Updated Guidance on Medi-Cal Failure to Respond NOAs

In response to the Korean Community Center of the East Bay settlement, DHCS has issued new guidance to clarify procedures for discontinuing Medi-Cal cases for failure to respond at annual redetermination for MAGI and Non-MAGI cases.

In both MAGI and Non-MAGI cases, the county should use ex-parte resources to confirm continued eligibility.  If information is missing, the county should send an appropriate request for only the information that could not be verified (MC 216 for MAGI, or an appropriate non-MAGI renewal form).  If the beneficiary does not respond (and not just providing incomplete or insufficient information), the county must discontinue with an appropriate notice.  Sample language for these notices is included in the guidance.  Beneficiaries continue to have a 90-day cure period.

DHCS ACWDL 17-32 (August 31, 2017).