Affordable Care Act
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ACWDL 14-29: Interim Non-Payment of Premium (NPP) Processes for the Optional Targeted Low-Income Children Program (August 8, 2014)
DHCS issued guidelines for counties to proceed on discontinuing Optional Targeted Low-Income Children Program cases on the basis of non-payment of premiums (NPP). The counties have experienced a backlog of NPPs that should have been terminated. DHCS has…
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DHCS MEDIL I 14-45: Clarification of Medi-Cal Eligibility for Deferred Action for Childhood Arrivals (DACA) (August 6, 2014)
DHCS has issued this letter to explain that those individuals granted deferred action status through DACA are eligible for full-scope state-funded Medi-Cal as PRUCOLs. Individuals must meet all other Medi-Cal eligibility requirements. DACA status will be verified through…
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DHCS MEDIL I 14-44: Processing State Residency Verifications on Pending and Current Applications in the California Health Care Eligibility, Enrollment, and Retention System (CalHEERS) and the Statewide Automated Welfare System (SAWS) (8/1/14)
DHCS provided this updated information on processing state residency verifications for pending and current applications through SAWS and CalHEERS. Previously, the paper verification of state residency status had been suspended until 8/1/14. That suspension is now extended until further…
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DHCS MEDIL I 14-43: Information Concerning the Future Implementation of the Full-Scope Medi-Cal Coverage and Affordability and Benefit Program for Low-Income Pregnant Women and Newly Qualified Immigrants (NQIs) (7/30/14)
DHCS issued this letter to the counties about the implementation of the new Full-scope Medi-Cal coverage and affordability benefits program for low-income women and non-qualifying immigrants, to be operational no sooner than 1/1/15. Currently, Medi-Cal limits full-scope benefits…
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DHCS MEDIL I 14-42: Denying Pending Applications from both the California Health Eligibility, Enrollment and Retention System (CalHEERS) and the Statewide Automated Welfare System (SAWS) Access Channels (7/25/14)
This DHCS letter instructs counties to follow the procedures outlined previous in MEDILs I 14-23 and 14-30 when counties need to deny pending applications after ex parte reviews and two ten-day letters while CalHEERS functionality is pending. SAWS…
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DHCS MEDIL I 14-41: Immigration Documents Commonly Used by Lawfully Present Immigrants (7/21/14)
In this update letter, DHCS provides a non-exhaustive desk reference for the different examples of immigration documents that applicants may use for verification purposes. The letter includes illustrations of these documents.
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DHCS MEDIL I 14-36: Using Modified Adjusted Gross Income and Express Lane Enrollment Aid Codes for Applications in the Pending Backlog (7/8/14)
In an effort to reduce the backlog of pending Medi-Cal applications, DHCS has issued this guidance to the counties on using MAGI and Express Lane Enrollment (ELE) aid codes as a manual workaround. These aid codes are to…
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DHCS ACWDL 14-28: Elimination of the Deprivation Requirement for Medi -Cal Linkage for the Modified Adjusted Gross Income Parent/Caretaker Group and the Aid to Families with Dependent Children-Medically Needy Program (7/7/14)
DHCS released this letter to clarify that the previous deprivation of requirement was eliminated as of January 1, 2014, as part of the implementation of the Affordable Care Act. Prior to January 1st, family linkage to 1931(b) or…
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DHCS APL 14-007: Dual-Eligible Special Needs Plans (6/26/14)
The Department issued this letter to Medi-Cal Managed Care plans providing guidance on D-SNPs as the state adopts the Coordinated Care Initiative and Cal MediConnect for dual eligibles. D-SNPs in non-CCI counties will continue to operate per contract. …
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DHCS MEDIL I 14-38: Department of Health Care Services (DHCS) Waiver Change Information (6/25/14)
DHCS released this letter to provide information about seven different DHCS Waivers constituting Home and Community-Based Services and Long-Term Care Services and Supports programs. Waivers coming up for renewal this year are being renewed for a five-year period. …