This letter corrects the date that affected beneficiaries will see the Part B premium deducted from their Social Security checks. Checks will be affected December, 2008, not November as stated in ACWDL 08-48. Counties are also reminded that they can suggest the 250% Working Disabled Program to beneficiaries as a program in which beneficiaries are not responsible for the Part B premium. DHCS sent a letter in October, 2008 alerting beneficiaries that they would have to begin paying the Part B premium; unfortunately they sent this letter to beneficiaries who are MSP eligible too. In November they will send a letter to the same group of people with more information about the Part B premium, MSPs, SOC, and the 250%WDP. Enclosed in this ACWDL is a copy of the letter SS will be sending to beneficiaries regarding the Part B premium. [Download]

This ACWDL puts part of budget trailer bill AB 1183 into effect by eliminating the state buy-in of Medicare Part B premiums for beneficiaries with a share of cost over $500 until or unless the SOC is met on a monthly basis. Some details:
-The change is effective 10/1/08 and will affect SS checks received in November (But not really, See ACWDL 08-48E)
-People eligible for a Medicare Savings Program will still have their Part B payments paid by the govt. Counties must determine MSP eligibility immediately for all Medi-Medis with or without a SOC. (See ACWDL 08-21)
-Beneficiaries who have to pay the Part B premium can disenroll from Medicare Part B with no negative affect on Medi-Cal eligibility, 22 CCR 50763(a)(1) only requires beneficiaries to apply for other health care coverage when no cost is involved.
-When beneficiaries begin to pay their own premiums Counties must recalculate the SOC deducting the Part B premium. They will receive a NOA letting them know why the SOC is being reduced and that they can disenroll form Medicare Part B and what some of the consequences of that will be.
-If a beneficiary pays the Part B premium and that deduction brings the SOC below $500 or makes them eligible for A&DFPL DHCS will pay the premium for that month retroactively, if the SOC then goes back up because the Part B premium is no longer being deducted the County needs to send a NOA.
-Reimbursement from SSA will be treated as property in the month of receipt
-Counties are not to predict buy-ins [Download]

Elton John’s plea to not let the sun go down on the working disabled was answered by AB1183. The sunset date of January 1, 2009 was eliminated by AB 1183 (Chapter 758, Statutes of 2008). The 250% Working Disabled Program will now operate indefinitely as a permanent Medi-Cal program. The 250% WDP allows employed individuals with disabilities to earn up to 250 % of the FPL and receive full scope Medi-Cal benefits. [Download]

This ACWDL lays out some changes in self-certification and independent evaluation minimum sample requirements. Included are the mandatory performance levels that must be achieved including 90% of regular applications processed in 45 days and disability applications processed in 90 days. [Download]

The Defecit Reduction Act requires U.S. Citizens and Nationals to provide proof of citizenship/ national status and identity for Medi-Cal eligibility. The NOAs related to the DRA are now available in Vietnamese, Chinese, Korean, Russian, Armenian, Farsi, Khmer, Hmong, Arabic, Tagalog, Spanish, and English. [Download]

This letter clarifies that the Refugee Medical Assistance and Entrant Medical Assistance program (RMA/EMA) is a fully federally funded non Medi-Cal program that gives full-scope medical assistance through the Medi-Cal program. RMA/EMA only lasts for 8 months and counties must evaluate RMA/EMA beneficiaries for ongoing Medi-Cal eligibility prior to discontinuance. If a refugee/ entrant claims a disability the county must submit the disability evaluation as soon as possible to increase the chances that the disability evaluation will be completed by the end of the eight month period. The letter also discusses who can be on the program, lists which documentation is acceptable evidence of status for the program, and lays out upcoming MEDS changes. [Download]