reglab/statecodes huggingface dataset:
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50071.5 - Prepaid Health Plan

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Prepaid
					 health plan means any health care service plan as defined in Health and Safety
					 Code Section
					 1345(f)
					 which:
(1) Is licensed as a health care
					 service plan by the Commissioner of Corporations pursuant to the Knox-Keene
					 Health Care Service Plan Act of 1975, Chapter 2.2, commencing with Section
					 1340, Division 2, Health and
					 Safety Code, or has an application for licensure pending and was registered
					 under the Knox-Mills Health Plan Act prior to its repeal in Chapter 941,
					 Statutes of 1975.
(2) Meets the
					 requirements for participation in the Medicaid Program, Title XIX of the Social
					 Security Act, on an at risk basis.
(3) Has a contract with the Department to
					 furnish directly or indirectly health services to Medi-Cal beneficiaries on a
					 predetermined periodic rate basis.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50071.6 - Prepaid Health Plan - Comprehensive

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Comprehensive prepaid health plan means a prepaid health
						plan that is required by contract with the Department to provide the full scope
						of benefits available under the Medi-Cal program.
1. New
						section filed 8-8-80; effective thirtieth day thereafter (Register 80, No.
						32).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14016.5,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50071.8 - Primary Care Case Management (PCCM) Plan

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Primary care case management plan or PCCM plan means any
						person or organization who:
(a) Has
					 entered into a contract with the Department on a capitated or risk sharing
					 basis, or both, to provide or arrange for the provision of health care services
					 under the provisions of Article 2.9 commencing with section
					 14088,
					 Welfare and Institutions Code; and
(b) Meets the requirements for participation
					 in the Medicaid Program, as stated in Title XIX of the Social Security Act, on
					 an at-risk basis.
1. New
						section filed 3-9-90 as an emergency, operative 3-9-90 (Register 90, No. 12). A
						Certificate of Compliance must be transmitted to OAL within 120 days or
						emergency language will be repealed on 7-9-90.
2. New section
						refiled 7-9-90 as an emergency; operative 7-9-90 (Register 90, No. 35). A
						Certificate of Compliance must be transmitted to OAL within 120 days or
						emergency language will be repealed by operation of law on
						11-6-90.
3. Request to readopt section on an emergency basis
						pursuant to Government Code section
						11346.1
						granted and filed 11-6-90 as an emergency; operative 11-6-90 (Register 91, No.
						6). A Certificate of Compliance must be transmitted to OAL by 3-6-91 or
						emergency language will be repealed by operation of law on the following
						day.
4. Certificate of Compliance as to 11-6-90 order transmitted to
						OAL 2-22-91; disapproved by OAL on 3-25-91 (Register 91, No. 18).
5.
						New section filed 3-25-91 as an emergency; operative 3-25-91 (Register 91, No.
						18). A Certificate of Compliance must be transmitted to OAL by 7-23-91 or
						emergency language will be repealed by operation of law on the following
						day.
6. Certificate of Compliance as to 3-25-91 order including
						amendment of section transmitted to OAL 7-19-91 and filed 8-19-91 (Register 92,
						No. 1).
Note: Authority cited: Sections
						  10725,
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14088,
						  14088.16
						  and
						  14088.2,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50072 - Property - Community

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Community property means property acquired by either
						spouse during marriage, unless the property was acquired as separate property
						or with funds that can be identified as separate property.
1.
						Editorial correction adding NOTE filed 7-7-83 (Register 83, No.
						29).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14006
						  and
						  14008,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50073 - Property - Personal

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Personal property means possessions or interests,
						exclusive of real property, that may be easily transported or stored; including
						but not limited to cash on hand, bank accounts, notes, mortgages, deeds of
						trust, cash surrender value of life insurance, motor vehicles, uncollected
						judgments, an interest in a firm in receivership, a lawsuit, patents and
						copyrights.
1.
						Editorial correction adding NOTE filed 7-7-83 (Register 83, No.
						29).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14006,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50074 - Property - Real

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Real property means land and improvements which generally
						includes any immovable property attached to the land and any oil, mineral,
						timber or other rights related to the land.
1.
						Editorial correction adding NOTE filed 7-7-83 (Register 83, No.
						29).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14006,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50075 - Property - Separate

