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 4 - Beneficiary Application Process › Section 50169 - Additional Verification Requirements

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The county department shall not require
					 verification of information, other than the verification specified in these
					 regulations, unless the county department considers the verification necessary
					 to ensure a correct eligibility determination in the specific case.
(b) The need for in-home supportive services
					 as determined under the IHSS program pursuant to the standards and procedures
					 established for that program, DSS Manual of Policies and Procedures, division
					 30, sections
					 30-700 through
					 30-775, shall be verified prior to
					 the application of the deduction specified in section
					 50551.6. Such determination and
					 verification shall be limited to the type and amount of services needed. The
					 payment for IHSS services shall be verified by viewing cancelled checks, or
					 receipts signed by the provider of service.
(c) The county department shall document in
					 the case file the type of verification obtained when verification is required
					 under (a) or (b) or under sections
					 50167 and
					 50168.
(d) The following items shall be verified at
					 each redetermination, restoration or reapplication.
(1) Incapacity.
(2) Legal responsibility for a child applying
					 alone.
(3) Refusal of the parent to
					 apply for an 18 to 21 year old child.
(4) Income, except income received from the
					 United States government which has previously been verified in accordance with
					 the provisions of sections
					 50167(a)(7)(A)1.
					 through 5. or for which verification has been obtained from the appropriate
					 government agency.
(5) Status and
					 value of nonexempt property.
(6)
					 The continuing need for IHSS services.
(7) Immigration status; provided, however,
					 that the county department shall not require or request an applicant for or a
					 beneficiary of restricted Medi-cal benefits to disclose their citizenship or
					 immigration status, birthplace, country of citizenship, alien registration
					 number and/or alien admission number, date of first entry into the United
					 States, or name upon first entry into the United States.
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 50171 - Clarification of Statement of Facts

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) All information provided on the Statement
					 of Facts other than that verified in accordance with Sections
					 50167,
					 50168 and
					 50169 shall be accepted as a basis
					 for determination of eligibility and share of cost, unless the Statement of
					 Facts is unclear or inconsistent.
(b) If additional clarification is needed,
					 the county department shall inform the person who signed the Statement of Facts
					 of the information needed and the reason for the request. Such persons shall be
					 responsible for securing the additional information.
(c) If the person who signed the Statement of
					 Facts has difficulty in securing the necessary information, the county
					 department shall, with the person's written consent, obtain the information.
					 The Applicant Authorization for Release of Information form shall identify
					 persons to be contacted and the specific information to be requested.
1.
						Amendment of subsection (b) and new subsection (c) filed 12-15-77; effective
						thirtieth day thereafter (Register 77, No. 51).
2. Editorial
						correction of subsection (c) filed 7-7-83 (Register 83, No.
						29).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  11004,
						  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 4 - Beneficiary Application Process › Section 50172 - Verification by Signature

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 The signature on the Statement of Facts shall be accepted as verification of
					 the facts if both of the following conditions are met, except as specified in
					 (c):
(1) The information required for
					 establishing eligibility under these regulations is not available.
(2) The county department determines that the
					 information provided on the Statement of Facts is sufficient to determine
					 eligibility. If the information on the Statement of Facts is insufficient, the
					 county department shall accept a signed statement, from the person completing
					 the Statement of Facts, providing the necessary supplemental
					 information.
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 50173 - Eligibility Determination

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The county department shall determine the
					 person's or family's eligibility and share of cost after the applicant for
					 Medi-Cal has applied, completed the Statement of Facts, and provided all
					 essential information. The eligibility and share of cost determination shall be
					 completed in the following manner:
(1) Those
					 persons whose eligibility is being determined as Other PA recipients shall have
					 their eligibility determined in accordance with the regulations and procedures
					 governing the program to which they are linked and any other requirements
					 applicable to their aid category, as specified in sections
					 50237 through
					 50247.
(2) Those persons whose eligibility is being
					 determined as MN or MI shall have their eligibility and share of cost
					 determined in accordance with articles 4 through 13 (commencing with section
					 50141).
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 50175 - Denial or Discontinuance Due to Lack of Information, Noncooperation or Loss of Contact

