Medi-Cal Status Report - State Of California - Health And Human Services Agency Page 9
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9STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
EDMUND G. BROWN JR. Governor
CALIFORNIA DEPARTMENT OF AGING
COMMUNITY-BASED ADULT SERVICES BRANCH
1300 NATIONAL DRIVE, SUITE 200
SACRAMENTO, CA 95834
Internet Home Page
TDD 1-800-735-2929
TEL (916) 419-7545
FAX (916) 928-2507
Date:
July 9, 2013
ACL # 13-11
To:
Community-Based Adult Services (CBAS) Center Administrators and Program
Directors
From:
CBAS Branch
Subject:
State Fair Hearing Penalty Payments Issued to Eligible CBAS Participants
Purpose
This letter provides information regarding State fair hearing penalty payment checks that
the California Department of Social Services (CDSS) is currently issuing to eligible CBAS
participants. Please share this information with those participants at your center who
receive checks and have questions.
Background
Medi-Cal rules require the State to pay penalties to Medi-Cal beneficiaries when they
Regarding
request fair hearings and do not receive a final decision within 90 days. The payment is
Payments
known as a Ball v. Swoap penalty payment, after the lawsuit that generated this rule.
Over the coming weeks, CDSS will be sending penalty checks to CBAS participants who
did not receive fair hearing decisions within the 90-day timeframe. The dollar amount paid
is based on the number of days past the 90-day timeframe to the date the hearing
decision was released, so check amounts for each participant will vary. Most of the
participants who will receive checks are individuals who were found ineligible at the time
of the transition from the Adult Day Health Care (ADHC) program to CBAS in 2012 and
later found eligible through the fair hearing process.
For individuals receiving checks, it is important that you clarify why they are receiving the
check and that the amount will NOT be counted as income or property relative to their
Medi-Cal eligibility status. However, recipients must report the payment on their Medi-Cal
Status Report Form (MC176S) as a "Ball Payment."
Questions
Questions regarding the penalty payments may be directed to CDSS Public Inquiry and
Response at (800) 952-5253.
For questions about this letter, please call the CBAS Branch at (916) 419-7546 or email us
at: CBAScda@aging.ca.gov.
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