Chapter 16.2. Transition Of Healthy Families Program Enrollees To Medi-cal of California Insurance Code >> Division 2. >> Part 6.2. >> Chapter 16.2.
(a) Pursuant to Sections 14005.26 and 14005.27 of the
Welfare and Institutions Code, subscribers enrolled in the Healthy
Families Program pursuant to this part shall, no sooner than January
1, 2013, transition to the Medi-Cal program pursuant to Sections
14005.26 and 14005.27 of the Welfare and Institutions Code to the
extent they are otherwise eligible. AIM-linked infants, as defined in
Section 12695.03, with incomes above 250 percent of the federal
poverty level are exempt from this transition.
(b) The board shall coordinate with the State Department of Health
Care Services to implement Sections 14005.26 and 14005.27 of the
Welfare and Institutions Code.
(c) The board's actions to coordinate with the State Department of
Health Care Services to implement Sections 14005.26 and 14005.27 of
the Welfare and Institutions Code, as specified in subdivision (b),
shall include, but not be limited to, all of the following:
(1) Notwithstanding Section 12693.74, disenrollment of subscribers
in the manner, and at the times, specified in Section 14005.27 of
the Welfare and Institutions Code. The board may retain a subscriber
in the program for longer than 12 months if needed to ensure a smooth
transition to the Medi-Cal program.
(2) In coordination with the State Department of Health Care
Services, provision of reasonable notice to applicants concerning
disenrollment of subscribers consistent with Section 14005.27 of the
Welfare and Institutions Code.
(3) Notwithstanding Section 12693.51, transfers of subscribers
from one participating plan to another at the times and under the
conditions prescribed by the board, without the obligation that the
board provide an annual opportunity for subscribers to transfer from
one participating plan to another.
(d) Nothing in subdivision (e) of Section 12693.43 shall be
construed to require any refund or adjustment of family contributions
if an applicant has paid for three months of required family
contributions in advance and the subscriber for whom the applicant
has paid these family contributions is disenrolled pursuant to this
section, or for any other reason, without receiving a fourth
consecutive month of coverage.
(e) (1) Notwithstanding Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code, the
board shall, without taking any further regulatory action,
implement, interpret, or make specific this section by means of
business rules, program bulletins, program correspondence to
subscribers and contractors, letters, or similar instructions.
(2) The board may adopt and readopt emergency regulations
implementing this section. The adoption and readoption, by the board,
of regulations implementing this section shall be deemed an
emergency and necessary to avoid serious harm to the public peace,
health, safety, or general welfare for purposes of Sections 11346.1
and 11349.6 of the Government Code, and the board is hereby exempted
from the requirement that it describe facts showing the need for
immediate action and from review by the Office of Administrative Law.
(f) The Healthy Families Program, pursuant to this part, shall
cease to enroll new subscribers no sooner than the date transition
begins pursuant to subdivision (a), and any transition of children
shall be in compliance with the implementation plan or plans as
contained in Section 14005.27 of the Welfare and Institutions Code.
All civil service employees who are currently employed by
the Managed Risk Medical Insurance Board, whose functions are
transferred to the State Department of Health Care Services as a
result of the act adding this section, shall retain their positions,
status, and rights pursuant to Section 19050.9 of the Government Code
and the State Civil Service Act (Part 2 (commencing with Section
18500) of Division 5 of Title 2 of the Government Code).