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The
					 application shall be denied or eligibility shall be discontinued under any of
					 the following circumstances:
(1) There is
					 insufficient information available to make an eligibility determination, after
					 the county department has made a reasonable effort to obtain the necessary
					 information.
(2) The applicant or
					 person completing the Statement of Facts fails, without good cause, to provide
					 necessary verification or to cooperate with the county department in resolving
					 incomplete, inconsistent or unclear information on the Statement of
					 Facts.
(3) The beneficiary fails,
					 without good cause, to return a status report required under Section
					 50191(a) or
					 (b).
(4) The applicant or beneficiary fails,
					 without good cause, to participate in the face-to-face interview in accordance
					 with Section
					 50157.
(5) The applicant or beneficiary fails,
					 without good cause, to respond within 10 days to a letter from the county
					 department identifying information received from the IEVS and requesting
					 further information.
(6) The county
					 department, after reasonable attempts to contact the applicant or beneficiary,
					 determines that there is loss of contact.
(7) The applicant or beneficiary;
(A) Refuses to assign to the state all rights
					 to medical support and payments as specified in Section
					 50185(a)(11).
(B) Fails to cooperate with the state, county
					 department, and the district attorney's office, without good cause, as
					 specified in Section
					 50771.5 in:
1. Providing information to establish
					 paternity for a child under eighteen years of age born out of wedlock for whom
					 Medi-Cal is requested;
2. Obtaining
					 medical support and payments; and
3. Identifying and providing information to
					 assist the state, county, or district attorney in pursuing any third party who
					 is or may be liable to pay for medical care, services, or support.
In the case of a refusal to assign rights or to cooperate
						in (B) above, the parent or caretaker relative will be given the opportunity to
						withdraw his/her application. Refusal to withdraw the application shall result
						in his/her ineligibility as specified in Section
						50379.
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 50176 - Discontinuance Due to Death

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Eligibility, shall be discontinued at the end of the
						month in which a person dies.
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 50177 - Promptness Requirement

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 The county department shall complete the determination of eligibility and share
					 of cost as quickly as possible but not later than any of the following:
(1) Forty-five days following the date the
					 application, reapplication or request for restoration is filed.
(2) Ninety days following the date the
					 application, reapplication or request for restoration is filed when eligibility
					 depends on establishing disability or blindness.
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 50179 - Notice of Action-Medi-Cal-Only Determinations or Redeterminations

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) County
					 departments shall notify beneficiaries in writing of their Medi-Cal-only
					 eligibility or ineligibility, and of any changes made in their eligibility
					 status or share of cost. This notification shall be called the "Notice of
					 Action."
(b) The Notice of Action
					 shall be on a form prescribed by the Department and shall include the name and
					 telephone number of the eligibility worker who completed the eligibility
					 determination, and the date the form was completed. A copy of the Notice of
					 Action shall be placed in the case file.
(c) The Notice of Action shall include the
					 following:
(1) The approval, denial or
					 discontinuance of eligibility, the recision of a denial or discontinuance, or
					 the change in the share of cost and the effective date of the action.
(2) The amount of the share of cost, if any,
					 and the amount of the net nonexempt income used to determine the share of
					 cost.
(3) The reason an action is
					 being taken and the law or regulation that requires the action, if the action
					 is a denial, discontinuance or increase in share of cost.
(4) The right to request a State hearing if
					 dissatisfied with:
(A) Any action or inaction
					 by the county department that affects the applicant's or beneficiary's Medi-Cal
					 eligibility or share of cost, except as limited in Section
					 50951(a).
(B) Any action taken by, or on behalf of, the
					 Department that affects the applicant's or beneficiary's Medi-Cal
					 benefits.
(5) The
					 procedures for requesting a State hearing and the time limits within which a
					 state hearing must be requested.
(6) The circumstances under which aid will be
					 continued if a hearing is requested.
(7) A statement, when appropriate, regarding
					 the information or action necessary to reestablish eligibility or determine a
					 correct share of cost.
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 50179.5 - Notice of Action - County Cash Assistance Determinations or Redeterminations Which Affect County Cash-Based Medi-Cal Eligibility

