Affordable Care Act
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DHCS ACWDL 14-15: Processing Change of Circumstances Redeterminations for Pre-Affordable Care Act (ACA) Medi-Cal Beneficiaries (3/28/14)
As of 3/24/14, CalHEERS is able to process change of circumstance redeterminations. This letter directs counties to proceed with converting old potential MAGI-linked cases to MAGI cases using the instructions contained therein. This is not to affect existing…
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DHCS ACWDL 14-14: Implementation of the Hospital Presumptive Eligibility (HPE) Program
This letter provides preliminary information on Hospital Presumptive Eligibility. Effective January 1, 2014, qualified hospitals can temporarily enroll certain individuals into MAGI Medi-Cal. Application is by one-page attestation, and qualified hospitals complete the process through online Hospital PE…
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DHCS MEDIL I-14-21: Statement of Citizenship, Alienage and Immigration Status Form (MC 13) Under the Affordable Care Act
This letter provides guidance on verifying applicant citizenship/immigration eligibility through the federal data hub before sending out the MC 13 Status Form.
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DHCS MEDIL I-14-21: Statement of Citizenship, Alienage and Immigration Status Form (MC 13) Under the Affordable Care Act
This letter, available here, clarifies when counties should send the MC 13 for immigration status. Applicants who claims to be citizens/nationals or have adequate immigration status on their applications will be run through the federal data hub in…
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CMSP ACL 14-02: CMSP Policy on Determination of Other Health Coverage Under Expanded Medi-Cal and Covered California
Earlier this year, the CMSP Governing Board issued guidance regarding eligibility for CMSP after the expansion of Medi-Cal and implementation of Covered California. All applicants will be considered for MAGI Medi-Cal and Covered California before being evaluated for…
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DHCS ACWDL 14-11: Pre-ACA Medi-Cal Annual Redetermination Process
This letter, in conjunction with DHCS ACL 14-03, provides instructions on Medi-Cal annual redeterminations to convert pre-ACA Medi-Cal to MAGI Medi-Cal during 2014. Read the full letter with example timelines here. For renewals normally scheduled January through June,…
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DHCS MEDIL I-14-20: Processing State Residency Verifications on Pended and Current Applications in California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS) and Statewide Automated Welfare System (SAWS)
To expedite processing of pending and current CalHEERS and SAWS applications, counties can accept self-attestation of residency in lieu of paper verification until May 1, 2014. Read the letter here.
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DHCS MEDIL I-14-19: Use of Electronic Notification of Action Process
This letter explains the State’s intent to leverage electronic processes to provide beneficiaries with notices on an opt-in, opt-out basis. MAGI notices should be available online through Covered California accounts. Further guidance is forthcoming. Read the letter here.
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DHCS MEDIL 14-17: Instructions to Counties When Beneficiaries Age Out of Certain Medi-Cal Programs or Reach the End of a Time Limited Coverage Period and Burman Holds
This letter furthers guidance already provided by DHCS that requires counties to continue not to make any negative changes to Medi-Cal cases for a period of time until certain programming can be completed by CalHEERS and SAWS that…
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DHCS ACWDL14-16: Income Verification for CalHEERS Pended Applications and the Processing of Retroactive Medi-Cal Eligibility
This letter instructs counties that when CalHEERS pends a MAGI Medi-Cal application because it is not reasonably compatible with data hub information, counties must conduct ex parte review to determine if income is already verified elsewhere. Also, the…