PD 23-01: (Obsolete)Temporary Undeliverable Mail Process Medi-Cal

Date: 1/17/2023 (Revised 9/18/23)
To: Eligibility Staff
From: Manuel Garcia, Megan Turney- SSA Policy and Business Process Implementation Specialist
Reference:

MEDI_22-45, MEDIL 23-11e
Obsolete: 10/17/2024; Added to HB, MC Update 2024-4

Background

The undeliverable mail process has been temporarily revised to have the most up-to-date contact information and help more individuals retain their Medi-Cal coverage. As counties prepare to process June 2023 Medi-Cal renewals, the Department of Health Care Services (DHCS) is allowing counties to use the United States Post Office Service (USPS) returned mail with an in-state forwarding address to update case records without requiring an additional contact. DHCS has also provided guidance for returned mail with an out-of-state forwarding address, returned mail with no forwarding address and undeliverable Medi-Cal renewal packets. 

 

NOTES: DHCS requires counties to complete a Medi-Cal renewal for all individuals at their next scheduled renewal in the CCU period and not take negative action outside of the annual renewal period in most cases. Refer to the Continuous Coverage Unwinding Period Guidance for additional information. All systems must be updated when an address change is processed. (CalSAWS/MEDS/CalHEERS). This temporary undeliverable mail process is for Medi-Cal only cases and does not apply to multi-program cases.

Temporary Undeliverable Mail Process for Medi-Cal Only Cases

In-state forwarding address

Undeliverable mail envelopes reporting an in-state forwarding address by the USPS are considered valid forwarding addresses and case records must be updated. No other contact needs to be made (MC 355, phone call, etc.) when an undeliverable mail envelope reporting an in-state forwarding address is received and processed.

Undeliverable mail envelopes reporting an in-state forwarding address require the following steps:

  1. Update the address in CalSAWS and ensure all three systems match,
  2. Resend the document that was included in the returned mail envelope to the new address.

Out-of-state forwarding address- Undeliverable mail envelopes reporting an out of state forwarding address require the following steps:

  1. Note the undeliverable mail in the case record,
  2. Complete an ex-parte review for a new mailing address (CalHEERS, Case records, MEDS, etc.),
  3. Send the MC 355 with a 30-day due date and follow up in 30 days,
  4. If the information is not received by the due date, discontinue with a 10-day Notice of Action as the individual is no longer a resident of California. 

No forwarding address- Undeliverable mail envelopes with no forwarding address require the following steps:

  1. Send the MC 355 with a 30-day due date and follow up in 30 days,
  2. If the information is not received by the due date, the eligibility determination will be completed at the scheduled CCU renewal period. If the CCU renewal has already been completed, discontinue the case with a 10-day Notice of Action. 

Undeliverable Medi-Cal Renewal Packets require the following steps:

  1. Note the undeliverable mail in the case record and the eligibility determination will be completed at their upcoming CCU renewal, 

  2. Send the MC 355 with a 30-day due date and the case must remain active during the 30-day due date,

  3. If returned mail is received during the 90-day cure period and the case is discontinued, staff must verify the MC 355 was sent and the case remained active until it was due, otherwise the case must be rescinded and an MC 355 sent with a 30-day due date.

CalSAWS is currently not programmed to discontinue a case when an MC 355 is due. A CalSAWS task will automatically be created at the 30-day due date. Staff must review the case record and use the above guidance when determining Medi-Cal eligibility. 

 The Following individuals are exempt from discontinuance due to undeliverable mail processing:

  • Former Foster Youth (FFY) 
  • Children eligible for Continuous Eligibility for Children (CEC) 
  • Deemed Eligible Infants (under 1 year)
  • Medi-Cal Access Infants Program (MCAIP) (under 2 years)
  • Pregnant beneficiaries, whether in Full Scope or a Pregnancy-Related aid code
  • Beneficiaries in their 12-month postpartum period
  • Categories where the county does not control the Medi-Cal record, such as Individuals eligible for Medi-Cal through Supplemental Security Income/State Supplementary Payment (excluding MSP beneficiaries for whom the county does control the eligibility record), KinGAP, or Adoption Assistance

Implementation

The information in this program directive is effective immediatley upon receipt.