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 2 - ADMINISTRATION › Section 50118 - Application of Medi-Cal Fiscal Penalties

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The Department shall notify the county in
					 writing when it determines that a Medi-Cal fiscal penalty will be
					 imposed.
(b) The county may request
					 reconsideration of the Medi-Cal fiscal penalty in accordance with Section
					 50118.5.
(c) When a Medi-Cal fiscal penalty is
					 imposed, the amount of the penalty shall be collected through direct
					 repayment.
1. New
						section 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						emergency language will be repealed on 11-3-83.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 12-6-83 (Register 83, No.
						50).
3. Corrected Certificate of Compliance as to 7-6-83 order filed
						1-9-84 (Register 84, No. 2).
4. Amendment filed 5-15-92; operative
						6-15-92 (Register 92, No. 21).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14016(f) and
						  (i), 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 50118.5 - Reconsideration of a Medi-Cal Fiscal Penalty

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A county may request reconsideration of a
					 Medi-Cal fiscal penalty if the county case error rate is caused by
					 circumstances outside the control of the county. Such circumstances may
					 include, but are not necessarily limited to, the following:
(1) Natural disasters which contribute
					 significantly to the county case error rate.
(2) Work stoppages or other work activity
					 beyond the control of the county which has a significant adverse impact on the
					 processing of Medi-Cal eligibility cases.
(3) Failure by the Department to meet the
					 minimum sample of cases specified in Section
					 50116.
(4) Such other occurrences as determined by
					 the Director.
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 50119 - County Corrective Action Requirements

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The county shall correct a case found in
					 error during the Department's sample case review within thirty days after being
					 notified of the Department's final decision that a case error has
					 occurred.
(b) A county whose case
					 error rate is found to be in excess of fifteen percent shall within 90 days of
					 being notified by the Department of this error rate provide a written report to
					 the Department which shall describe the steps the county has taken or plans to
					 take to reduce or eliminate the causes of error. The Department shall provide
					 direction on the form and content of the report and shall be responsible for
					 approving the county's Corrective Action Plan.
(c) The data collected on an individual
					 county during the review conducted by the Department shall be analyzed by the
					 county to determine causes of error. The county shall utilize this information
					 in conjunction with other information available to the county to develop and
					 implement correction actions which will reduce or eliminate the causes of
					 error.
1. New
						section 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 12-6-83 (Register 83, No.
						50).
3. Corrected Certificate of Compliance as to 7-6-83 order filed
						1-9-84 (Register 84, No. 2).
4. Amendment filed 5-15-92; operative
						6-15-92 (Register 92, No. 21).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14016(h),
						  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 3 - COUNTY OF RESPONSIBILITY FOR DETERMINATION OF MEDI-CAL ELIGIBILITY › Section 50120 - County of Responsibility

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The county of responsibility shall be the
					 county whose county department is responsible for determining the initial and
					 continuing Medi-Cal eligibility for a person or family. The appropriate county
					 of responsibility shall be determined in accordance with the regulations in
					 this article.
(b) Disputes between
					 counties regarding county of responsibility shall be resolved by the
					 Director.
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
						  10806
						  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 3 - COUNTY OF RESPONSIBILITY FOR DETERMINATION OF MEDI-CAL ELIGIBILITY › Section 50121 - Persons Eligible Under SSI/SSP

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The county of responsibility for determining Medi-Cal
						eligibility for persons eligible under AFDC or SSI/SSP shall be established in
						accordance with the regulations of the applicable public assistance
						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).
4. Editorial correction of
						section heading 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 3 - COUNTY OF RESPONSIBILITY FOR DETERMINATION OF MEDI-CAL ELIGIBILITY › Section 50123 - County of Responsibility -Persons with a Family

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The county of responsibility for
					 determining Medi-Cal eligibility for persons whose eligibility as MN, MI or
					 Other PA is determined as part of a family, or based on family income, shall be
					 either of the following:
(1) The county in
					 which the family's residence is located.
(2) The county of physical presence if the
					 family's residence is unclear.
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 3 - COUNTY OF RESPONSIBILITY FOR DETERMINATION OF MEDI-CAL ELIGIBILITY › Section 50125 - County of Responsibility -Persons with No Family

