首頁提供者& 合作夥伴Medi-Cal 州囚犯計劃和 Medi-Cal 縣囚犯計劃

加州醫療補助健康保健計劃 State Inmate 專案和 California 醫療補助健康保健計劃 County Inmate 專案

歷史

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.

聯邦管理局

Section 1905(a)(29)(A) of the Social Security Act
- 醫療援助不包括對公營機構的囚犯的照顧或服務，除非作為醫療機構的病人。

國家管理局

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
- Government Code (GOV) §26605.6; GOV §26605.7 & GOV §26605.8

概述

加州醫療補助健康保健計劃 Inmate 專案在州和縣兩級進行，允許加州醫療補助健康保健計劃允許住院醫院服務，包括住院精神科服務以及在懲教所的囚犯住院期間提供的醫生服務被確定有資格享受加州醫療補助健康保健計劃的機構。

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.