Medi-Cal
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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…
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Medi-Cal managed care coverage of oral contraceptive supplies
DHCS has clarified to managed care plans that they must pay for up to a 12-month supply of oral contraceptives when dispensed by an onsite clinic and billed by a qualified family planning provider. APL 16-003 (2/5/16)
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Medi-Cal voicemail applications should be considered as of the timestamp
DHCS is directing counties to count a voicemail application request after business hours on the date the request is made rather than the next business date. This was especially important for applicants transferred from a Covered California service…