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The county of responsibility for
					 determining Medi-Cal eligibility for persons whose eligibility as MN, MI or
					 Other PA is not determined as part of a family, nor based on family income,
					 shall be:
(1) The placing county for:
(A) Persons placed by a county agency in a
					 private or county-administered facility in order to receive long-term
					 care.
(B) Children placed by a
					 county agency in foster or adoptive care under Aid Codes 04, 43, 44, 45, 46 and
					 47.
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 3 - COUNTY OF RESPONSIBILITY FOR DETERMINATION OF MEDI-CAL ELIGIBILITY › Section 50126 - County of Responsibility -Persons Eligible Under Special Programs

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The county of
					 responsibility for determining Medi-Cal eligibility for persons eligible under
					 the Cuban Refugee, Indochinese Refugee, and Medi-Cal Dialysis Programs shall
					 be:
(1) The county in which the person's
					 residence is located.
(2) The
					 county of physical presence if the person's residence is
					 unclear.
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 3 - COUNTY OF RESPONSIBILITY FOR DETERMINATION OF MEDI-CAL ELIGIBILITY › Section 50127 - Persons with a Guardian

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The
					 county of responsibility for persons with a county public guardian shall be the
					 county in which the public guardian is located except that if the person is
					 physically present in another county and the new county will accept a transfer
					 of guardianship, the new county shall be the county of
					 responsibility.
(b) The county of
					 responsibility for persons with a private guardian or persons with a guardian
					 employed by the state shall be established as if there were no guardian in
					 accordance with Sections
					 50121,
					 50123 and
					 50129 through
					 50134, provided the ward is a
					 resident of the State.
1.
						Amendment filed 12-15-77; effective thirtieth day thereafter (Register 77, No.
						51).
2. Editorial correction filed 7-7-83 (Register 83, No.
						29).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  11050,
						  14001
						  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 3 - COUNTY OF RESPONSIBILITY FOR DETERMINATION OF MEDI-CAL ELIGIBILITY › Section 50129 - County of Responsibility -Persons Placed in State Hospitals by County Mental Health Agencies or Regional Centers for the Developmentally Disabled

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Notwithstanding the requirements of any other section in
						this article, the county of responsibility for determining Medi-Cal eligibility
						for persons placed in state hospitals after screening and referral by a county
						mental health agency or a regional center for the Developmentally Disabled
						shall be the county in which the state hospital is located, unless the person's
						eligibility is determined as part of a family or based on family income. In
						this case the county of responsibility shall be determined in accordance with
						Section 50123.
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 3 - COUNTY OF RESPONSIBILITY FOR DETERMINATION OF MEDI-CAL ELIGIBILITY › Section 50131 - Placement in Long-Term Care After Release from a State Hospital

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Notwithstanding
					 the requirements of any other section in this article, the county of
					 responsibility for determining Medi-Cal eligibility for persons released from a
					 state hospital and placed in a long-term care facility shall be the county in
					 which the long-term care facility is located, with the following exceptions:
(1) If the person has a public guardian or
					 conservator in the original county of placement into the state hospital, then
					 that county shall remain the county of responsibility, unless the county in
					 which the long-term care facility is located agrees to accept guardianship or
					 conservatorship of the person.
(2)
					 If the person's eligibility is determined as part of a family or based upon
					 family income, then the county of responsibility shall be determined in
					 accordance with Section
					 50123.
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 3 - COUNTY OF RESPONSIBILITY FOR DETERMINATION OF MEDI-CAL ELIGIBILITY › Section 50133 - County of Responsibility -Deceased Persons

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The county of responsibility for determining Medi-Cal
						eligibility for persons who are deceased shall be the county which would have
						been the county of responsibility at the time of the person's
						death.
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 3 - COUNTY OF RESPONSIBILITY FOR DETERMINATION OF MEDI-CAL ELIGIBILITY › Section 50134 - County of Responsibility -Persons Absent from the State

