DHCS MEDIL I 14-31: Pregnancy Changes in Circumstance Workaround (6/4/14)
This letter from DHCS provides a workaround for MAGI beneficiaries who report a change in circumstance due to pregnancy. A woman in one of the new adult coverage groups (M1, M2) who reports a change in circumstance due to pregnancy will remain in her current coverage group aid code; this policy applies to all MAGI aid codes.
Counties are not to accept any transactions from CalHEERS that move a woman from an M1 to M4 aid code into any of the pregnant woman coverage group aid codes when a woman reports her pregnancy. If CalHEERS attempts to do that, counties should change the case to show not pregnant to keep the beneficiary in the same aid code. Counties are to document use of this workaround and pregnancy due date until the design gap is fixed.