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 Separate property means any item that is considered separate property under
					 California Property Law. Generally, separate property is property acquired by
					 an individual by any method prior to marriage, after obtaining an interlocutory
					 or final judgment of dissolution, or while voluntarily separated; or at any
					 time by gift or inheritance, or purchases made with funds that are separate
					 property or with funds from the sale of separate property.
(b) Separate property also includes that
					 portion of a couple's former community property which has been transmuted into
					 separate property by a written interspousal agreement in accordance with
					 50403(c).
1.
						Editorial correction adding NOTE filed 7-7-83 (Register 83, No.
						29).
2. New subsection (b) filed 2-16-88 as an emergency; operative
						2-16-88 (Register 88, No. 10). A Certificate of Compliance must be transmitted
						to OAL within 120 days or emergency language will be repealed on
						6-15-88.
3. New subsection (b) refiled 6-16-88 as an emergency;
						operative 6-16-88 (Register 88, No. 26). A Certificate of Compliance must be
						transmitted to OAL within 120 days or emergency language will be repealed on
						10-14-88.
4. Emergency language of subsection (b) refiled and
						operative 6-16-88 repealed on 10-14-88 by operation of Government Code Section
						11346.1
						(Register 88, No. 49).
5. New subsection (b) filed 11-16-88;
						operative 11-16-88 pursuant to Government Code Section
						11346.2(d)
						(Register 88, No. 49).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14006,
						  14006.2
						  and
						  14008,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50076 - Property - Share of Community

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
For the purpose of determining Medi-Cal eligibility,
						share of community property is to be treated as if each spouse owns one-half of
						the community property.
1.
						Amendment filed 2-11-82; effective thirtieth day thereafter (Register 82, No.
						7).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14006,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50077 - Public Agency

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Public agency means an administrative division of local,
						state or federal government, or an organization that has a contract to act in
						behalf of the local, state or federal government.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50078 - Public Assistance (PA) Recipient

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Public assistance (PA) recipient means a person or family
						receiving assistance under the AFDC, SSI/SSP, Indochinese refugee or Cuban
						refugee program.
1.
						Amendment filed 8-7-78; effective thirtieth day thereafter (Register 78, No.
						32).
2. Amendment filed 7-31-81 as an emergency; effective upon
						filing (Register 81, No. 33). A Certificate of Compliance must be transmitted
						to OAL within 120 days or emergency language will be repealed on
						11-28-81.
3. Certificate of Compliance transmitted to OAL 11-6-81
						and filed 1-27-82 (Register 82, No. 5).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14005.1
						  and
						  14050.1,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50079 - Public Funds

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Public funds means monies provided by local, state or
						federal government.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50079.5 - Publicly Operated Community Residence

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Publicly operated community residence
					 means a facility designed and planned to serve no more than 16 residents which
					 is actually serving 16 or fewer residents. The facility provides food and
					 shelter and must provide some additional services such as:
(1) Social services.
(2) Help with personal activities.
(3) Training in socialization and life
					 skills.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50079.6 - Qualified Disabled and Working Individual

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Qualified Disabled and Working Individual" means an
						individual who meets the eligibility criteria for the Qualified Disabled and
						Working Individual program specified in Section
						50256.
1.
						Renumbering of former section
						50079.6 to section
						50079.7 and new section filed
						10-3-94 as an emergency; operative 10-3-94 (Register 94, No. 40). A Certificate
						of Compliance must be transmitted to OAL by 1-31-95 or emergency language will
						be repealed by operation of law on the following day. For prior history, see
						Register 91, No. 8.
2. Editorial correction of HISTORY NOTE 1
						(Register 95, No. 9).
3. Reinstatement of section as it existed
						prior to emergency filed 3-2-95 by operation of Government Code section
						11346.1(f)
						(Register 95, No. 9).
4. Renumbering of former section
						50079.6 to section
						50079.7 and new section refiled
						3-3-95 as an emergency; operative 3-3-95 (Register 95, No. 9). A Certificate of
						Compliance must be transmitted to OAL by 7-1-95 or emergency language will be
						repealed by operation of law on the following day.
5. Certificate of
						Compliance as to 3-3-95 order including amendment of NOTE transmitted to OAL
						2-22-95 and filed 4-5-95 (Register 95, No. 14).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code; and Section
						  12, Chapter 1430, Statutes of
						  1989. Reference: Section
						  14005.3,
						  Welfare and Institutions Code; and Sections
						  1396 a(a)(10)(E) and 1396d(s),
						  Title 42, United States Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50079.7 - Qualified Medicare Beneficiary

