This letter informs counties that they no longer have to make a third contact for verification of pending applications. DHCS MEDIL I 15-02 (2/12/15).
Summaries of select CalWORKs, CalFresh, Health and Housing Regulations
Medi-Cal premium waivers for American Indians/Alaskan Natives on the Targeted Low Income Children Program
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).
Medi-Cal Pre-Populated renewal forms have been translated
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).
The effect of the January 2015 COLA on Medi-Cal eligibility
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).
Medi-Cal coverage of podiatric and chiropractic services provided by FQHCs and RHCs
DHCS issued a letter to all Medi-Cal managed care plans regarding podiatric and chiropractic services in light of California Rural Health Clinics v. Douglas. If these services are provided at a Federally Qualified Health Center or Rural Health Center, plans shall cover them but may restrict reimbursement to contracted providers. APL 15-003 (1/26/15).
How to count self-employment or fluctuating income for MAGI determinations
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).