The Medi-Cal Eligibility Division (MCED) is responsible for the development, coordination, clarification, and implementation of Medi-Cal regulations, policy, and procedures to assure that Medi-Cal eligibility is determined accurately and on a timely basis by the 58 county public social services agencies.
The MCED functions include:
- Development of policy, regulations and new statutes (Legislation) necessary to determine eligibility of applicants for the Medi-Cal program;
- Ensuring that eligibility rules and procedures enroll and retain all eligible beneficiaries that are entitled to services from the Medi-Cal program;
- Providing guidance and technical assistance to county public social services agencies who administer eligibility for the Medi-Cal program;
- Providing oversight and monitoring of the county eligibility determination process to ensure compliance with state and federal laws
- Assisting Medi-Cal applicants/beneficiaries in obtaining benefits through the county and answering eligibility questions.
- Issuing All County Welfare Director Letters (ACWDLs) and Medi-Cal Eligibility Information Letters (MEBILs) regarding new or amended policies and or procedures used in determining eligibility for Medi-Cal benefits;
- Responding to lawsuits involving the California Medi-Cal program;
- Developing policies and responding to questions related to the Medi-Cal Eligibility Data System (MEDS) and other automated systems that impact the Medi-Cal program;
- Ensuring the security and confidentiality of data contained in MEDS by monitoring and authorizing access to MEDS;
- Reviewing Proposed State Hearing Decisions concerning eligibility issues and Recommendation of Action to the Director; and
- Reviewing and Evaluating Program Eligibility Requirements and assuring compliance with Federal Medicaid (Title XIX) Regulations;
- Working cooperatively with stakeholders, consumer advocates and business partners interested in administration of the Medi-Cal program.
- Overseeing the statewide application and eligibility functions of the Breast and Cervical Cancer Treatment Program
- Enrolling qualified providers to participate in the Presumptive Eligibility for Pregnant Women Program