medi-cal

ACIN I-03-10: Conlan II Reimbursement Process (1/21/10)

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More clarification on the Conlan reimbursements. DHCS is required to provide recipients reimbursement for medically necessary services received and paid for during the following time periods: 1) the retroactive period (up to 3 months prior application for Medi-Cal, 2) the evaluation period (time between the dates that an application for Medi-Cal eligibility was submitted and approved); and 3) the post approval period which is after the recipient was approved for Medi-Cal and addresses the excess share of cost expenses.

IHSS recipients who paid their provider an excess share of cost can file a Conlan II claim to request reimbursement. [Download]

ACWDL 10-04: Low income subsidy data exchange update (1/13/10)

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A data exchange between SSA and DHCS started on a daily basis on January 1, 2010. Counties will receive two types of applications from SSA. The first will be LIS Extra Help applications where SSA has completed a determination of whether the individual is eligible for LIS Extra Help.The second are applications where the applicant self-assesses that they are apparently over the resource limit for LIS and they wish to have their information sent to the state to determine whether they are eligible for an MSP. The letter has extensive details on what data must be exchanged and what the counties are responsible for. [Download]

ACWDL 10-03: Language access services for LEP and non-English proficient individuals (1/12/10)

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This ACWDL delineates the responsibilities of counties when providing language services to Limited-English Proficient (LEP) and
non-English proficient applicants/beneficiaries, and it establishes procedures to ensure that LEP and non-English proficient applicants/beneficiaries are informed that free interpreter services are available.

Counties are responsible for ensuring that LEP individuals have access to meaningful language services, and must take necessary steps to ensure that interpretive services and written translations are provided to LEP applicants/beneficiaries, regardless of the size of the language group. The letter contains six guidelines for providing appropriate service to LEP individuals. [http://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/c10-03.pdf]

ACWDL 10-1: Pickle – tickler system (1/4/10)

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DHCS mailed out the Pickle Tickler NOAs the first week of January 2010 to individuals who currently receive Title II benefits; have been discontinued from the SSI/SSP since December 2004 (for any reason); and were determined ineligible during the Pickle screening process. Pursuant to the Lynch v. Rank lawsuit, each potentially eligible Pickle individual must receive a Pickle Medi-Cal notice for three consecutive years. [Download]

ACWDL 09-65: Social security number data match for verification of citizenship and indentity for purposes of Medi-Cal eligibility (12/31/09)

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Effective January 4, 2010, DHCS implemented a Social Security Number matching process to verify the citizenship and identity of Medi-Cal applicants and beneficiaries who are subject to the citizenship/identity requirements of the DRA. A successful match fulfils the DRA’s Citizenship and Identity requirements and no further documentation is needed from the applicant or beneficiary for this purpose. Thus, counties will see savings in administrative costs and staff time needed for DRA compliance. Further, most applicants and beneficiaries are spared the effort and expense of having to locate or obtain acceptable documentation. [Download]