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Persons who are granted, denied or
					 discontinued from county cash-based programs shall be notified by the county
					 department, in writing, of their eligibility or ineligibility for county
					 cash-based Medi-Cal.
Additionally, persons who are discontinued shall be
						notified of their continued Medi-Cal eligibility status in accordance with
						(c).
(b) The form of
					 notification shall be one of the following:
(1) The appropriate Notice of Action
					 prescribed by the Department of Social Services, if the notification regarding
					 Medi-Cal eligibility does not affect the adequacy of timeliness of the cash
					 assistance.
(2) A Medi-Cal Notice
					 of Action, if the notification regarding Medi-Cal eligibility would affect the
					 adequacy of timeliness of the cash assistance.
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 50179.7 - Notice of Action - Medi-Cal Eligibility of SSI/SSP Recipients

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The Department
					 of Health Services shall notify persons determined to be eligible for SSI/SSP
					 by the Social Security Administration that they are also eligible for
					 Medi-Cal.
(b) The Department of
					 Health Services shall notify persons whose Medi-Cal eligibility has been
					 discontinued by the Department pursuant to Section
					 50183.5 that their public
					 assistance Medi-Cal eligibility has been discontinued and that the county
					 department will contact them to assist them with the completion of a
					 Medi-Cal-only application.
1. New
						section filed 4-13-81; effective thirtieth day thereafter (Register 81, No.
						16).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  11004
						  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 4 - Beneficiary Application Process › Section 50180 - Action Prior to Denial of Application

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Persons or families denied Medi-Cal eligibility under any
						program other than SSI/SSP shall have their circumstances evaluated by the
						county department prior to denial. If it appears that eligibility would exist
						under any program other than SSI/SSP, the application shall be processed under
						that program. The date of application shall be the date of the original
						application.
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 50181 - Action Following Denial of an SSI/SSP Application

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Persons denied SSI/SSP eligibility, who
					 then apply for Medi-Cal at the county department, shall have their application
					 processed under the appropriate program. The date of application shall be:
(1) The date of the original application for
					 SSI/SSP for those persons who apply at the county department within 30 days of
					 receipt of a written notice of denial of SSI/SSP benefits.
(2) The date the person's completed
					 application form is received by the county department for those persons who do
					 not apply at the county department within the 30-day period specified in
					 (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 50182 - Corrective Action on Denied Applications

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A denial of an application shall be
					 rescinded in either of the following situations:
(1) A fair hearing decision orders such
					 action.
(2) The county department
					 determines that the denial was in error.
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 50183 - Transfer Between Programs

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A
					 person or family who has been receiving Medi-Cal under any program other than
					 SSI/SSP and whose eligibility is discontinued shall be evaluated by the county
					 department to determine if Medi-Cal eligibility exists under any other program.
					 If it appears that eligibility would exist for:
(1) AFDC, regulations pertaining to the
					 appropriate AFDC program shall be followed in transferring the case and
					 establishing eligibility.
(2)
					 SSI/SSP, the person shall be referred to the Social Security Administration.
					 This referral shall be documented in the case file. Pending the SSI/SSP
					 determination, the county department shall determine eligibility under any
					 other program for which the person may be eligible.
(3) Only Medi-Cal-only, the county department
					 shall initiate an intraprogram status change or interprogram transfer to the
					 appropriate aid category and shall determine eligibility under that aid
					 category. A new application form is not required.
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 50183.5 - Action Following Medi-Cal Discontinuance by the Department

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The Department
					 shall inform the county department of any ABD person whose Medi-Cal eligibility
					 as an SSI/SSP PA recipient has been discontinued because the conditions in
					 (1)(A) and (B) exist.
(1) The county
					 department shall contact the person and assist the person with the completion
					 of an application for Medi-Cal-only pursuant to Section
					 50147 when the following
					 conditions exist.
(A) The 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 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 50184 - Referral for Social Services

