The letter notifies counties that the federal SGA amount will increase effective 1/1/14 and instructs counties that were unable to implement the change by 1/1/14 to retroactively redetermine Medi-Cal eligibility based on disability if a case has been denied erroneously or budgeted incorrectly.  Click here to access the letter.

This one is pretty self-explanatory.  Click here to review the circumstances in which Medi-Cal beneficiaries are entitled to continuity of care, what continuity of care entails, and the processes for providing services through continuity of care.

Prior to 2014, Medi-Cal beneficiaries enrolled in a Medi-Cal Managed Care Plan (MCP) received services within the scope of their primary care provider’s (PCP’s) practice through their PCP and received specialty mental health services for serious mental illness through the county Mental Health Plan (MHP). Effective January 1, 2014, Medi-Cal Managed Care Plans are responsible for providing certain mental health services through the plan’s provider network to beneficiaries with mild to moderate impairment of mental, emotional, or behavioral functioning resulting from a mental health disorder even when those services are outside the PCP’s scope of practice.  The letter, available here, delineates the MCP’s responsibilities for referring to, and coordinating with MHPs for the delivery of mental health services.

Reminds counties that Medically Needy Medi-CAl cases with Title II income must have the Share of Cost adjusted effective 1/1/14.  Instructions for how to apply the COLA to these cases are included.  Importantly, note that the COLA is NOT to be applied to A&D FPL, FPL-Blind, Medicare Savings Programs, 200 Percent Women and Infants, children’s FPL programs – these cases should NOT have the COLA applied until the 2014 FPL rates are published.  Also, the COLA should not be applied to MAGI Medi-Cal cases as they have no redeterminations before April 2014. Read the full letter here.

While LSNC does not represent state or county inmates, the letter also provides information about Medi-Cal eligibility for parolees and babies born to inmates. The letter specifies that inmates who had eligibility through Medi-Cal Inmate Eligibility Program (MCIEP), who are entitled to an SB87 review of their eligibility when they are paroled.  Parolees who were on the Low Income Health Program (LIHP) as inmates and were transitioned to Medi-Cal keep their eligibility until redetermination.  Babies born to inmates on MCIEP are also deemed Medi-Cal eligible for one year.  View the full letter here.