DHCS MEDIL I-14-22: Informational Update and Guidance on Medi-Cal Notices of Action (NOA) Generation (4/14/14)

DHCS issued guidance on how Medi-Cal NOAs are being generated by CalHEERS and SAWS beginning 4/15/14.  The full letter is available here.  Two sets of NOAs will be released:

  1. A “one-time batch” of NOAs from pre-enrollment and pre-CalHEERS/SAWS interface (applications filed 10/1/13 to 1/20/14) and post-interface (1/21/14-3/10/14)
  2. Ongoing as part of regular processing of NOAs dating from 3/11/14 onwards

The letter identifies some issues that may cause confusion among Medi-Cal beneficiaries:

  1. Both CalHEERS and SAWS may issue separate NOAs regarding MAGI and Non-MAGI Medi-Cal, respectively.  SAWS will reflect the correct eligibility category.
  2. CalHEERS NOAs may have the wrong coverage effective date, using the date of eligibility determination instead of the correct effective date of eligibility.
  3. CalHEERS is generating NOAs for each month of eligibility or conditional eligibility in certain circumstances.