Acknowledging that inclusion of promissory notes along with CalWORKs overpayment notices of action constituted an unlawful demand in violation of its regulations (MPP Section 44-351.1), CDSS directed counties to stop sending such agreements to reimburse. Recipients may still voluntarily request a reimbursement agreement, which must be in writing and clearly indicate that repayment is voluntary. CDSS further instructed counties to begin using a new form, CW 2217 “CalWORKs Request for Voluntary Repayment,” which they may provide upon request as long as the recipient has asked if he or she may voluntarily repay, the overpayment was already explained to the recipient, the county did not initiate or request the repayment, and the recipient understands he or she may suspend the repayment at any time. ACL 15-13.
Summaries of select CalWORKs, CalFresh, Health and Housing Regulations
Medi-Cal managed care coverage of inpatient psychiatric facilities
DHCS issued this letter to clarify managed care plan requirements to cover inpatient psychiatric services. Plans are supposed to cover medically necessary covered services when contacted by specialty mental health providers post-admission to psychiatric inpatient hospitals. The letter lists the requirements.
Plans do not need to cover room and board charges. However, they do need to cover medically necessary covered nursing facility services when the services are provided to those who are less than age 22 or greater than age 64.
DHCS APL 15-015 (6/12/15).
Edits to Fluctuating income section of Pre-populated MC 216 form
DHCS updated the MC 216 Pre-Populated Renewal form to replace a question about fluctuating income. The forms are available in all threshold languages. DHCS MEDIL I 15-14 (5/19/15).
More guidance about Medi-Cal application batches for Rivera, Covered CA transition
DHCS provided an update on the batching process for dealing with processing Medi-Cal applications in a more timely manner in the wake of the Rivera decision. DHCS was to issue a Notice of Inaction mailer for individuals who have not received a final Medi-Cal determination and NOA. The letter describes the different batches and what counties must do.
DHCS provides weekly results files to SAWS counties, which includes individuals whose applications are nearing the 45 days. Counties must review these files for the Rivera mailing.
The batch process to transition beneficiaries from Covered California to Medi-Cal will continue on a monthly basis until the process is automated.
DHCS MEDIL I 15-13 (5/15/15).
Coverage of anesthesia services for Medi-Cal dental services
DHCS issued instructions on the coverage of IV sedation and general anesthesia services in connection with dental services. Medi-Cal beneficiaries are entitled to dental services under IV sedation and general anesthesia when medically necessary in an appropriate setting. The letter lists the requirements for MCPs to cover general anesthesia services. All Plan Letter 15-012 (5/14/15).
AB 1614 codifies existing practices and establishes new requirements for EBT program
CDSS has published instructions to local county welfare departments to assure compliance with recently enacted AB 1614 (2014). Its provisions codify a range of established practices in California’s EBT program, the default payment mechanism for CalFresh, CalWORKs, Refugee Cash Assistance (RCA), Cash Assistance Program for Immigrants (CAPI), and several other state-administered cash programs, as well as some local county general assistance programs. AB 1614 also establishes a set of new requirements to make certain elements of the EBT program easier to use by recipients, including more ready access to the recipient’s EBT account information. Among the requirements now codified in AB 1614 are:
- 24-hour recipient access by toll-free telephone so they can hear a listing of their last ten EBT transactions, with the option to request by telephone to have a copy of their transaction history detail for the past two months mailed to them;
- Local county welfare offices must make a recipient’s EBT transaction history available to them within 10 business days of such a request, at no cost to the recipient;
- The EBT system must establish the capacity to deliver “system outage alerts” to recipients, to inform them when the system is not functioning or is expected not to function for more than one hour between 6am and midnight during any 24-hour period;
- Recipients must be informed by the county welfare department where they can use their EBT cards to withdraw benefits without incurring a fee, charge, or surcharge;
- If a local county welfare department makes direct deposit available to its employees, then it must also make direct deposit available to its CalWORKs recipients.
Providing recipients with information about how to access their EBT benefits without surcharge fees is no small matter. CDSS confirms in this ACL that “almost two-thirds of ATM withdrawals made by EBT recipients incur surcharge fees.” (Federal law prohibits surcharge fees for CalFresh transactions.) CDSS also notes that recipients can access the MoneyPass website (or its mobile apps, linked there) to locate ATMs that provide surcharge-free transactions. ACL 15-39 (April 21, 2015).