ACL 14-30: CalWORKs :  Inter-County Transfer (ICT) Procedures, Revised CW 215 Form (5/2/14)

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CDSS modified some Inter-County Transfer (ICT) processes, pursuant to AB 1612, and sent along a new ITC form to go with it.  The sending county is to send the application (SAWs 1 and 2) and the new county is not to require the individual to reapply, unless the change in circumstances is such that a determination of continuing eligibility cannot be made without it. Rather, the new county is to just seek updated information.  The ICT does not result in the change of the redetermination/renewal process.  If a family moves out of the county during either of the last two months of the
redetermination/recertification period, the sending county and receiving county will need to complete the redetermination/recertification in sufficient time to avoid its expiration during the ICT process. The sending county may complete the redetermination/recertification and then transfer the case to the receiving county, or the receiving county may complete it  [Download]

DHCS MEDIL I 14-31: Pregnancy Changes in Circumstance Workaround (6/4/14)

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This letter from DHCS provides a workaround for MAGI beneficiaries who report a change in circumstance due to pregnancy.  A woman in one of the new adult coverage groups (M1, M2) who reports a change in circumstance due to pregnancy will remain in her current coverage group aid code; this policy applies to all MAGI aid codes.

Counties are not to accept any transactions from CalHEERS that move a woman from an M1 to M4 aid code into any of the pregnant woman coverage group aid codes when a woman reports her pregnancy.  If CalHEERS attempts to do that, counties should change the case to show not pregnant to keep the beneficiary in the same aid code.  Counties are to document use of this workaround and pregnancy due date until the design gap is fixed.

DHCS MEDIL I 14-30: Denying Pending Applications Originating Through the CalHEERS Access Channel (5/22/14)

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A previous letter directed counties to deny pending SAWS Medi-Cal applications after completing an ex parte review and making two 10-day requests for income verification.  A third 10-day request was required when the prior requests were sent before March 15, 2014.  Counties were directed to use the appropriate SAWS denial Notice of Action for failure to cooperate.

This letter from DHCS instructs counties to use the same procedures for applications that originated in CalHEERS.  The third 10-day request for income verification is required if an ex parte review was completed and two 10-day requests were sent prior to May 22, 2014.  After that date, only two such requests are required prior to denying the application for failure to provide income verification.  Counties will contact SAWS for denial instructions until CalHEERS functionality is implemented.

DHCS MEDIL I 14-27: Application Process for Retroactive Medi-Cal Coverage (5/15/14)

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DHCS issued this letter to provide updated guidance on retroactive Medi-Cal coverage as a result of the Affordable Care Act.  Individuals could previously request retroactive coverage before a year from the date of service by completing an MC 210A for each month in which retroactive coverage was requested.

For ongoing MAGI cases, counties will ask for information in addition to the MC 210A when the information is needed to complete the determination.  If a current MAGI beneficiary is requesting retroactive months prior to December 31, 2013, eligibility would be based on non-MAGI rules.  For applications for retroactive months where no ongoing coverage is requested, counties must complete a SAWS 2 Plus for the other months requested.

The non-MAGI applications will continue to use the MC 210A along with property and income verification as needed.