Medi-Cal
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New Notices for 250% Working Disabled Program
DHCS has issued new guidance directing counties to issue discontinuance and denial notices for applicants for the 250% Working Disabled Program. Prior to discontinuing a case, the county must evaluate individuals for all other programs, including MAGI Medi-Cal…
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Medi-Cal Managed Care Network Adequacy Requirements
Beginning July 1, 2018, all Medi-Cal managed care plans (MCPs) will be required to submit annual network certifications in addition to continuing requirements for reporting significant changes to their networks. MCPs must confirm that their networks will meet…
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2018 Thresholds for Insurance Affordability Programs
DHCS has updated its charts for thresholds for Medi-Cal, MCAP, and APTC eligibility to reflect 2018 Federal Poverty Levels. Updated thresholds for Non-MAGI Medi-Cal will not be effective until April. DHCS ACWDL 18-03 (January 30, 2018).
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Providing Voluntary Inpatient Detox Services through Medi-Cal Fee for Service
Voluntary inpatient detoxification (VID) services are a Medi-Cal benefit carved out of managed care and covered through Medi-Cal fee for service. To be eligible, inpatient detoxification must be the primary reason for voluntary admission. DHCS’s All Plan Letter…
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Clarification of Medi-Cal ICT Process after SB 1339
SB 1339 codified the Medi-Cal Intercounty Transfer (ICT) process, effective June 1, 2017. Medi-Cal beneficiaries must notify either the county they are leaving (sending county) or the county to which they are moving (receiving county) of a change…
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Denials and Terminations of Caretaker Adult MAGI Medi-Cal Cases when Child Lacks Coverage
Under current State and Federal regulations, a parent or caretaker relative with a dependent child under 19 living in the home does not qualify for MAGI Medi-Cal if the child does not have minimum essential coverage (MEC). Applicants…
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2018 Update to Spousal Impoverishment Cap
Effective January 1, 2018, the community spouse resource allocation (CSRA) under the Medicare Catastrophic Coverage Act has been increased to $123,600. The minimum monthly maintenance needs allowance (MMMNA) has also been increased to $3090 per month. DHCS ACWDL…
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Medi-Cal Pregnancy Services Available Regardless of Gender Identity
DHCS issued an All County Letter to update counties about eligibility for pregnancy services. Based on Section 1557 of the Affordable Care Act, SAWS will change its language for Medi-Cal NOAs about coverage of pregnancy services. The programming…
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Resources for Denti-Cal Adult Dental Benefit Restoration
As of January 1, 2018, the Department of Health Care Services has restored all optional adult dental benefits that had been eliminated in 2009. DHCS issued an All Plan Letter to dental managed care plans with a benefits…
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Medi-Cal Asset Verification
Starting this month, DHCS will be sending counties new asset verification reports for screening specific Aged, Blind and Disabled Medi-Cal beneficiaries and applicants. After a three-month pilot, counties will use these reports to detect any unreported assets from…