Medi-Cal
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DHCS ACWDL 14-26: Implementation of AB 720 – Suspension of Medi-Cal Benefits for All Inmates and Other Requirements (5/6/14)
DHCS issued a letter providing information about AB 720, which requires counties to suspend rather than terminate Medi-Cal benefits for all inmates regardless of age who were Medi-Cal beneficiaries at the time they became inmates of a public…
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DHCS ACWDL 14-25: The Extension of the Qualifying Individual 1 (QI-1) Program and Transitional Medical Assistance (TMA) Sunset Date (5/6/14)
This letter notifies counties that the QI-1 and TMA programs, which were originally scheduled to sunset on March 31, 2014, were extended to March 31, 2015, by the Protecting Access to Medicare Act of 2014. Counties are advised…
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DHCS ACWDL 14-24: State Inmate Pre-Release Medi-Cal Application Process (5/6/14)
DHCS released an all-county letter to clarify how to handle Medi-Cal applications from pre-release state inmates. The full letter is available here. CDCR pre-release staff is to identify potential Medi-Cal eligible inmates nearing parole and offer assistance with applying…
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DHCS ACWDL 14-22: Resetting Annual Redetermination Dates (4/25/24)
Earlier this week, DHCS released instructions on resetting redetermination dates for those Medi-Cal beneficiaries who retain eligibility due to a change in circumstances. The letter can be found here. Where the county is responsible for Medi-Cal case management.…
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DHCS ACWDL 14-21: 2014 Annual Redeterminations: Continued Eligibility for Pre-ACA Medi-CAl Children Implementing 2101(f) Protection (4/25/14)
DHCS is providing guidance to ensure continuing eligibility for children during 2014 annual redeterminations as pre-ACA coverage transitions to ACA MAGI coverage. The full letter is available here. Children currently enrolled in pre-ACA Medi-Cal coverage that would no…
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DHCS MEDIL I-14-23: Processing Income Verifications on Pended and Current Applications in the Statewide Automated Welfare System (SAWS) (4/24/14)
This week, the Department of Health Care Services has issued guidance to counties about verifying income for pending Medi-Cal cases. Those cases currently pending in SAWS are first to be rerun through the federal data hub when available. …
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DHCS ACWDL 14-20: 2014 Statewide Average Private Pay Rate (APPR) for Nursing Facility Services (4/22/14)
The Department of Health Care Services this week announced that the statewide APPR for 2014 is $7628. This amount is used to calculate periods of ineligibility when nonexempt property has been transferred for less than market value. Full…
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DHCS ACWDL 14-19: 2014 Medicare Catastrophic Coverage Act Spousal Impoverishment Caps.
Effective 1/1/14, the community spouse resource allowance has increased from $115,920 to $117,240. Additionally, the maximum spousal income allocation has increased from $2,898 to $2,931 per month. Full letter available here.
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DHCS MEDIL I-14-22: Informational Update and Guidance on Medi-Cal Notices of Action (NOA) Generation (4/14/14)
DHCS issued guidance on how Medi-Cal NOAs are being generated by CalHEERS and SAWS beginning 4/15/14. The full letter is available here. Two sets of NOAs will be released: A “one-time batch” of NOAs from pre-enrollment and pre-CalHEERS/SAWS…
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DHCS PL 14-003: Enteral Nutrition Products (4/11/14)
Effective May 1, 2014, enteral nutrition products are restored as a Medi-Cal benefit. This letter sets out the Standard of Care policy for managed care plans.