Section 50262.5 - Special Zero Share of Cost Program for Children of Age One Up to Age Six (133 Percent Program)(a) Children who have attained one year of age but have not attained six years of age are eligible to receive Medi-Cal benefits under the 133 Percent program if the following conditions are satisfied:(1) The net nonexempt Medi-Cal Family Budget Unit (MFBU) income of otherwise eligible children shall not exceed 133 percent of the federal income official poverty line as defined by the Office of Management and Budget, and revised annually in accordance with section 673(2) of the Omnibus Budget Reconciliation Act of 1981 (Public Law 97-35).(2) In determining net nonexempt income of the MFBU, all deductions and exemptions applicable solely to AFDC-MN persons or families, as provided in article 10, shall be allowed except health insurance premiums.(3) A child may not reduce MFBU income to the 133 percent level by meeting a share of cost.(4) When determining eligibility for the 133 Percent Program, property shall be disregarded in accordance with Section 50401(c).(b) Period of Eligibility: (1) The period of eligibility for the 133 Percent program shall begin no earlier than the first day of the month of the child's first birthday unless the child is an inpatient for whom medical services are provided during a continuous period which began before his/her first birthday and he/she remains eligible under the 185 or 200 percent program. Once the continuous inpatient stay ends, the child must be evaluated for the 133 Percent program if he/she has not attained age six.(2) The period of eligibility for the 133 Percent program shall end on the last day of the month in which the child attains age six unless the child is an inpatient for whom medical services are provided during a continuous period which began before his/her sixth birthday. In that event, the period of eligibility continues under the 133 Percent program until the end of the stay for which the inpatient services are furnished so long as the child would have remained eligible under the 133 Percent program but for attaining the age of six.(c) Scope of Benefits: (1) An otherwise eligible child shall receive full Medi-Cal benefits if the child is a United States citizen or meets the requirements of section 50302. If the child does not meet the requirements of this section, services shall be restricted to treatment of emergency medical conditions only.(2) Services provided under this section shall not be subject to any share of cost requirements.Cal. Code Regs. Tit. 22, § 50262.5
1. New section filed 10-01-90 as an emergency; operative 10-1-90 (Register 90, No. 45). A Certificate of Compliance must be transmitted by OAL by 1-29-91 or emergency language will be repealed by operation of law on the following day.
2. Certificate of Compliance including amendment of subsections (a) and (c) transmitted to OAL 1-28-91 and filed 2-19-91 (Register 91, No. 12).
3. Amendment of subsection (a), new subsection (a)(4), and amendment of NOTE filed 4-2-98 as an emergency; operative 4-2-98. Submitted to OAL for printing only pursuant to Welfare and Institutions Code section 14148.75 (Register 98, No. 16). A Certificate of Compliance must be transmitted to OAL by 9-29-98 or emergency language will be repealed by operation of law on the following day.
4. Amendment of subsection (a), new subsection (a)(4), and amendment of NOTE refiled 4-15-98 as an emergency, including additional amendment of subsection (a)(4); operative 4-15-98. Submitted to OAL for printing only pursuant to Welfare and Institutions Code section 14148.75 (Register 98, No. 16). A Certificate of Compliance must be transmitted to OAL by 10-12-98 or emergency language will be repealed by operation of law on the following day.
5. Editorial correction of HISTORY 3 and HISTORY 4 (Register 98, No. 47).
6. Certificate of Compliance as to 4-15-98 order transmitted to OAL 10-9-98 and filed 11-18-98 (Register 98, No. 47). Note: Authority cited: Sections 10725 and 14124.5, Welfare and Institutions Code. Reference: Sections 14005.1, 14007.5, 14050.1 and 14148.75, Welfare and Institutions Code; and Title 42, Sections 1395(a)(3)(E), 1396 a(a)(10)(A)(i)(VI), (e)(7), (l) and 1396b(v), United States Code.
1. New section filed 10-01-90 as an emergency; operative 10-1-90 (Register 90, No. 45). A Certificate of Compliance must be transmitted by OAL by 1-29-91 or emergency language will be repealed by operation of law on the following day.
2. Certificate of Compliance including amendment of subsections (a) and (c) transmitted to OAL 1-28-91 and filed 2-19-91 (Register 91, No. 12).
3. Amendment of subsection (a), new subsection (a)(4), and amendment of Note filed 4-2-98 as an emergency; operative 4-2-98. Submitted to OAL for printing only pursuant to Welfare and Institutions Code section 14148.75 (Register 98, No. 16). A Certificate of Compliance must be transmitted to OAL by 9-29-98 or emergency language will be repealed by operation of law on the following day.
4. Amendment of subsection (a), new subsection (a)(4), and amendment of Note refiled 4-15-98 as an emergency, including additional amendment of subsection (a)(4); operative 4-15-98. Submitted to OAL for printing only pursuant to Welfare and Institutions Code section 14148.75 (Register 98, No. 16). A Certificate of Compliance must be transmitted to OAL by 10-12-98 or emergency language will be repealed by operation of law on the following day.
5. Editorial correction of History 3 and History 4 (Register 98, No. 47).
6. Certificate of Compliance as to 4-15-98 order transmitted to OAL 10-9-98 and filed 11-18-98 (Register 98, No. 47).