DHCS MEDIL 14-11 System Workarounds and Overrides

Instructs counties to manually correct cases for applicants with immediate medical need incorrectly found ineligible by CalHEERS, for immigrants who should get full scope Medi-Cal but erroneously received restricted scope through CalHEERS, and for Former Foster Care youth up to 26 due to SAWS programming issues.  The letter, available here, further directs counties to report any new eligibility problems to DHCS and states that DHCS will fix the issues within 2 days.

DHCS MEDIL 14-08: E-HIT Workarounds- January 21, 2014

This letter provides temporary guidance to counties on certain workarounds necessary to process MAGI Medi-Cal eligibility while the SAWS and CalHEERS interface is being improved.  This letter addresses how to manually process MAGI Medi-Cal applications with two primary tax filers on the same application as well as how to process cases that are rejected by CalHEERS because the applicant does not meet the 5 year immigration bar but is eligible for Medi-Cal per California rules.  To see the entire letter, click here.

DHCS MEDIL 14-02: Affordable Care Act Guidance

This letter provides guidance to counties on: 1) processing pending CalHEERS applications for individuals with current Medi-Cal eligibility; 2) ex parte review of pending CalHEERS Medi-Cal applications using existing CalWORKS and CalFresh cases; and 3) verifying state residency and remote identity proofing procedures until the CalHEERS/SAWS interface is functional. The letter is linked here.

DHCS ACWDL 14-01: Low Income Health Program Transition to Medi-Cal

Enrollees in the Low Income Health Program (LIHP) prior to December 31, 2013 have been and will continue to be administratively moved to MAGI Medi-Cal by DHCS until the end of March 2014.   These individuals were given a transition aid code which will remain in place until the next scheduled redetermination unless the enrollee makes a new application or reports a change in circumstance  that requires a new eligibility determination. For more information on the LIHP transition to Medi-Cal, view the letter here.