California § 14007.12 - No later than January 1, 2027, the department shall establish a process to regula

§ 14007.12. No later than January 1, 2027, the department shall establish a process to regula

(a) No later than January 1, 2027, the department shall establish a process to regularly obtain address information for individuals enrolled in the Medi-Cal program in accordance with Section 1396a(vv) of Title 42 of the United States Code for the purpose of preventing simultaneous enrollment under Medicaid state plans or waivers of multiple states. (b) (1) The process described in subdivision (a) to regularly obtain address information for individuals enrolled in the Medi-Cal program shall obtain address information from reliable data sources described in paragraph (2) and take actions as the United States Secretary of Health and Human Services specifies with respect to any changes to the address based on the information. (2) For purposes of this subdivision, the following are reliable data sources: (A) Mail returned to the state by the United States Postal Service with a forwarding address. (B) The National Change of Address Database maintained by the United States Postal Service. (C) A managed care entity, as defined in Section 1396u-2(a)(1)(B) of Title 42 of the United States Code, or prepaid inpatient health plan or prepaid ambulatory health plan, as these terms are defined in Section 1396b(m)(9)(D) of Title 42 of the United States Code, that has a contract under the Medi-Cal program if the address information is provided to the entity or plan directly from, or verified by the entity or plan directly with, the individual. (D) Other data sources as identified by the department and approved by the United States Secretary of Health and Human Services. (c) Beginning January 1, 2027, each contract under the Medi-Cal program with a managed care entity, as defined in Section 1396u-2(a)(1)(B) of Title 42 of the United States Code, or with a prepaid inpatient health plan or prepaid ambulatory health plan, as these terms are defined in Section 1396b(m)(9)(D) of Title 42 of the United States Code, shall provide that the entity or plan shall promptly transmit to the county any address information for an individual enrolled with the entity or plan that is provided to the entity or plan directly from, or verified by the entity or plan directly with, the individual. (d) At least 10 days before terminating Medi-Cal eligibility, the department shall send residency verification letters to members requesting that members contact the department to verify their residency and receipt of benefits only in California, informing members about the methods to report this information, and that they shall be granted the 90-day cure period. (e) (1) This section shall be implemented only after the director determines, and communicates in writing to the Department of Finance, that systems have been programmed for implementation of this section. (2) This section shall be implemented only to the extent that any necessary federal approvals are obtained and that federal financial participation is available and not otherwise jeopardized.