County of Responsibility for Incarcerated Medi-Cal Beneficiaries

DHCS issued clarification to the counties about how to deal with Medi-Cal Inmate Eligibility Program (MCIEP) applications for beneficiaries who reside in one county (County of Residency) but are incarcerated in a different county (County of Incarceration) in order to ensure proper billing to inmate claims to the correct county.  As of July 1, 2016, an inmate’s full scope and restricted scope inmate coverage can coexist in the MEDS system, along with the proper county of responsibility.

Under MCIEP, the county of incarceration is responsible for paying the non-federal portion of fee-for-service services provided to eligible inmates.  The county of incarceration is responsible for completing the eligibility determination for MCIEP.  Where the county receiving the MCIEP program is not the county of incarceration, the application will be forwarded to the county of responsibility.

DHCS MEDIL I 16-23 (December 23, 2016).

DHCS MEDIL I 16-23E (January 12, 2017).