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The county department shall refer a
					 person or family for social services in accordance with Department procedures
					 if it appears that there is a need for such services.
(b) A referral for social services shall also
					 be made for the following needs related to the CHDP Program unless other
					 arrangements have been made with the local CHDP Program:
(1) Assistance in:
(A) Arranging for screening services for
					 persons under 21 years of age under the CHDP Program.
(B) Overcoming fears of medical
					 treatment.
(C) Understanding the
					 importance of preventive health.
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 50186 - Unconditionally Available Income

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) An applicant or beneficiary shall, as a
					 condition of Medi-Cal eligibility, take all actions necessary to obtain
					 unconditionally available income. This includes applying for such income and
					 cooperating in supplying the information requested by the agency making the
					 award determination.
(b) Income
					 shall be considered unconditionally available if the applicant or beneficiary
					 has only to claim or accept the income. Such income includes, but is not
					 limited to:
(1) Disability insurance
					 benefits.
(2) Benefits available to
					 veterans of military service.
(3)
					 OASDI benefits.
(4) Unemployment
					 insurance benefits.
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 50187 - Social Security Numbers and Health Insurance Claim Numbers

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Each applicant or beneficiary shall, as a
					 condition of eligibility for full Medi-Cal benefits, obtain and provide to the
					 county department a Social Security Number (SSN) and, if eligible, a Social
					 Security Health Insurance Claim (HIC) Number. In addition, amnesty aliens
					 eligible for restricted Medi-Cal benefits pursuant to section
					 50302(b)(3) must
					 possess or have applied for an SSN and, if eligible, a HIC number.
(b) The SSN shall be provided at the time of
					 application unless the applicant must apply for the number. If application for
					 an SSN must be made, the number will be provided to the county department by
					 the Department or by the Social Security Administration.
(c) The HIC number shall be provided by the
					 applicant or beneficiary in accordance with section
					 50777.
(d) Medi-Cal shall not be denied, delayed or
					 discontinued for an applicant or beneficiary because of these requirements
					 unless the applicant or beneficiary refuses to cooperate.
(1) Eligibility of an applicant or
					 beneficiary who refuses to apply for or provide a number shall be denied or
					 discontinued.
(2) Eligibility of a
					 child who is not applying on the child's own behalf shall be denied or
					 discontinued if a parent or caretaker relative living with the child refuses to
					 apply for or provide a number for the child.
(3) Persons ineligible for Medi-Cal in
					 accordance with (1) or (2) shall be ineligible members of the MFBU in
					 accordance with section
					 50379.
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 50189 - Redetermination -Frequency and Process

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Persons or families determined to be
					 eligible for Medi-Cal shall have their eligibility redetermined at least once
					 every 12 months.
(b) At the time of
					 the redetermination, the beneficiary shall complete a new Statement of
					 Facts.
(c) The county department
					 shall:
(1) Complete the redetermination
					 within 12 months of the most recent of the following:
(A) Approval of eligibility on any
					 application, reapplication or restoration which required a Statement of Facts
					 form.
(B) Last
					 redetermination.
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 50191 - Status Reports

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The
					 county department shall require the completion of a Medi-Cal Status Report form
					 at three month intervals for all MFBU's which contain at least one AFDC-MN or
					 MI person. The requirement to complete status reports shall not apply to 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.
(4) Children who are requesting Medi-Cal in
					 accordance with Section
					 50147.1.
(5) Persons who receive county General
					 Assistance Benefits and whose Medi-Cal eligibility factors are monitored at
					 least quarterly by the county Department under its general assistance
					 program.
(6) MFBUs consisting
					 solely of an eligible pregnant woman and/or infant under one year of
					 age.
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 50192 - Testing Techniques for Redeterminations, Status Reporting and Verification

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 Notwithstanding Sections
					 50169,
					 50189 and
					 50191, the Director may, in
					 counties selected by the Director, establish requirements for redeterminations,
					 status reporting, and verification of information on the Statement of Facts for
					 the purpose of testing the effectiveness of the different administrative
					 requirements.
(b) Selection
					 criteria may include, but shall not be limited to:
(1) Caseload size.
(2) Past county administrative
					 requirements.
(3) Population
					 characteristics.
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 50193 - Beginning Date of Eligibility