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Qualified Medicare Beneficiary" means an individual who
						meets the eligibility criteria for the Qualified Medicare Beneficiary program
						specified in Section
						50258.
1.
						Renumbering of former section
						50079.6 to new section
						50079.7 filed 10-3-94 as an
						emergency; operative 10-3-94 (Register 94, No. 40). A Certificate of Compliance
						must be transmitted to OAL by 1-31-95 or emergency language will be repealed by
						operation of law on the following day.
2. Editorial correction of
						HISTORY NOTE 1 (Register 95, No. 9).
3. Repealed by operation of
						Government Code section
						11346.1(g)
						(Register 95, No. 9).
4. Renumbering of former section
						50079.6 to section
						50079.7 and new section refiled
						3-3-95 as an emergency; operative 3-3-95 (Register 95, No. 9). A Certificate of
						Compliance must be transmitted to OAL by 7-1-95 or emergency language will be
						repealed by operation of law on the following day.
5. Certificate of
						Compliance as to 3-3-95 order transmitted to OAL 2-22-95 and filed 4-5-95
						(Register 95, No. 14).
Note: Authority cited: Sections
						  10725,
						  14005.11
						  and
						  14124.5,
						  Welfare and Institutions Code; and Section
						  12, Chapter 1430, Statutes of
						  1989. Reference: Section
						  1396 d(p), Title 42, United States
						  Code; and Section
						  14005.11,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50080 - Quality Control. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Repealer filed 7-6-83 as an emergency; effective upon filing (Register 83, No.
						33). A Certificate of Compliance must be transmitted to OAL within 120 days or
						emergency language will be repealed on 11-3-83.
2. Certificate of
						Compliance transmitted to OAL 11-3-83 and filed 2-6-83 (Register 83, No.
						50).
3. Corrected Certificate of Compliance as to 7-6-83 order filed
						1-9-84 (Register 84, No. 2).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14016(b), (d)
						  and (e)(1) and
						  14100.1,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50081 - Reapplication

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Reapplication means an application for Medi-Cal-only
						eligibility made in the same county as a previous application, if the previous
						application was denied or withdrawn, or Medi-Cal-only eligibility based on the
						previous application has been discontinued for more than 12
						months.
1.
						Amendment filed 8-7-78; effective thirtieth day thereafter (Register 78, No.
						32).
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50082 - Recipient

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Recipient means a person or family receiving aid under a
						public assistance program or the Other Public Assistance
						program.
1.
						Editorial correction adding NOTE filed 7-7-83 (Register 83, No.
						29).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14005.1
						  and
						  14050.1,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50083 - Redetermination

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Redetermination means the review of a person's or
						family's Medi-Cal eligibility.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50084 - Relative

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Relative means a mother, father, grandfather,
						grandmother, son, daughter, brother, sister, stepfather, stepmother,
						stepbrother, stepsister, uncle, aunt, first cousin, nephew, niece,
						half-brother, half-sister, any such person of a preceding or succeeding
						generation denoted by a prefix of grand, great or great-great or the suffix
						in-law.
1.
						Editorial correction adding NOTE filed 7-7-83 (Register 83, No.
						29).
2. Amendment filed 12-2-85 as an emergency; effective upon
						filing (Register 85, No. 50). A Certificate of Compliance must be transmitted
						to OAL within 120 days or emergency language will be repealed on
						4-1-86.
3. Certificate of Compliance transmitted to OAL 3-31-86 and
						filed 4-30-86 (Register 86, No. 18).
Note: Authority cited: Sections
						  10725,
						  14006.1
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14005.7,
						  14006
						  and
						  14008,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50085 - Relative - Caretaker

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Caretaker relative means a relative who provides care and
						supervision to a child, if there is no natural or adoptive parent in the
						home.
1.
						Editorial correction adding NOTE filed 7-7-83 (Register 83, No.
						29).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14005.7,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50086 - Repayment

