DHCS issued a letter explaining a new state policy to grant accelerated enrollment (AE) to Medi-Cal applicants who have not had an eligibility determination within the statutory 45-day timeline. During Covered California’s 2015 open enrollment period, DHCS will implement a new batch process to provide AE for those in the backlog. The batch process will occur weekly and will target those who have made applications starting November 15, 2014, and going through February 15, 2015. These applicants will be given fee-for-service Medi-Cal through aid code 8E until a final eligibility determination is made. DHCS MEDIL I 14-61 (12/31/14).
Summaries of select CalWORKs, CalFresh, Health and Housing Regulations
Author: John Tan
New Job Aid issued to explain 90-day cure period
DHCS issued a MEDIL providing the counties a job aid to outline the requirements for the 90-day cure period for the Medi-Cal renewal process. The cure period begins from the date of a NOA for discontinuance. The job aid states that this process applies for both MAGI and Non-MAGI beneficiaries and will treat as timely any required information received within the 90-day cure period. MEDIL 1 14-60 (12/10/14).
Change in treatment of work expenses for disability-linked Medi-Cal beneficiaries
DHCS has issued instruction to the counties regarding the retroactive exclusion of impairment-related and blind work expenses for all disability-linked Medi-Cal cases going back to 12/1/90. Counties are to make these changes when a case comes to its attention and review systems and cases to reestablish eligibility for those who were discontinued or denied for this reason.
Until DHCS develops appropriate worksheets, counties are directed to use SSI/SSP definition and methodologies to determine eligibility. The exclusion for IRWE is applied before the one-half earned income deduction, while the BWE exclusion applies after the half earned income deduction. These exclusions both apply before the determination of SGA level. Attached to the letter are examples of deductible expenses and detailed explanations of the income exclusion applications. DHCS ACWDL 14-42 (12/10/14).
New instructions on Medi-Cal enrollment for former foster care children
DHCS issued a letter outlining the handling of former foster care youth in the Mandatory Coverage Group (MCG) and Optional Coverage Group (OCG) for Medi-Cal applications and enrollment. Applicants in these categories are supposed to be provided with a simplified eligibility determination and enrollment process through the use of self-attestation. Instructions, frequently asked questions, and the application form are included with the letter.
DHCS defines MCG as those youth who were receiving Medi-Cal in foster care under the responsibility of any state of tribe on their 18th birthday or a later age. OCG includes youth that were not receiving Medi-Cal benefits while in foster care on their 18th birthday and are between ages 18-21. DHCS ACWDL 14-41.
Counties must remove “deprivation” language from Medi-Cal Notices of Action
DHCS issued a letter directing the counties to remove references to deprivation from Notices of Action that refer to Medi-Cal program linkage. All non-MAGI notices must also include specific language about potential separate notices about eligibility for other Medi-Cal programs. DHCS MEDIL I 14-58.
Change to Medi-Cal Appointment Period for Authorized Representatives
DHCS issued a letter on November 26, 2014, reminding counties that the appointment of authorized representatives now lasts until a change is made. This change could be the applicant/beneficiary modifying/cancelling the authorization, the appointment of a new representative, the representative withdrawing, or a change in the law. Previously, the appointment period lasted for a year. DHCS MEDIL I 14-57.