Effective May 1, 2014, enteral nutrition products are restored as a Medi-Cal benefit. This letter sets out the Standard of Care policy for managed care plans.
Summaries of select CalWORKs, CalFresh, Health and Housing Regulations
Medi-Cal
DHCS ACWDL 14-18: Policies and Procedures for Annual Renewal and Change in Circumstance Redeterminations and Discontinuance from Medi-Cal (4/8/14)
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.
DHCS ACWDL 14-12E: Erratum Regarding New Limits and Disregards for the Aged and Disabled (A&D) Federal Poverty Level (FPL) Program for 2014 – Beginning April 1, 2014 (4/7/14)
The Department of Health Care Services issued All-County Welfare Director Letter 14-12E this week. This letter, accessible here, corrects the A&D income limit for couples from $1,641 to $1,621 (100% FPL of $1,311 plus $310 disregard).
DHCS ACWDL 14-17: Treatment of Student Earned Income Exclusion (4/4/14)
This letter informs counties of an increase in student income deductions for working students under 22 in an MFBU with an aged, blind or disabled individual. This change should be applied retroactively.
DHCS ACWDL 14-16: Refugee Medical Assistance and the Affordable Care Act (4/1/14)
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.
DHCS ACWDL 14-15: Processing Change of Circumstances Redeterminations for Pre-Affordable Care Act (ACA) Medi-Cal Beneficiaries (3/28/14)
As of 3/24/14, CalHEERS is able to process change of circumstance redeterminations. This letter directs counties to proceed with converting old potential MAGI-linked cases to MAGI cases using the instructions contained therein. This is not to affect existing pre-ACA cases until their 2014 annual redetermination.
If a pre-ACA case submits a change of circumstance, the county will request additional tax household information and process for MAGI eligibility through CalHEERS. If MAGI-eligible, the county will review the determination for potential negative action (e.g., ineligibility, share of cost, restricted scope of benefits) before approving for MAGI Medi-Cal.
The letter also presents a list of new Medi-Cal aid codes and their corresponding pre-MAGI codes.