Under recently enacted state law (SEC. 137 of SB 184 (Chapter 47, Statutes of 2022)), DHCS is required to implement the Newborn Gateway process by July 1, 2024. The Newborn Gateway process will be designed to standardize the reporting of births of infants with linkage to Medi-Cal and the Medi-Cal Infant Access Program to ensure a more expeditious enrollment of newborns into coverage and into a health care plan. The Newborn Gateway will also address federal findings and concerns related to mothers without satisfactory immigration status and incorrect claiming issues associated with the newborn. DHCS envisions the enrollment of newborns through the Newborn Gateway will leverage Hospital Presumptive Eligibility processes, providing hospitals the ability to establish eligibility for infants at birth using a system and process they are already familiar with.
The Newborn Gateway will allow qualified Medi-Cal providers to enroll eligible newborns into coverage where an identifier, referred to as the Client Identification Number (CIN) will be provided to the newborn in real-time, creating a separate record in the state eligibility system unique from their mother’s CIN. The infant’s eligibility and CIN will post to the state system the following day and the appropriate entity, either the county or DHCS’ administrative vendor, will be notified of the birth and would allow providers to bill under the infant’s CIN right away.
The Newborn Gateway presentation will provide an overview of the policies associated with this initiative and provide a DHCS’s initial thinking of the process flow of its operation. The webinar will provide an opportunity for hospitals to provide feedback on DHCS’s policy and processes to inform the eventual implementation of this program.
Audience:
COO, CFO, Finance, Billing and Collections Staff, Case Manager
Yingjia Huang
Assistant Deputy Director, Health Care Benefits and Eligibility
California Department of Health Care Services
Samantha Fraser
Associate Government Program Analyst
California Department of Healthcare Service
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For additional assistance and other inquiries, email CHA’s Education Department at education@calhospital.org.