Cal. Code Regs. tit. 22 § 50189

Current through Register 2024 Notice Reg. No. 50, December 13, 2024

Section 50189 - Redetermination -Frequency and Process

(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.

(2) Inform beneficiaries in writing that income and eligibility information, including tax information, will be obtained through the IEVS.

(3) Verify information on the Statement of Facts in accordance with Section 50169(d).

(4) Send a Notice of Action if there is a change in the beneficiary's eligibility status or share of cost.

(5) Provide an informational pamphlet on the CHDP program to the beneficiary which describes the CHDP benefits available, and how and where the benefits are provided in the county, if there are persons under 21 years of age in the family.

(d) A face-to-face interview shall be required at the 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.

Cal. Code Regs. Tit. 22, § 50189

1. Amendment of subsections (c) and (d) filed 12-15-77; effective thirtieth day thereafter (Register 77, No. 51).
2. Amendment of subsection (c)(1)(A) filed 8-7-78; effective thirtieth day thereafter (Register 78, No. 32).
3. Amendment of subsection (d) filed 9-1-78; effective thirtieth day thereafter (Register 78, No. 35).
4. Editorial correction to History Note 3 (Register 78, No. 40).
5. Amendment of subsection (d)(3) filed 8-8-80; effective thirtieth day thereafter (Register 80, No. 32).
6. Editorial correction of subsection (c)(1)(A) filed 7-7-83 (Register 83, No. 29).
7. Amendment of subsection (c) filed 7-16-87; operative 7-16-87 pursuant to Government Code Section 11346.2(d) (Register 87, No. 30).
8. Governor Newsom issued Executive Order N-29-20 (2019 CA EO 29-20), dated March 17, 2020, which temporarily suspended certain provisions of this section relating to redetermination of benefits, due to the COVID-19 pandemic.
9. Governor Newsom issued Executive Order N-71-20 (2019 CA EO 71-20), dated June 30, 2020, which withdrew and superseded certain provisions from Executive Order N-29-20, relating to redetermination of Medi-Cal benefits, due to the COVID-19 pandemic.

Note: Authority cited: Sections 10725, 10740 and 14124.5, Welfare and Institutions Code. Reference: Sections 11004, 14001, 14005.4 and 14012, Welfare and Institutions Code; and 42 Code of Federal Regulations 435.945(d).