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The county of responsibility for determining Medi-Cal
						eligibility for persons who are absent from the State and retain California
						residence, in accordance with Article 7 of these regulations, shall be the
						county which would have been the county of responsibility prior to the person's
						absence from 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 3 - COUNTY OF RESPONSIBILITY FOR DETERMINATION OF MEDI-CAL ELIGIBILITY › Section 50135 - Application Made in County Other Than County of Responsibility

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The county in which a person applies for
					 Medi-Cal shall accept the application and a Statement of Facts from such person
					 or family on behalf of the county of responsibility. If a Statement of Facts
					 cannot be obtained, the county accepting the application shall provide
					 information to the county of responsibility for the latter county to locate the
					 applicant.
(b) The information
					 described above shall be forwarded to the county of responsibility not later
					 than 15 days from the date of application.
(c) The county in which a person applies may
					 with the consent of the applicant or beneficiary, choose to become the county
					 of responsibility for determining initial eligibility and initiating an
					 intercounty transfer.
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
						  11050,
						  14001
						  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 3 - COUNTY OF RESPONSIBILITY FOR DETERMINATION OF MEDI-CAL ELIGIBILITY › Section 50136 - Intercounty Transfer Procedure

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) An intercounty transfer shall be
					 initiated if persons or families receiving Medi-Cal-only become the
					 responsibility of a new county. The transfer shall be accomplished in
					 accordance with the following procedure, as modified by Section
					 50138.
(1) The county department initiating the
					 transfer shall inform the beneficiary in writing of his/her responsibility to
					 apply for a redetermination of eligibility in the new county of residence and,
					 within 7 calendar days of the date the county department learns of the change
					 in county of responsibility, send the following to the county department in the
					 new county of responsibility:
(A) Two copies
					 of the Notification of Transfer, Form ABCDM 215, with Section A completed
					 indicating the date of discontinuance determined in accordance with Section
					 50137.
(B) One copy of the most recently completed
					 of each of the following forms with the Notification of Transfer, Form ABCDM
					 215, or within one week after this form is sent:
1. Application for Public Social Services, CA
					 1.
2. Statement of Fact, MC 210, MC
					 250 or CA 2.
3. Share of Cost
					 Determination--MN and MI Person, MC 176M.
4. Allocation/Special Deduction Worksheet, MC
					 176W, if any.
5. Property
					 Worksheet, MC 176P, if any.
6.
					 Rights of Persons Requesting Medi-Cal, MC 216, if any.
7. Medi-Cal Responsibilities Checklist, MC
					 217, if any.
8. Verification of
					 disability, if any.
9. Notification
					 of Action, Utilization of Property, Form MC 239U, if the person or family is
					 within a six-month utilization period at the time of
					 transfer.
(C) The amount,
					 if any, of a remaining adjustment for decreases in income pursuant to Section
					 50653.3.
(D) Other information that the initiating
					 county considers important in order for the new county of responsibility to
					 determine 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 3 - COUNTY OF RESPONSIBILITY FOR DETERMINATION OF MEDI-CAL ELIGIBILITY › Section 50137 - Intercounty Transfer -Effective Date of Discontinuance/Eligibility

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) In a change in
					 county of responsibility, the effective date of discontinuance as determined by
					 the initiating county department shall be the last day of the month in which
					 the 30th day after notification to the new county of the change in county of
					 responsibility occurs except that:
(1) If the
					 initiating county department determines the person or family is no longer
					 eligible, the last day of the month in which the determination of ineligibility
					 is made, provided a 10-day notice is given or is waived. Otherwise,
					 discontinuance is effective on the last day of the month in which the 10-day
					 notice is given.
(2) If the person
					 or family is receiving Medi-Cal under either the Four Month or Nine Month
					 Continuing Eligibility categories, the last day of the final month in which
					 four month or nine month continuing eligibility exists.
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 3 - COUNTY OF RESPONSIBILITY FOR DETERMINATION OF MEDI-CAL ELIGIBILITY › Section 50138 - Intercounty Transfer -Blindness or Disability Determination Pending

