DHCS issued guidance on how Medi-Cal NOAs are being generated by CalHEERS and SAWS beginning 4/15/14.  The full letter is available here.  Two sets of NOAs will be released:

1. A “one-time batch” of NOAs from pre-enrollment and pre-CalHEERS/SAWS interface (applications filed 10/1/13 to 1/20/14) and post-interface (1/21/14-3/10/14)
2. Ongoing as part of regular processing of NOAs dating from 3/11/14 onwards

The letter identifies some issues that may cause confusion among Medi-Cal beneficiaries:

1. Both CalHEERS and SAWS may issue separate NOAs regarding MAGI and Non-MAGI Medi-Cal, respectively.  SAWS will reflect the correct eligibility category.
2. CalHEERS NOAs may have the wrong coverage effective date, using the date of eligibility determination instead of the correct effective date of eligibility.
3. CalHEERS is generating NOAs for each month of eligibility or conditional eligibility in certain circumstances.

This week, DHCS issued a letter clarifying what counties should do when discontinuing Medi-Cal beneficiaries at annual or change in circumstance redeterminations.  The letter explains that beneficiaries should be reviewed for all programs, including MAGI Medi-Cal and non-MAGI Medi-Cal, before terminating them from the program and evaluating for APTCs/CSRs.  The letter is posted here with attachments.

In this letter, DHCS clarifies the redetermination process for beneficiaries on the Refugee Medical Assistance (RMA) program.  Currently, RMA provides Medi-Cal benefits to refugees (including asylees, trafficking victims and special immigrants without categorical linkage) for their first eight months in the United States.  Post-ACA, RMA beneficiaries are still entitled to the full eight months but should be evaluated for MAGI Medi-Cal eligibility.