DHCS ACWDL 14-27: Additional Express Lane Enrollment Guidance (6/16/14)

Posted on by

This letter clarifies questions about the CalFresh Express Lane Enrollment procedures for Medi-Cal, particularly about aid code 7S (those individuals eligible for Medi-Cal under pre-ACA rules).

  • Parents, guardians and caretakers relatives are to be put in aid code 7S as opposed to aid code 7U. These individuals will be eligible even if a child is not on CalFresh or Medi-Cal; the children only have to meet the age and residence requirements.
  • DHCS will transfer Medicare beneficiaries in Express Lane aid codes to aid code 7S.
  • Those who are found ineligible for CalFresh will be sent RFTHIs to determine Medi-Cal eligibility.

Additionally, the letter discusses discontinuance NOAs for Express Lane beneficiaries upon change of circumstances or expiration.  NOAs will be generated by SAWS, and beneficiaries will be referred for APTC/CSR determinations with a special enrollment period.

Finally, Express Lane enrolled individuals are eligible for retroactive months of coverage up to February 2014.  For determination of months before February, individuals will need to submit a RFTHI (for January 2014) or a full pre-ACA application (for December 2013 and before).

DHCS MEDIL I 14-33: Pre-Affordable Care Act Medi-Cal Annual Redetermination Discontinuances (6/12/14)

Posted on by

This letter instructs counties to use the existing SAWS negative case action functions when discontinuing pre-ACA cases for failure to provide the RFTHI or other requested information.  The letter also reminds counties that the RFTHI form is only a means to collect information and does not have to be completed for a beneficiary to comply with the annual redetermination requirement.

DHCS MEDIL I 14-32: Inter-County Transfer (ICT) of former Low Income Health Program (LIHP) Cases in Aid Code L1 (6/11/14)

Posted on by

DHCS issued this letter to provide guidance to counties regarding the transfer of L1 Aid Code cases (former LIHP cases) through the described workaround process.  This workaround is necessary because SAWS does not yet support L1 aid code cases.  Cases where a Medi-Cal beneficiary reports a change in county of residence do not require an eligibility review.  Instead, the receiving county will assist the transferring beneficiary with enrolling in a new local plan (as needed).

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

Posted on by

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]