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Form MC196 Transmittal Form for Notifying Dhcs of Medi-Cal Inmate Eligibility Program (Mciep) Changes in Status for County Medical Probation or Compassionate Release Inmates - California
What Is Form MC196?
This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the purpose of form MC196?
A: Form MC196 is used to notify DHCS of changes in status for County Medical Probation or Compassionate Release inmates in the Medi-Cal Inmate Eligibility Program (MCIEP) in California.
Q: Who uses form MC196?
A: County Medical Probation or Compassionate Release inmates and their associated agencies use form MC196 to notify DHCS of changes in their eligibility status in the MCIEP.
Q: What changes in status can be reported using form MC196?
A: Form MC196 can be used to report changes in the inmate's enrollment status, release date, change in custody status, change in medical eligibility, or any other relevant changes.
Q: Is form MC196 mandatory for reporting changes in status?
A: Yes, form MC196 is mandatory for reporting any changes in status for County Medical Probation or Compassionate Release inmates in the MCIEP.
Form Details:
- Released on March 1, 2020;
- The latest edition provided by the California Department of Health Care Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form MC196 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
