no sooner than…
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Manual Workaround to Preserve Covered California Coverage for Pregnant Women
DHCS issued a letter to the counties about a workaround for women enrolled in a Covered California plan with premium tax credits to remain in their health plans and not transition to Medi-Cal when they report a pregnancy.…
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Clarifying the Inter-county Transfer Process
DHCS has issued this letter to update information about how to process an ICT and how that affects managed care enrollment. A beneficiary needs to report a change in county address within ten days of the change in…
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Transitioning from APTCs to Medi-Cal
CMS has recently issued guidance to DHCS about how to help those enrolled in Covered California plans with APTCs who are later determined eligible for Medi-Cal. DHCS has issued this letter to explain that those who transition from…
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Updated 2016 Limits and Disregards for Aged and Disabled FPL starting April 2016
DHCS has updated the threshold limits for Aged and Disabled FPL Medi-Cal, effective 4/1/16. This limit is $1220 for individuals and $1645 for couples. DHCS ACWDL 16-06 (4/21/16).
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Guidance on COLAs and Health Insurance Costs
DHCS has issued guidance about the effect of this year’s lack of a Social Security COLA on Medicare premiums and costs, along with other programs such as the Pickle program. The Medicare Part A premium increased to $411…
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Clarifying the definition of Medi-Cal carved-out drugs
DHCS has clarified to managed care plan how it defines carved-out versus capitated drugs once any particular drug is FDA-approved. In general, any new combination of drugs that includes a carved-out drug may be considered a carved-out drug.…
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New DHCS FPL charts for state health programs
DHCS has issued updated charts for monthly and annual FPLs. Effective dates vary based on program: FPLs are effective 1/1/16 for MAGI and non-Title II RSDI Medicare Savings programs, 3/1/16 for Title II RSDI MSP recipients, and 4/1/16…