Medi-Cal State Inmate ProgramおよびMedi-Cal County Inmate Program(メディカル州立受刑者プログラム)
Medi-Cal State Inmate ProgramおよびMedi-Cal County Inmate Program(メディカル州立受刑者プログラム)
歴史
Federal law prohibits claiming Medicaid funds for healthcare services provided to inmates residing in correctional facilities. There is an exception to this federal prohibition when an inmate receives inpatient services at a medical facility located off the grounds of the correctional facility for an expected stay of more than 24 hours, and the inmate is found to be Medicaid eligible.
連邦当局
- Section 1905(a)(29)(A) of the Social Security Act
- 医療扶助には、医療機関の患者としてを除き、公的機関の受刑者に対するケアやサービスは含まれません。
国家当局
- Assembly Bill (AB) 1628 (Chapter 729, Statutes of 2010) – Adults
- Welfare and Institution Code (WIC) §14053.7
- Assembly Bill (AB) 396 (Chapter 394, Statutes of 2011) – Juveniles
- Senate Bill (SB) 695 (Chapter 647, Statutes of 2011) – Juveniles
- Welfare and Institution Code (WIC) §14053.8
- Senate Bill (SB) 1462 (Chapter 837, Statutes of 2012) – Compassionate Release and Medical Probation
概要
Medi-Cal受刑者プログラムは、州レベルと郡レベルの両方で発生し、入院精神科サービスを含むMedi-Calの許容入院病院サービス、およびMedi-Calの資格があると判断された矯正施設の受刑者の入院入院中に提供される医師サービスを許可します。
The Medi-Cal County Inmate Program (MCIP) is voluntary and counties have the option to participate in this program by entering into an agreement with the Department of Health Care Services (DHCS). Per legislation, there is to be no General Fund (GF) impact under MCIP. The purpose of the MCIP agreement is to establish the amounts needed to satisfy each county’s responsibility to reimburse DHCS for the nonfederal share of MCIP service costs incurred by DHCS. If a County does not participate in MCIP or does not abide by the terms of this Agreement, the County remains responsible for arranging for and paying for medical care for its inmates.
The Medi-Cal State Inmate Program (MSIP) is unique from standard Medi-Cal claiming because Medi-Cal providers do not directly bill the DHCS for MSIP services. Under the MSIP, the California Department of Corrections and Rehabilitation (CDCR) pays providers for healthcare services rendered to state inmates off the grounds of the correctional facility, and submits claims to the DHCS’ Fiscal Intermediary (FI) for Medi-Cal allowable services provided to MSIP eligible inmates. DHCS’ FI prices the claims and suspends without payment and forwards claims data to the Safety Net Financing Division (SNFD). SNFD generates an invoice for federal reimbursement paid to CDCR.
メディカル州立受刑者プログラム
Medi-Cal郡受刑者プログラム
利用資格情報
お 問い合わせ
- クレームに関するお問い合わせ先: dhcsimcu@dhcs.ca.gov
- Medi-Calの適格性に関するお問い合わせ: mciep@dhcs.ca.gov
- メンタルヘルスに関する専門的なお問い合わせ: medccc@dhcs.ca.gov