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Repayment means the liquidation of an overpayment in
						response to issuance of demands and recovery thereof by the Department of
						Benefit Payments.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50087 - Residence

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Residence means the place in which a person or family
						lives or is physically present if the person or family has no present intention
						of leaving.
1.
						Editorial correction adding NOTE filed 7-7-83 (Register 83, No.
						29).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14007
						  and
						  14016,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50088 - Responsible Relative

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Responsible relative means a relative who is responsible
						to contribute to the cost of health care services received by a Medi-Cal
						beneficiary.
1.
						Editorial correction adding NOTE filed 7-7-83 (Register 83, No.
						29).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14008,
						  14008.5,
						  14009
						  and
						  14010,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50089 - Restoration

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Restoration means the approval of Medi-Cal-only
						eligibility for a person or family in the same county as that in which they
						were previously eligible for Medi-Cal-only, if the effective date of the
						approval occurs within 12 months of the end of the previous period of
						eligibility.
1.
						Amendment filed 8-7-78; effective thirtieth day thereafter (Register 78, No.
						32).
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50090 - Share of Cost

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Share of cost means a person's or family's net income in
						excess of their maintenance need that must be paid or obligated toward the cost
						of health care services before the person or family may be certified and
						receive Medi-Cal cards.
1.
						Editorial correction adding NOTE filed 7-7-83 (Register 83, No.
						29).
2. Change without regulatory effect amending NOTE filed
						12-16-2013 pursuant to section
						100, title 1, California Code of
						Regulations (Register
						2013,
						No. 51).
Note: Authority cited: Section
						  20, Health and Safety Code; and
						  Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14005.9,
						  14021,
						  14053,
						  14054,
						  14124.24
						  and
						  14131,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50091 - Share of Encumbrances

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Share of encumbrances means that portion of the
						encumbrances attributed to each portion of jointly owned
						property.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50091.5 - Specified Low-Income Medicare Beneficiary

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Specified Low-Income Medicare Beneficiary" (SLMB) means
						an individual who meets the eligibility criteria for the SLMB Program specified
						in Section
						50258.1.
1. New
						section filed 12-21-93; operative 1-20-94 (Register 93, No.
						52).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5
						  of the Welfare and Institutions Code. Reference: Section
						  1396 a(a)(10)(E)(iii), Title 42,
						  United States Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50092 - Spenddown. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Repealer filed 8-18-82 as an emergency; effective upon filing (Register 82, No.
						34). A Certificate of Compliance must be transmitted to OAL within 120 days or
						emergency language will be repealed on 12-16-82.
2. Certificate of
						Compliance transmitted to OAL 12-14-82 and filed 1-21-83 (Register 83, No.
						4).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code; and Section
						  57(c), Chapter
						  328, Statutes of 1982. Reference: Section
						  14019.6,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50093 - State Data Exchange (SDX)

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
State Data Exchange (SDX) means the data system by which
						the Federal Government provides information to the State regarding the
						eligibility of SSI/SSP applicants and recipients.
1.
						Editorial correction adding NOTE filed 7-7-83 (Register 83, No.
						29).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14017,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50094 - Stepparent

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Stepparent means a person who is married to the parent of
						a child and who is not the other parent of the child.
1.
						Editorial correction adding NOTE filed 7-7-83 (Register 83, No.
						29).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  11261,
						  14001.1
						  and
						  14005.7,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50095 - Supplemental Security Income/State Supplemental Program (SSI/SSP)

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Supplemental Security Income/State Supplemental Program
						(SSI/SSP) means the federal and state payments, respectively, which are based
						on need, and are paid to aged, blind or disabled persons.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50095.1 - Title II Disregard Person. [Renumbered]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New
						section filed 1-5-78 as an emergency; effective upon filing (Register 78, No.
						1).
2. Certificate of Compliance filed 5-5-78 (Register 78, No.
						18).
3. Renumbering of Section
						50095.1 to Section
						50095.7 filed 8-9-85 as an
						emergency; effective upon filing (Register 85, No. 32). A Certificate of
						Compliance must be transmitted to OAL within 120 days or emergency language
						will be repealed on 12-9-85.
4. Certificate of Compliance as to
						8-9-85 order transmitted to OAL 11-13-85 and filed 12-11-85 (Register 85, No.
						50).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14005.7,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50095.5 - Therapeutic Wages