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The beginning date of eligibility for
					 Medi-Cal for persons who apply under any public assistance program shall be the
					 first day of the month of application, providing the person meets the
					 citizenship, residency, linkage and financial eligibility criteria of the
					 appropriate program, notwithstanding the beginning date of the cash grant. For
					 persons who do not meet these eligibility criteria during the month of
					 application, the beginning date of eligibility shall be the first day of the
					 first month in which the above specified eligibility criteria of the
					 appropriate program are met.
(b)
					 The beginning date of eligibility for Medi-Cal specified in (a) shall also
					 apply to:
(1) Persons who apply for AFDC and
					 meet eligibility criteria in the month of application but whose eligibility is
					 denied because they no longer meet eligibility criteria at the time eligibility
					 for AFDC is determined.
(2) Persons
					 who apply for SSI/SSP and meet the eligibility criteria but are denied because
					 they die before the application can be processed and an application is filed on
					 their behalf at the county department within 30 days of receipt of a written
					 notice of denial.
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 50195 - Period of Eligibility

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 The period of eligibility for Medi-Cal for persons eligible for AFDC or SSI/SSP
					 shall begin with the date specified in Section
					 50193(a) and (b),
					 and shall continue through each successive month during which the person is
					 determined to be eligible.
(b) The
					 period of eligibility for Medi-Cal for persons eligible as Other PA recipients
					 shall begin with the date specified in Section
					 50193(c), and
					 shall continue through each successive month during which the person meets all
					 eligibility requirements of the appropriate Other PA category.
(c) The period of eligibility for Medi-Cal
					 for persons eligible as MN or MI, except as specified in (d), shall begin with
					 the date specified in Section
					 50193(c), and
					 shall continue through each successive month during which the beneficiary meets
					 the appropriate basic program requirements in Article 5 of this chapter and all
					 of the following conditions:
(1) Has
					 cooperated with the county department to the extent required by Sections
					 50185 and
					 50187.
(2) Has met the property requirements
					 specified in Article 9 at some time during the month.
(3) Has met the citizenship, residence and
					 institutional status requirements specified in Articles 6 and 7 at some time
					 during the month.
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 50197 - Retroactive Eligibility

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 In addition to the period of eligibility specified in Section
					 50195, an applicant shall be
					 eligible for Medi-Cal in any of the three months immediately preceding the
					 month of application or reapplication if all of the following requirements are
					 met in that month:
(1) The county department
					 determines that the applicant would have been eligible for one of the programs
					 specified in Section
					 50201, except as specified in (c),
					 had an application been made.
(2)
					 The applicant received health services.
(3) The applicant was not previously denied
					 Medi-Cal for the month in question, unless the application was denied for one
					 of the following reasons:
(A) County
					 error.
(B) The applicant's failure
					 to cooperate, when that failure, or the applicant's subsequent failure to
					 reapply, was due to circumstances beyond the control of 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 50199 - Certification for Medi-Cal -Completion

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A person or family determined to be
					 eligible for Medi-Cal shall not receive a Medi-Cal card until certified for
					 Medi-Cal.
(b) Certification for
					 Medi-Cal shall be completed by:
(1) The county
					 department for:
(A) Persons who have no share
					 of cost or who have a share of cost for long-term care which is less than the
					 cost of care.
(B) Persons who have
					 a share of cost, other than those specified in (A), and who complete form MC
					 113, in accordance with Section
					 50658(d).
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 5 - MEDI-CAL PROGRAMS › Section 50201 - Medi-Cal Programs -General

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A person or family may be eligible for
					 Medi-Cal under one of the following programs.
(1) Aid to Families with Dependent Children
					 (AFDC).
(2) Supplemental Security
					 Income/State Supplemental Program (SSI/SSP).
(3) Other Public Assistance (Other
					 PA).
(4) Medically Needy
					 (MN).
(5) Medically Indigent
					 (MI).
(6) Miscellaneous Special
					 Programs.
(7) Medi-Cal Special
					 Treatment Programs.
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 5 - MEDI-CAL PROGRAMS › Section 50203 - Medically Needy Program

