Change in Circumstance (CIC)
A reported change in circumstances that requires a redetermination of eligibility, and if found eligible, establishes a new 12-month period of eligibility.
Electronic Verification (e-verification)
Process of sending self-attested information to the Federal Data Service Hub (FDSH) for verification. If the attested information is electronically verified (e-verified) by the FDSH, then there is no need to request physical verification (e.g. check stubs) from the applicant/beneficiary.
Federal Data Service Hub (FDSH)
The electronic verification system that is used to compare and verify information with other State and Federal systems during the eligibility determination process.
Medi-Cal Hierarchy
The specific order in which individuals must be evaluated for MC coverage programs.
MEGA Mandatory
Categorical/mandatory programs required by federal law or where eligibility is determined by another program that automatically includes Medi-Cal eligibility as part of the determination, such as Foster Care.
Pickle Program
Federally funded program administered by the State, named after the 1976 amendment to the Social Security Act introduced by Congressman J.J. Pickle. Under the program, individuals are treated like a Supplemental Security Income recipient and are therefore, eligible to zero Share of Cost (SOC) MC.
SB 87 Redetermination
Three step MC Redetermination process that counties must follow sequentially until the beneficiary’s continued MC eligibility or ineligibility is accurately determined. The three steps are:
- Ex-Parte Review
- Direct Contact
- Request for Information (MC 355)
Self-Attestation
A formal declaration by an applicant/beneficiary that information is true and correct.