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 Therapeutic wages are wages earned by the individual when all of the following
					 conditions are met:
(1) A physician who does
					 not have a financial interest in the long-term care facility in which the
					 individual resides, and who is in charge of the individual's case prescribes
					 this work as therapy for the individual.
(2) The individual must be employed by the
					 same long-term care facility in which he or she resides.
(3) The individual's employment does not
					 displace any existing employees.
(4) The individual has resided in a long-term
					 care facility continuously since September 1979.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50095.7 - Title II Disregard Person

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Title II disregard person" means a person who meets all
						the conditions of Section
						50564.
1.
						Renumbering of Section
						50095.1 to Section
						50095.7 filed 8-9-85 as an
						emergency; effective upon filing (Register 85, No. 32). A Certificate of
						Compliance must be transmitted to OAL within 120 days or emergency language
						will be repealed on 12-9-85. For prior history, see Registers 78, No. 18, and
						78, No. 1.
2. Certificate of Compliance transmitted to OAL 11-13-85
						and filed 12-11-85 (Register 85, No. 50).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14005.7,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50096 - Transfer of Property

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Transfer of property means a change in ownership whereby
						a person no longer holds title to, or beneficial interest in,
						property.
1.
						Editorial correction adding NOTE filed 7-7-83 (Register 83, No.
						29).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14006
						  and
						  14015,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 1 - DEFINITIONS, ABBREVIATIONS AND PROGRAM TERMS › Section 50097 - Verification

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Verification means the process of obtaining acceptable
						evidence which substantiates statements made by an
						applicant/beneficiary.
1. New
						section filed 8-18-82 as an emergency; effective upon filing (Register 82, No.
						34). A Certificate of Compliance must be transmitted to OAL within 120 days or
						emergency language will be repealed on 12-16-82.
2. Certificate of
						Compliance transmitted to OAL 12-14-82 and filed 1-21-83 (Register 83, No.
						4).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code; and Section
						  57, Chapter 328, Statutes of 1982.
						  Reference: Section
						  14011,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 2 - ADMINISTRATION › Section 50101 - County Department Responsibilities

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The county department shall:
(1) Be responsible for determining initial
					 and continuing eligibility for Medi-Cal applicants or beneficiaries promptly
					 and humanely, in accordance with:
(A)
					 Medi-Cal regulations.
(B)
					 Departmental directives.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 2 - ADMINISTRATION › Section 50103 - Civil Service or Merit Systems

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
All persons employed by a county and engaged in
						administration of the Medi-Cal program shall be employed under a civil service
						or merit system that meets the requirements established by the California State
						Personnel Board.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 2 - ADMINISTRATION › Section 50105 - Staffing Requirements

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 Medi-Cal eligibility services may be provided by personnel in those technical
					 nonsocial work job classifications that are established by the county personnel
					 agency responsible for approving such job classification.
(b) The county department shall assign
					 Medi-Cal eligibility staff in sufficient numbers so that any applicant or
					 beneficiary in need of eligibility services shall be provided with those
					 services.
(c) Eligibility
					 information shall be available 24 hours a day, 7 days a week, to persons with
					 medical and related emergencies.
1.
						Editorial correction adding NOTE filed 7-7-83 (Register 83, No.
						29).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  10809
						  and
						  14001,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 2 - ADMINISTRATION › Section 50106 - Staff Training

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The county department shall train Medi-Cal eligibility
						staff in accordance with the training requirements of Division 14, Manual of
						Policies and Procedures, Department of Social Services.
1.
						Editorial correction filed 7-7-83 (Register 83, No.
						29).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  10800,
						  10820,
						  10900,
						  10906
						  and
						  14001,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 2 - ADMINISTRATION › Section 50107 - Civil Rights

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The
					 county department shall not discriminate against any applicant or beneficiary
					 on the basis of race, color, creed, ethnic origin, sex, marital status, age,
					 physical or mental handicap, national origin or political
					 affiliation.
(b) Persons who
					 believe that they have been discriminated against may file a grievance with the
					 Department in accordance with departmental procedures.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 2 - ADMINISTRATION › Section 50109 - Reports