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A
					 person's eligibility shall be determined under the Medically Needy program if
					 that person is any of the following:
(1) An
					 aged, blind or disabled person who meets one of the following conditions:
(A) Is not eligible for or does not want to
					 receive assistance as a PA or Other PA recipient.
(B) Has an application pending for
					 SSI/SSP.
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 5 - MEDI-CAL PROGRAMS › Section 50205 - Linkage to AFDC

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Linkage
					 to AFDC exists if a child is living with a relative and deprived of parental
					 support or care. Deprivation shall be established if all conditions of any one
					 of the following sections are met at any time during the month:
(1) Deprivation--Deceased Parent, section
					 50209.
(2) Deprivation--Physical or Mental
					 Incapacity of Parent, Section
					 50211.
(3) Deprivation--Absent Parent, Section
					 50213.
(4) Deprivation--Unemployed Parent, Section
					 50215.
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 5 - MEDI-CAL PROGRAMS › Section 50207 - Deprivation - Relinquishment for Adoption. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Repealer filed 3-24-82; effective thirtieth day thereafter (Register 82, No.
						13).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14005.4,
						  14005.7,
						  14051
						  and
						  14052,
						  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 5 - MEDI-CAL PROGRAMS › Section 50209 - Deprivation - Deceased Parent

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Deprivation of parental support or care
					 exists if either of the child's parents is deceased.
(b) Children of a deceased parent and the
					 remaining parent living with the child shall be linked to AFDC on the basis of
					 this deprivation factor.
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
						  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 5 - MEDI-CAL PROGRAMS › Section 50211 - Deprivation - Physical or Mental Incapacity of a Parent

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Deprivation of parental support or care
					 exists if either of the child's parents is physically or mentally
					 incapacitated.
(b) A parent is
					 incapacitated if such parent has a physical or mental illness, defect or
					 impairment that is expected to last at least 30 days, is verifiable in
					 accordance with Section
					 50167, and does either of the
					 following:
(1) Reduces substantially or
					 eliminates the parent's ability to support or care for the child.
(2) Causes one of the following situations:
(A) The parent is prevented from working
					 full-time at a job in which customarily engaged, and from working full-time on
					 another job for which equipped by education, training or experience or which
					 could be learned by on-the-job training.
(B) Employers refuse to employ the parent for
					 work the parent could do and is willing to do, because of behavioral or other
					 disorders which interfere with the securing and maintaining of
					 employment.
(C) The parent is
					 prevented from accomplishing as much on a job as a regular employee and, as a
					 result, is paid on a reduced basis.
(D) The parent is blind or disabled in
					 accordance with Section
					 50223(a)(1) or
					 (b).
(E) The parent has qualified for and is
					 employed in a job which is rehabilitative or therapeutic or is in a sheltered
					 workshop, and which is not considered to be
					 full-time.
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 5 - MEDI-CAL PROGRAMS › Section 50213 - Deprivation - Absent Parent

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Deprivation of parental support or care
					 exists if there is continued absence of one or both of a child's parents from
					 the home.
(b) Deprivation does not
					 exist when one or both of the parents is absent from the home on a temporary
					 basis, such as for a:
(1) Visit.
(2) Trip.
(3) Temporary assignment undertaken in
					 connection with current or prospective employment.
(4) Parental absence due solely to active
					 duty in the uniformed services of the United States. Uniformed services means
					 the Army, Navy, Air Force, Marine Corps, Coast Guard, National Oceanographic
					 and Atmospheric Administration and Public Health Service of the United
					 States.
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 5 - MEDI-CAL PROGRAMS › Section 50215 - Deprivation - Unemployed Parent

