The letter provides information about processing requests for waiver of premium payments for eligible American Indian and Alaskan Native child as allowed by federal statute.  Workers will submit waiver requests for the Optional Targeted Low Income Children Program (OTLICP) with parental self-attestation or tribal health letter.  DHCS ACWDL 15-10 (2/10/15).

DHCS has issued a letter with the MC 216 pre-populated renewal forms, which have now been translated into the threshold languages.  DHCS ACWDL 15-09 (1/30/15).

DHCS has issued guidance on how to process the 2015 cost of living adjustment in SAWS.  This COLA does not affect MAGI groups, and CalHEERS will wait for the 2015 FPL updates to run retroactive eligibility batches.  The letter provides instructions on calculating gross income for Social Security recipients and Pickle amendment applicants.  The letter also lays out SSI/SSP payment levels, 2015 resource limits, benefit rates, and Pickle disregards.  DHCS ACWDL 15-08 (2/9/15).

DHCS issued guidance to counties regarding how to treat fluctuating or self-employment income and how to use projected annual income in MAGI determinations in CalHEERS.  The letter notes that IRS rules for net income from self-employment activities are different from non-MAGI rules; IRS deductions are broader than those allowed for non-MAGI programs.

For projected annual income, counties can take an average to determine monthly income.  If income fluctuates monthly, the single streamlined application uses projected annual income.  If the individual’s current monthly income is lower than the projected annual income, counties should use the current monthly income.  CalHEERS is expected to be fixed in March 2015 to address this situation.  DHCS ACWDL 15-06 (1/21/15).

DHCS issued additional guidance to counties for those cases transitioning to Medi-Cal due to the Covered California annual redetermination process.  A prior letter referred to a batch data file sorted rejected cases into categories of “eligible,” “conditionally eligible,” or “pending eligible.”  This file has 1720 cases, 879 of which were provided temporary coverage and 841 rejected for a second time.

The 841 rejected cases are to be evaluated manually by the counties and consortia for eligibility.  The 879 temporary coverage cases were granted Express Lane aid codes and Medi-Cal coverage until the cases can be evaluated.  DHCS ACWDL 15-05 (1/20/15).

DHCS issued a letter directing counties to stop terminating cases for specific aged, blind and disabled cases where the beneficiary did not return the Request for Tax Household Information form associated with MAGI rules.  Counties will also be reinstating those ABD beneficiaries who were terminated for not returning the RFTHI.  In these cases, the county must restore eligibility back to the date of discontinuance, then proceed to complete a 2014 redetermination based on ABD status before going onto a MAGI determination.  DHCS ACWDL 15-03 (1/20/15).