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) In a change of
					 county of responsibility for persons or families who have an application
					 pending for either the SSI/SSP or MN programs on the basis of blindness or
					 disability, the responsibility shall be transferred to the new county in
					 accordance with the following:
(1) If the
					 person or family is eligible for Medi-Cal at the time the county of
					 responsibility changes, responsibility shall be transferred in accordance with
					 Sections 50136 and
					 50137.
(2) The pending determination of blindness or
					 disability shall be retained by the initiating county department until the
					 blindness or disability determination is received. The initiating county
					 department shall forward the blindness or disability determination, along with
					 the documents specified in Section
					 50136(a) (1) (B),
					 within 14 calendar days of the date the determination was
					 received.
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 4 - Beneficiary Application Process › Section 50141 - Application Process -General

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The county department shall receive and act upon all
						applications, reapplications, requests for restoration and redeterminations
						without delay and in accordance with the provisions of this
						article.
1. Change
						without regulatory effect amending article 4 heading filed 9-19-2000 pursuant
						to section
						100, title 1, California Code of
						Regulations (Register 2000, No. 38).
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 4 - Beneficiary Application Process › Section 50142 - Screening

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) County
					 departments that have established a procedure for screening potential
					 applicants prior to application shall:
(1)
					 Determine the Medi-Cal program under which the person or family should be
					 processed.
(2) Provide information
					 regarding Medi-Cal eligibility requirements to all persons being
					 screened.
(3) Inform each person
					 being screened of that person's rights under the Medi-Cal program, even if it
					 appears that the person is ineligible. Rights of Persons Requesting Medi-Cal,
					 MC 216, shall be explained to, and signed by, the person being screened.
(A) The original shall be retained by the
					 county department. If the person being screened does not apply for Medi-Cal,
					 the form shall be retained for at least 90 days.
(B) A copy shall be given to the person being
					 screened.
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 4 - Beneficiary Application Process › Section 50143 - Persons Who May File an Application for Medi-Cal

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Any person who wishes to receive Medi-Cal
					 may file an application. If the applicant for any reason is unable to apply on
					 his own behalf, or is deceased, any of the following persons may file the
					 application for the applicant.
(1) The
					 applicant's guardian or conservator or executor.
(2) A person who knows of the applicant's
					 need to apply.
(3) A public agency
					 representative.
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 4 - Beneficiary Application Process › Section 50145 - Medi-Cal Application for Persons Applying for a Cash Grant

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A person or
					 family applying and approved for any public assistance program as specified in
					 Section 50227 shall not be required to
					 submit a separate application for Medi-Cal. Medi-Cal eligibility is established
					 automatically.
(b) A person or
					 family specified in (a) may also apply for retroactive Medi-Cal in accordance
					 with Section
					 50148.
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).
4. Amendment filed 7-9-87;
						operative 8-8-87 (Register 87, No. 30).
5. Amendment of section
						heading, subsection (a) and NOTE filed 7-21-2011; operative 8-20-2011 (Register
						2011,
						No. 29).
Note: Authority cited: Section
						  20, Health and Safety Code; and
						  Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14005.1,
						  14019
						  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 4 - Beneficiary Application Process › Section 50146 - Medi-Cal Application for Persons Applying for In-Home Supportive Services. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Amendment filed 8-7-78; effective thirtieth day thereafter (Register 78, No.
						32).
2. Repealer filed 7-9-87; operative 8-8-87 (Register 87, No.
						30).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14005.1
						  and
						  12305,
						  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 4 - Beneficiary Application Process › Section 50147 - Application for Medi-Cal Only