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The county department shall submit reports as required by
						the Department and shall comply with such provisions as the Department may find
						necessary to ensure the correctness of the reports.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 2 - ADMINISTRATION › Section 50110 - Medi-Cal Case

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Each
					 MFBU shall be one Medi-Cal case.
(b) Each Other PA person or Other PA family
					 group shall be one Medi-Cal case.
(c) A PA recipient or PA family group shall
					 not be a Medi-Cal case.
1.
						Editorial correction adding NOTE filed 7-7-83 (Register 83, No.
						29).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14005
						  and
						  14008,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 2 - ADMINISTRATION › Section 50111 - Case Records and Confidentiality

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The county department shall adhere to the
					 requirements in Divisions 19 and 23, Manual of Policies and Procedures,
					 Department of Social Services, governing:
(1)
					 Maintenance of case records.
(2)
					 Confidentiality of case records.
(3) Safeguarding federal tax
					 information.
(4) Access to case
					 records.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 2 - ADMINISTRATION › Section 50113 - Forms

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The county
					 department shall use the forms prescribed by the Department in providing
					 Medi-Cal eligibility services.
(b)
					 Other forms shall not be substituted by the county department unless
					 specifically approved by the Department.
1.
						Editorial correction adding NOTE filed 7-7-83 (Register 83, No.
						29).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  10820,
						  1085,
						  11050,
						  14001
						  and
						  14011,
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 2 - ADMINISTRATION › Section 50115 - Quality Control -County Cooperation

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The county department shall cooperate with the Department
						in ensuring that federal quality control requirements are
						met.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 2 - ADMINISTRATION › Section 50116 - Medi-Cal Fiscal Penalties

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 The Department shall assess fiscal penalties to counties whenever the state
					 dollar error rate exceeds the federal standard.
(b) A county's case error rate shall be
					 determined based on reviews by Department staff of a random sample of a minimum
					 number of cases for each period, as follows:
(1) All cases shall be sampled in any county
					 with less than 50 Medi-Cal cases.
(2) Fifty cases in any county with greater
					 than 0.01 percent and less than or equal to 0.50 percent of the Medi-Cal cases
					 in the state.
(3) Seventy-five
					 cases in any county with greater than 0.50 percent and less than or equal to
					 1.0 percent of the Medi-Cal cases in the state.
(4) One hundred cases in any county with
					 greater than 1.0 percent and less than or equal to 3.0 percent of the Medi-Cal
					 cases in the state.
(5) One hundred
					 twenty-five cases in any county with greater than 3.0 percent and less than or
					 equal to 10.0 percent of the Medi-Cal cases in the state.
(6) Six hundred fifty cases in any county
					 with greater than 10.0 percent of the Medi-Cal cases in the
					 state.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 2 - ADMINISTRATION › Section 50116.5 - Appeal of Quality Control Review Findings

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) When the Department finds a sampled case
					 that includes an ineligible person or a person with an understated share of
					 cost, written notification which describes the error shall be sent to the
					 county department.
(b) The county
					 department shall respond to the Department in writing within two weeks from
					 receipt of notification of the error and shall indicate whether it agrees or
					 disagrees with the findings.
(c) If
					 the county disagrees, the Department shall reevaluate the error findings,
					 taking into consideration any additional facts contained in the county's
					 response.
(d) The Department shall
					 again notify the county of the Department's findings.
(e) The county may then appeal to the Chief,
					 Medi-Cal Policy Division, requesting that the Department review the case and
					 render a final decision.
1. New
						section filed 5-15-92; operative 6-19-92 (Register 92, No.
						21).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14016(f),
						  Welfare and Institutions Code.
California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 2 - Determination of Medi-Cal Eligibility and Share of Cost › Article 2 - ADMINISTRATION › Section 50117 - Calculation of Medi-Cal Fiscal Penalties

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The Department shall calculate the fiscal
					 penalty for a liable county for each monitoring period as follows:
(1) A penalty multiple shall be calculated by
					 multiplying a county's case error rate times its percentage of statewide
					 Medi-Cal cases.
(2) A county's
					 penalty multiple shall be divided by the sum of the penalty multiples of all
					 counties then multiplied times the penalty bank.