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 institution.  County boards of supervisors may designate an entity to assist county jail inmates with insurance applications, as being an inmate shall not preclude the county from processing a Medi-Cal application from such an applicant.

An inmate’s Medi-Cal benefits must be suspended until the day an eligible inmate is no longer an inmate of a public institution (reinstate) or one year from the date he/she becomes an inmate (terminated), whichever is sooner.  Redetermination will still occur, and eligibility changes should be entered as appropriate.

Additionally, the letter addresses the Medi-Cal Inmate Eligibility Program application process.  MCIEP covers acute inpatient hospital services to eligible inmates if those services are provided off the grounds of the correctional facility.  The inmate must meet all Medi-Cal eligibility requirements.  The county will process applications received by a designate county entity for MAGI and non-MAGI programs.  Inmate cases might get pended in CalHEERS, so counties must take steps to complete the eligibility process.  If the inmate has a suspended case, the county must lift the suspension before MCIEP eligibility begins.