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A person or family applying for Medi-Cal
					 only shall submit a completed application form to the county
					 department.
(b) The county
					 department shall, within 30 days of receipt of a referral from the Department
					 pursuant to 50183.5, contact an ABD person in a long-term care facility and
					 assist the ABD person with the completion of an application form for
					 Medi-Cal-only.
(1) An application for
					 Medi-Cal-only shall be completed when:
(A) The
					 ABD person has been in long-term care for more than the month of admission and
					 is expected to remain in the facility for at least 30 days.
(B) The ABD person has nonexempt monthly
					 gross income in excess of $44.90.
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 4 - Beneficiary Application Process › Section 50147.1 - Child Applying for Medi-Cal

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 A child may apply for Medi-Cal without parental contact in order to receive
					 minor consent services.
(b) A child
					 applying on the basis of a need for minor consent services other than mental
					 health care shall submit to the county welfare department a completed and
					 signed form Request for Eligibility for Limited Services indicating the need
					 for services related to one or more of these needs.
(c) A child applying for Medi-Cal solely on
					 the basis of a need for mental health care shall submit to the county welfare
					 department a statement from a mental health professional: licensed marriage,
					 family and child counselor; licensed educational psychologist; credentialed
					 school psychologist; clinical psychologist; or a licensed psychologist which
					 states that the child needs mental health treatment or counseling and meets
					 both of the following conditions:
(1) Is
					 mature enough to participate intelligently in the mental health treatment or
					 counseling on an outpatient basis.
(2) Is one of the following:
(A) In danger of causing serious physical or
					 mental harm to self or others without mental health treatment or
					 counseling.
(B) The alleged victim
					 of incest or child abuse.
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 4 - Beneficiary Application Process › Section 50148 - Application for Retroactive Medi-Cal

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A person or family applying for
					 retroactive Medi-Cal shall:
(1) Submit a
					 completed application form to the county department, if the application is for
					 retroactive coverage only.
(2)
					 Request retroactive coverage in one of the following ways if the request for
					 retroactive Medi-Cal is made in conjunction with, or after, an application for
					 public assistance or Medi-Cal:
(A) On the
					 application form.
(B) On the
					 Statement of Facts.
(C) By
					 submitting a written request.
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 4 - Beneficiary Application Process › Section 50149 - Application Form

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) An
					 application for Public Social Services shall be used as the application form
					 for all Medi-Cal applications.
(b)
					 The original of the completed form shall be placed in the case file.
(c) A copy of the completed form shall be
					 given to the applicant at the time of application.
(d) Only one person's signature shall be
					 required on the application or any other forms necessary to complete the
					 eligibility determination.
(e) A
					 new application form shall not be required for:
(1) Requests for restoration of
					 aid.
(2) Interprogram
					 transfers.
(3) Interprogram status
					 changes.
(4) Request to add a
					 family member to the Medi-Cal case.
(5) Redeterminations.
(6) Infants meeting the criteria under the
					 Continued Eligibility Program as described in Section
					 50262.3.
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 4 - Beneficiary Application Process › Section 50151 - Date of the Application

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 The date of application for a person or family applying for Medi-Cal shall be
					 the date the completed application form is received by the county
					 department.
(b) The date of
					 application for a person or family applying for Medi-Cal in a county other than
					 the county of responsibility shall be the date the completed application form
					 is received by the county department in which the application is being
					 made.
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 4 - Beneficiary Application Process › Section 50153 - Medi-Cal Application -Process for All Programs

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) An application for Medi-Cal under any
					 program other than SSI/SSP shall be an application for Medi-Cal under all such
					 programs for which the person or family may be eligible.
(b) When taking an application, the county
					 department shall:
(1) Determine the program
					 under which the person or family may be eligible.
(2) Process the application under the
					 appropriate program. Applications by persons who appear to be eligible for
					 SSI/SSP shall be processed in accordance with (3). Applications by persons who
					 appear to be eligible for AFDC hall be processed in accordance with
					 (4).
(3) Refer persons who may be
					 eligible for SSI/SSP, and who do not refuse to apply for that program, to the
					 Social Security Administration for a determination of SSI/SSP eligibility.
(A) The referral shall be documented in the
					 case file.
(B) Pending the SSI/SSP
					 determination, the county department shall determine eligibility under any
					 other program for which the person may be eligible.
(4) Applicants who appear to be eligible for
					 an AFDC cash grant shall be advised of their potential eligibility and the
					 application shall be processed under the AFDC cash grant program if the
					 applicant so desires. The fact that the applicant was advised of potential AFDC
					 cash grant eligibility shall be documented in the case
					 file.
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 4 - Beneficiary Application Process › Section 50155 - Withdrawal of Application -Request for Discontinuance

