Recent Changes to Medi-Cal Notice of Action Requirements

Revised NOA for 250% Working Disabled Program Approval

DHCS has revised NOAs for Working Disabled Program approvals to clarify that couples do not need to pay separate premiums as a couple.  DHCS has also revised its EFT premium payment flyer for county use. DHCS ACWDL 18-18 (August 9, 2018).

NOAs for Beneficiaries Who Do Not Complete Non-MAGI Evaluation at Annual Renewal/Change in Circumstance

DHCS updated guidance to counties regarding MAGI discontinuance NOAs when the beneficiary is ineligible for MAGI, is potentially eligible for Non-MAGI, and the beneficiary does not complete the Non-MAGI evaluation when ex parte review is not successful.  The discontinuance NOA must indicate both why a beneficiary is not eligible for MAGI and why the county could not complete the Non-MAGI evaluation.  This guidance provide required language for such notices. DHCS ACWDL 18-24 (October 29, 2018).

Information Regarding Reporting Requirements on NOAs

DHCS is providing guidance about the requirement to include information about an applicant’s or beneficiary’s responsibility to report changes in circumstances on all MAGI and Non-MAGI NOAs that approve, change, or continue Medi-Cal eligibility.  The letter includes sample NOA snippets for various situations. DHCS ACWDL 19-02 (January 9, 2019).

NOA Requirements at Annual Renewal or Change in Circumstance Resulting in Resetting Annual Renewal Date

DHCS has issued updated requirements for NOAs for continuing eligibility at annual renewal and change in circumstances.  Federal regulations require counties to send NOAs when there are no changes to eligibility at annual renewal or following a change in circumstances resulting in resetting of the annual renewal date.  DHCS has provided sample language for these circumstances. DHCS ACWDL 19-03 (January 9, 2019).