Medi-Cal
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DHCS ACWDL 14-33: Reviewing Caseloads for Individuals Who are Linked to Medi-Cal Coverage Groups Based Upon Modified Adjusted Gross Income (MAGI) (9/19/14)
DHCS issued this letter instructing counties to search for and identify potential MAGI-eligible individuals. These individuals need to meet all of the following criteria: Must not have been evaluated under MAGI rules, Must be eligible of retroactively eligible…
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DHCS MEDIL I 14-47: Deactivating Aid Code Programming in Medi-Cal Eligibility Data System (MEDS) and Statewide Automated Welfare System (SAWS) (9/19/14)
DHCS issued this MEDIL regarding aid code deactivation in the SAWS and MEDS systems. Pre-ACA programming will stay active in both systems until further notice. When all beneficiaries are transferred to MAGI aid codes, counties will receive instructions…
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DHCS ACWDL 14-32: Medi-Cal Annual Redetermination Process for MAGI Beneficiaries (9/19/14)
DHCS has issued this letter to guide SAWS and counties on implemented annual redeterminations for 2015 for MAGI Medi-Cal beneficiaries. First, counties are to review any ex parte information available to the county about the beneficiary or beneficiary’s…
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DHCS MMCD APL 14-011: Interim Policy for the Provision of Behavioral Health Treatment Coverage for Children Diagnosed with Autism Spectrum Disorder (9/15/14)
Following the release of federal guidance on the matter, DHCS issued interim policy guidance on the provision of BHT services to Medi-Cal beneficiaries 0-21 diagnosed with Autism spectrum disorder. Under Federal law, states are required to provide coverage…
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DHCS ACWDL 14-31: 2014 Alternate Renewal Policy Letter (9/11/14)
DHCS issued this letter about implementing Medi-Cal annual redeterminations in 2014, a process meant to convert some beneficiaries from pre-ACA Medi-Cal to MAGI Medi-Cal. At the 2014 annual redetermination, counties will try to convert beneficiaries to MAGI by…
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ACWDL 14-30: 2014/2015 Family Member Base Allocation Amount (August 11, 2014)
DHCS issued this letter to update the family member base allowance from $1,939 to $1,967. This allowance is used to determine how much a long-term care beneficiary may allocate to family members living with a community spouse.
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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…