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) An applicant or beneficiary may withdraw
					 an application for or request discontinuance from Medi-Cal by any of the
					 following methods:
(1) Completion of a Request
					 for Withdrawal of Application or Discontinuance of Eligibility form.
(A) The original shall be placed in the case
					 file.
(B) A copy shall be given to
					 the applicant.
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 4 - Beneficiary Application Process › Section 50157 - Face-to-Face Interview

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 A face-to-face interview with the applicant, or the person completing the
					 Statement of Facts, is required only at the time of application, reapplication,
					 restoration or as specified in (d). The interview shall be completed within 30
					 days of the date of application, reapplication or restoration.
(b) A face-to-face interview shall not be
					 required at time of application, reapplication or restoration for persons who
					 have a government representative, such as a public guardian, acting on their
					 behalf.
(c) A face-to-face
					 interview at restoration shall not be required, for beneficiaries who have been
					 notified that eligibility will be discontinued, if the request for restoration
					 is received before the effective date of discontinuance.
(d) A face-to-face interview shall be
					 required at redetermination of eligibility for persons or families indicated in
					 this paragraph. The interview shall be completed within the month in which
					 redetermination is required. A face-to-face interview shall be completed once a
					 year at time of redetermination for all MFBUs which contain at least one
					 AFDC-MN or MI member, except for MFBUs consisting of any of the following:
(1) Persons who receive Medi-Cal through the
					 Aid for Adoption of Children program.
(2) Persons who have a government
					 representative, such as a public guardian, acting on their behalf.
(3) MI children who are not living with a
					 parent or relative and for whom a public agency is assuming financial
					 responsibility in whole or in part.
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 4 - Beneficiary Application Process › Section 50159 - Statement of Facts

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 Following completion of the application form, a Statement of Facts shall be
					 completed, signed and filed with the county department.
(b) The Statement of Facts shall be used by
					 the county department in the determination of the applicant's:
(1) Eligibility.
(2) Share of cost.
(3) Other health care
					 coverage.
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 4 - Beneficiary Application Process › Section 50161 - Statement of Facts Form

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 A Statement of Facts is not required in determining Medi-Cal eligibility for a
					 child receiving aid under the Aid for Adoption of Children program.
(b) A public agency, applying on behalf of a
					 child who may be eligible as an MI child who is not living with a parent or
					 relative and for whom a public agency is assuming financial responsibility in
					 whole or in part, shall complete the Application and Statement of Facts for
					 Child in Foster Care Supported by Public Funds, MC 250.
(c) An applicant applying for Medi-Cal under
					 any other program shall complete the Statement of Facts, form MC 210.
(d) A person applying for Medi-Cal and
					 requesting retroactive coverage shall complete the appropriate Statement of
					 Facts for the current month and the Supplement to Statement of Facts for
					 Retroactive Coverage/Restoration, MC 213, for the retroactive months. If only
					 retroactive coverage is requested, a Statement of Facts, MC 210, shall be
					 completed for one retroactive month for which Medi-Cal is requested and the MC
					 213 shall be completed for each additional retroactive month.
(e) An applicant or beneficiary who has a
					 form CA 2 which has been completed within the last 12 months and which is on
					 file with the county department need not complete the MC 210, unless the county
					 department determines that the applicant's or beneficiary's circumstances have
					 changed to such a degree as to require a new Statement of Facts.
(f) Any person requesting a restoration of
					 Medi-Cal-only eligibility shall complete the Supplement to Statement of Facts
					 for Retroactive Coverage/Restoration, form MC 213, unless the county department
					 determines that the applicant's circumstances have changed to such a degree as
					 to require a new MC 210, or unless a new MC 210 is required as part of
					 redetermination of eligibility under Section
					 50189.
1.
						Amendment of subsection (c) filed 12-15-77; effective thirtieth day thereafter
						(Register 77, No. 51).
2. Amendment filed 8-7-78; effective
						thirtieth day thereafter (Register 78, No. 32).
3. Amendment of
						subsection (b) 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
						  14005.4,
						  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 4 - Beneficiary Application Process › Section 50163 - Persons Who May Complete and Sign the Statement of Facts

