COVID-19 guidance on various Medi-Cal issues

The Department of Health Care Services (DHCS) has issued guidance on various Medi-Cal issues affected by COVID-19.

The county computer systems were successfully programmed to delay processing of annual renewals and reported changes, and delay discontinuances and negative actions as a result of annual renewals or reported changes while Executive Order N-29-20 is in effect.

Individual case workers can discontinue cases.  This should happen when people have died, people are no longer living in California, people request voluntary discontinuance of Medi-Cal and when non-MAGI Medi-Cal individuals move to a Long Term Care aid code.

The requirement to maintain continuous coverage applies to people who might otherwise have coverage terminated or reduced because of a change in circumstances, including people who age out of a Medi-Cal eligibility group, people who lose other benefits that would affect their Medi-Cal eligibility, people whose whereabouts become unknown, children in the Optional Targeted Low Income Children Program who would otherwise move to a premium aid code, people who would have a new or increased share of cost, and people who would otherwise move from full scope to restricted scope coverage.

Some cases may have been discontinued as early as February 20 for failure to provide information or respond effective April 1. Counties must prioritize requests for reimstatement from these individuals.

Individuals discontinued prior to March 17, 2020 who are in their 90 day cure period must work with the county to resolve outstanding eligibility issues before the county can restore eligibility.

The time to request a hearing regarding Medi-Cal eligibility or fee for service issues is extended by 120 days to a total of 210 days.  Persons who are receiving aid paid pending during the Executive Order period are enrolled for benefits and must remain eligible.  Counties must delay processing negative actions because of a hearing decision through the duration of the Executive Order.

Counties shall conduct telephone interviews or appointments when applicants are usually required to visit the office.  Counties shall accept written affidavits by telephonic signature.

Counties must process transactions for individuals released from incarceration by reporting the release date because it is a positive action that addresses a barrier to care.

Persons who are in Managed Care Plan hold status need to obtain services through Fee for Service.  (MEDIL I 20-08, April 10, 2020.)