Ratner & Pinchman

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing federal law requires the state to seek adjustment or recovery from an individual’s estate for specified medical assistance, including nursing facility services, home and community-based servic

Many who support broader access to health care for low-income people are decrying a U.S. Supreme Court decision this week in a case involving reimbursement levels for doctors who treat the poor. But while we share the goal of broader access, we think the court was wise to rule that private parties have no standing to sue the government to force higher payments to medical providers under the federal-state Medicaid program, known as Medi-Cal in California. http://www.sacbee.com

Download CANHR's: Cost of Living Adjustments http://www.canhr.org/medcal/PDFs/RateCOLA2015.pdf #MediCal

The Aged and Disabled Federal Poverty Level increase effective April 1, 2015 (ACWDL # 15-12) http://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/ACWDL2015/ACWDL15-12.pdf The income limit for an A&D FPL individual is $1,211 The income limit for an A&D FPL couple is $1,638 #MediCal

Average Private Pay Rate increased to $8,092 (ACWDL #15-17) http://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/ACWDL2015/ACWDL15-17.pdf #MediCal

We are pleased to announce that we have completely revised our Consumer's Guide to the Medi-Cal Program. This guide is intended as a resource for anyone with a loved one in a nursing home. A copy of the revised guide can be downloaded here: 2015 Medi-Cal Guide. #MediCal

Co-sponsored by CANHR and Western Center on Law and Poverty, SB 33: Limits recovery for those 55+ to what is required by federal law – e.g. nursing facility, home and community based services and related hospital and prescription drug services – eliminates optional recovery. Eliminates recovery from the estate of a surviving spouse of a deceased Medi-Cal beneficiary. Requires DHCS to provide claims detail information free of charge to Medi-Cal beneficiaries or their represent

An Alternative to Medi-Cal Financed Nursing Home Care Until recently, an elderly individual who did not have the means to pay for 24/7 medical care, had to be placed into a skilled nursing facility. Assisted living facilities could not accept Medi-Cal as payment for their monthly bill. Accordingly, children and spouses were forced to place their loved ones into an environment not ideally suited for their family member solely because of their financial situation. The ALWP is

Alameda County Superior Court Judge Evelio Grillo ruled on January 20 that if California's Department of Health Care Services cannot process a Medi-Cal application within its 45-day deadline, then it must grant applicants who are likely eligible with provisional health benefits. This lawsuit, which was filed in September 2014, accused the Department of leaving hundreds of thousands of Californians without vital health care benefits, while their applications lingered well beyo

California has one of the most aggressive estate recovery programs in the Country. The Medi-Cal Estate recovery regulations provide that after the death of a Medi-Cal recipient, the State has a right to repayment from: “All real and personal property and other assets in which the decedent had any legal title or interest at the time of death (to the extent of such interest), including assets conveyed to a dependent, heir, survivor, or assignee of the decedent through joint te