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 sending a RFTHI form at least 60 days prior to the redetermination date. If a beneficiary reports certain changes (e.g., size of household, categorical eligibility), counties will complete the annual redetermination process per previous guidance. If there are no such cases, the county will just renew without a CalHEERS transaction. Counties must also review Share of Cost cases for MAGI Medi-Cal. Those ineligible will be granted APTC eligibility per Covered California requirements for special enrollment periods.
For MAGI populations, RFTHI information must be provided but not necessarily in paper form. The information will be entered into SAWS for the next renewal. If a beneficiary fails to respond to the RFTHI, counties must try to contact the beneficiary to get this information. If after these attempts the beneficiary still does not respond, and if the information is not available ex parte, then the county shall send a timely NOA to discontinue benefits. There is a 90 day cure period.