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The applicant or spouse of the applicant
					 shall complete and sign the Statement of Facts, unless:
(1) The applicant is a child. Generally, the
					 person or agency having legal responsibility for the child shall complete and
					 sign the Statement of Facts. The child shall complete and sign the Statement of
					 Facts if the child is competent and either of the following applies:
(A) The child is not living with the child's
					 parents or caretaker relatives and the county has determined that no person or
					 agency accepts legal responsibility for the child.
(B) The child is applying on his or her own
					 behalf in accordance with Section
					 50147.1(a).
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 4 - Beneficiary Application Process › Section 50165 - Filing the Statement of Facts

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) At the time the Statement of Facts is
					 given or mailed to an applicant, the county department shall:
(1) Set a reasonable deadline for returning
					 the Statement of Facts to the county department.
(2) Inform the applicant of the
					 deadline.
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 4 - Beneficiary Application Process › Section 50166 - Obtaining Information for the Completion of the Statement of Facts

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The county
					 department or the representative of a public agency completing the Statement of
					 Facts in accordance with Section
					 50163(a)(3)
					 shall:
(1) Perform a diligent search to obtain
					 available information regarding the applicant's circumstances applicable to
					 Medi-Cal eligibility determination.
(2) Complete the Statement of Facts based
					 upon the findings of the diligent search.
(3) Establish disability in accordance with
					 Section 50167(a)(1).
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 4 - Beneficiary Application Process › Section 50167.2 - Verification of Income -IEVS Requirements

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) In administering the Medi-Cal program,
					 the county department shall adhere to the requirements in Division 20.006,
					 Manual of Policy and Procedures, Department of Social Services, governing:
(1) Submission of information to IEVS on
					 applicants, beneficiaries and any other family member whose income and
					 resources are considered in establishing eligibility and share of cost, for
					 persons in long-term care status except as provided in (c).
(2) Use of matched IEVS information received
					 from the Departments of Health Services and Social Services.
(3) Time requirements for completing case
					 action based on IEVS information.
(4) Maintenance of records.
(5) Submission of
					 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 4 - Beneficiary Application Process › Section 50167.5 - Verification of Unearned Income Information from Internal Revenue Service (IRS) or Franchise Tax Board (FTB) -IEVS Requirements

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The county department shall not deny or
					 terminate benefits to an applicant or beneficiary or increase the share of cost
					 based on unearned income information from IRS or FTB until it has:
(1) Verified the amount of the income and the
					 value of the property involved.
(2)
					 Established whether the income or property was available to the
					 individual.
(3) Determined the
					 period or periods when the individual actually had the income or
					 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 4 - Beneficiary Application Process › Section 50168 - Verification -Within 60 Days

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) With regard to information on the
					 Statement of Facts, the county department shall obtain verification of the
					 following items in the manner specified below, within 60 days of the date of
					 initial application, but not necessarily prior to approval of eligibility:
(1) Social Security Numbers (SSNs) shall be
					 submitted through the IEVS to the Social Security Administration for
					 verification in accordance with procedures established by the Department.
(A) SSN(s) shall be confirmed by viewing
					 Social Security cards, Social Security Administration form series OA-702. Any
					 one of the following shall be acceptable if the Social Security card is not
					 available:
1. An award letter, Medicare card
					 or a check from the Social Security Administration showing the applicant's name
					 and SSN with letters A, HA, J, T or M following the SSN.
2. Other documentation from the Social
					 Security Administration upon approval by the Department.