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Deprivation of parental support or care
					 exists if a parent with whom the the child lives is any of the following as
					 limited by (b), (c) and (d):
(1) Not
					 working.
(2) Working less than 100
					 hours a month.
(3) Employed on an
					 intermittent basis more than 100 hours per month and the hours in excess of 100
					 hours are of a temporary nature. Temporary nature is shown if the parent was
					 under the 100 hour standard for the two prior calendar months and is expected
					 to be under the standard during the next month.
(4) Unemployed and has been accepted for or
					 is participating in an education or training program essential to future
					 self-support which is all of the following:
(A) Directed toward a specific occupation and
					 will qualify the unemployed person for an occupation in demand in the local
					 area.
(B) A program which will be
					 completed by the unemployed person within a maximum of two years.
(C) Not a program which involves post
					 baccalaureate work.
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 5 - MEDI-CAL PROGRAMS › Section 50216 - Good Cause - Refusal of Employment

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Good cause for refusal of employment or
					 training or for quitting a job or training as required in Section
					 50215(b), shall
					 be found if the applicant or beneficiary refuses or quits for any of the
					 following reasons:
(1) The offer of
					 employment was from an employer who did not:
(A) Possess an appropriate license to engage
					 in business.
(B) Withhold or hold
					 in trust the employee contributions required by Part 2 of Division 1 of the
					 Unemployment Insurance Code, Section
					 2601
					 et seq., for unemployment compensation disability benefits and does not
					 transmit all such employee contributions to the Department of Social Services
					 as required by Section
					 986
					 of the Unemployment Insurance Code.
(C) Carry either workers' compensation
					 insurance or possess a certificate of self-insurance as required by Division 4
					 of the Labor Code, Section
					 3201 et
					 seq.
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 5 - MEDI-CAL PROGRAMS › Section 50216.5 - Linkage to AFDC - Placement in Foster Care. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New
						section filed 3-7-80; effective thirtieth day thereafter (Register 80, No.
						9).
2. Amendment of subsection (a) filed 1-8-81; effective thirtieth
						day thereafter (Register 81, No. 2).
3. Repealer filed 3-24-82;
						effective thirtieth day thereafter (Register 82, No.
						13).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14005.4,
						  14005.7,
						  14051,
						  and
						  14052,
						  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 5 - MEDI-CAL PROGRAMS › Section 50217 - Linkage to SSI/SSP. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Repealer filed 3-7-80 as an emergency; effective upon filing (Register 80, No.
						9). A Certificate of Compliance must be transmitted to OAH within 120 days or
						emergency language will be repealed on 7-6-80.
2. Certificate of
						Compliance filed 6-6-80 (Register 80, No. 23).
Note: Authority cited: Sections
						  10725
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Section
						  14005.3,
						  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 5 - MEDI-CAL PROGRAMS › Section 50219 - Blindness

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Persons shall
					 be considered to be blind if there has been a medical determination that they
					 have either of the following conditions:
(1)
					 Central visual acuity of no more than 20/200 with correction.
(2) Tunnel vision, which is a limited visual
					 field of 20 degrees or less.
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 5 - MEDI-CAL PROGRAMS › Section 50221 - Age

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Persons are
					 aged if they are 65 years of age or older. Persons are considered to be 65
					 years of age on the first day of the month in which they reach age
					 65.
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
						  14005.3,
						  14005.7
						  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 5 - MEDI-CAL PROGRAMS › Section 50223 - Disability

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Persons 18
					 years of age or over are disabled if they meet the definition in (1) or the
					 definition in (2):
(1) Federally disabled
					 persons are persons who meet the definition of disability in Title II or Title
					 XVI, Social Security Act.
(2)
					 SGA-disabled persons are persons who were once determined to be disabled in
					 accordance with the provisions of the SSI/SSP program (Section
					 1614, Part A, Title XVI, Social
					 Security Act) and meet both the following conditions:
(A) Were eligible for SSI/SSP but became
					 ineligible because of engagement in substantial gainful activity as defined in
					 Title XVI regulations.
(B) Continue
					 to suffer from the physical or mental impairment which was the basis of the
					 disability determination.
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 5 - MEDI-CAL PROGRAMS › Section 50227 - Public Assistance Cash Grant Programs

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Public assistance cash grant programs
					 include the following programs:
(1)
					 AFDC.
(2) SSI/SSP.
(3) Cuban Refugee Cash Grant.
(4) Indochinese Refugee Cash Grant.
(5) Emergency Assistance
					 (EA).