News and Updates Archive
State Seeks Coverage Ambassadors to Reach Medi-Cal Beneficiaries (December 2022)
California is launching a statewide effort to help Medi-Cal beneficiaries keep their Medi-Cal coverage or be enrolled in other coverage.
During the national public health emergency (PHE), the annual reevaluation of ongoing eligibility was temporarily paused to ensure vulnerable Californians had ongoing access to health coverage. When the PHE ends, the state will resume normal Medi-Cal eligibility operations and the annual eligibility review. As a result of that process, two to three million beneficiaries could no longer be eligible for Medi-Cal. The state, along with its partners, are engaging in a comprehensive campaign to reach beneficiaries with information about what to expect and what they need to do to keep their health coverage.
DHCS has launched a customizable Medi-Cal Continuous Coverage toolkit and webpage to help trusted entities and individuals act as DHCS Coverage Ambassadors to push communications to Medi-Cal beneficiaries to encourage them to update their contact information with their counties to ensure they receive important information about keeping their Medi-Cal coverage.
Our primary goals through the DHCS Coverage Ambassador campaign are to help our beneficiaries keep their current Medi-Cal coverage, get free or low-cost coverage from Covered California or other government programs, or transition to their employer-sponsored health coverage.
The eligibility redeterminations will be conducted by counties based upon a beneficiary’s next annual renewal date (done on a rolling basis and not all at once). Before the PHE, California would review information provided by beneficiaries annually and renew their coverage if they still qualified. When the COVID-19 continuous coverage requirement expires at the end of the PHE, California will need to conduct a full redetermination for all beneficiaries. States will have up to 12 months, plus two additional months due to renewal processing policies, to return to normal eligibility and enrollment operations, which includes conducting a full renewal for all individuals enrolled in Medi-Cal and CHIP.
DHCS will shift the focus of the campaign 60 days prior to the end of the COVID-19 PHE and will encourage beneficiaries to report any changes in their personal circumstances, and check their mail for upcoming renewal packets, should the county be unable to complete the renewal using information already available to them without having to contact the beneficiary.
Updated toolkits will be posted on the DHCS website and be distributed to people who signed up to serve as DHCS Coverage Ambassadors. DHCS encourages everyone to join the mailing list to receive the latest information and updated toolkits.
As additional toolkits or resources become available, DHCS will also email critical updates to keep DHCS Coverage Ambassadors informed so they can spread the word to their community.
Availability of Long-acting Reversible Contraceptives in Los Angeles County Clinics Through a Medicaid State Plan Amendment Program (December 2018)
Recent research indicated that many family planning clients in California did not have same-day on-site access to long-acting reversible contraceptives.
Family PACT Client Eligibility Verification Issue (October 3, 2018)
The Department of Health Care Services (DHCS) has resolved the issue of using the Family Planning, Access, Care and Treatment (Family PACT) Internet Transaction application to inquire about Family PACT eligibility status. Providers can now use the Internet Transaction application or Automated Eligibility Verification System (AEVS) to verify a Family PACT client’s eligibility.
Select Comprehensive Family Planning Services Policy Update (December 29, 2017)
The Family PACT program will provide time-limited supplemental payments to Family PACT providers for Evaluation and Management (E&M) office visits rendered for comprehensive family planning services for the period of July 1, 2018 through June 30, 2019. These supplemental payments are equal to 150% of the reimbursement amount for procedure codes 99201, 99202, 99203, 99204, 99211, 99212, 99213, and 99214.
Accuracy and Correction of Claims or Payments (October 2017)
Family PACT providers are responsible for all claims submitted, regardless of who completes the claim on behalf of the provider. Family PACT providers are responsible for the review and verification of the accuracy of claims payment information promptly upon the receipt of any payment. The Family PACT provider agrees to seek correction of any claim errors through the appropriate processes as designated by the Department of Health Care Services or its fiscal intermediary (Source: Medi-Cal Provider Manual, Part I and your signed Form DHCS 6153, Medi-Cal Telecommunications Provider and Biller Application/Agreement).
ACA’s Nondiscrimination Policy Applies to Family PACT (August 8, 2017)
Section 1557 of Patient Protection and Affordable Care Act (ACA) prohibits discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs or activities. In effect since 2010, Section 1557 builds on long-standing federal civil rights laws: Title VI of the Civil Rights Act of 1964; Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973 and the Age Discrimination Act of 1975.
Effective July 18, 2016, the Health and Human Services (HHS) Office for Civil Rights issued its final rule implementing Section 1557 at Title 45 Code of Federal Regulations (CFR) Part 92. The rule applies to any health program or activity, any part of which receives federal financial assistance, an entity established under Title I of the ACA that administers a health program or activity, and HHS. In addition to other requirements, Title 45 CFR Part 92.201, requires:
- Language assistance services requirements. Language assistance services required under paragraph (a) of Part 92.201 must be accurate, timely and provided free of charge, and protect the privacy and independence of the individual with limited English proficiency
- Specific requirements for interpreter and translation services. Subject to paragraph (a) of Part 92.201:
- A covered entity shall offer a qualified interpreter to an individual with limited English proficiency when oral interpretation is a reasonable step to provide meaningful access for that individual with limited English proficiency
- A covered entity shall use a qualified translator when translating written content in paper or electronic form.
For more information about the application and requirements of the final rule implementing Section 1557, providers should contact their representative professional organizations. They may also visit Section 1557 of the Patient Protection and Affordable Care Act page of the HHS website to find sample materials and other resources.