Client Responsibility for OHC

Reporting

All MC clients have the responsibility to report:

Current OHC information. This includes not only current health insurance, but also health insurance which is available, but not applied for.
The availability of employer related health benefits.
OHC changes within ten days (for example, termination, lapses, or a different insurance carrier).
OHC information to their doctors and other health care providers.

Note: The client must utilize private health insurance prior to using MC. If the beneficiary refuses to cooperate in the State's purchase of health insurance under the HIPP program, when it is found to be cost effective, DHCS may decline payment for medical services which would otherwise be covered by the insurance policy.

Fraud Referrals

If the EW suspects that an MC recpient is withholding information about OHC, the client's name, CIN and any available OHC information must be communicated to:

Department Of Health Care Services Medi-Cal Investigations Unit - North
P.O. Box 977413 - MS 2201
Sacramento, CA 95899
Main Line: 916-650-6630
Fax: 916-324-0772

Client Responsibility for OHC

Reporting

Fraud Referrals

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