Medi-Cal
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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 PL 14-002: Requirement to Use Food and Drug Administration Approved Drugs, Rather Than Compounded Alternatives
In this Policy Letter to all Medi-Cal managed care plans, DHCS requires the use of FDA-approved and nationally marketed drugs unless a medical necessity can be established for the use of a compounded alternative. Read the letter here.
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DHCS APL 14-005: New Benefit — Voluntary Inpatient Detox
This letter to Medi-Cal managed care plans outlines a new benefit available on a fee-for-service basis. Beneficiaries with medical necessity may receive voluntary inpatient detoxification services at general acute care hospitals. The letter is available here.
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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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Public Comment Period on Regulation Packages
Semi-Annual Reporting (SAR) in the CalWORKs Program, ORD No. 0513-04 The public comment period for this package closed on September 4, 2013 at 5:00 pm. Residential Care Facilities for the Elderly Hospice Care, Terminally Ill Persons, ORD No. 0713-07 The…
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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…
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DHCS ACWDL 14-07: 2014 Medicare Premiums and SSI Standard and Parent Allocations and Property Limits for the MSPs and Other Programs
The purpose of this letter is to inform counties of the 2014 SSI Standard Allocation, Parent Allocation, property limits for the Medicare Savings Programs, and Medicare premium amounts to be used in determining eligibility and the cost of…