Retailer Participation and Benefit Adjustments

Retailer Participation

Every merchant that accepts CalFresh benefits may participate in the EBT program for CalFresh and cash transactions. As a result of the 2014 Farm Bill, EBT-only retailers must pay for their EBT POS equipment, supplies, and services, and sign up with a TPP for EBT processing. Retailers may be referred to the Food and Nutrition website for a list of TPPs for EBT equipment and services.

The following CalFresh authorized retailers are exempt from the 2014 Farm Bill: eligible farmers’ markets, direct-marketing farmers, military commissaries, nonprofit cooperatives, group living arrangements, treatment centers, and prepared meal services. These exempt EBT-only retailers may continue to qualify for free EBT equipment and services. Additional merchants that are not FNS authorized (such as retail stores, restaurants, gas stations, check cashiers, and ATM machines) may also participate in EBT for cash benefits.

Retailers No Longer Accepting EBT

EBT cardholders who report that the retailer they normally went to is no longer accepting EBT, should be referred to the California EBT Client website to find other retailers by clicking the link “Where can I use my EBT card?” on the left side of the home page.

Manual Vouchers

A Manual Voucher is used when the POS device is unavailable. The vendor will call the CSR at (866) 328-4212 and provide his/her valid FNS retail number, the card number of the customer, the amount of the transaction he/she is attempting to process, and the serial number of the paper voucher that is being used. The CSR documents this information and verifies if there is enough money in the account to complete the transaction.This process is only available for CalFresh. It is NOT available for cash benefits.

Benefit Adjustments

Benefit adjustments for EBT is the process whereby a debit or credit is applied to an EBT account to correct a:

• System error that is identified in the settlement process,
• Client-initiated CalFresh and/or cash benefit adjustment, or
• Retailer or commercial institution-initiated CalFresh or cash benefit adjustment.

System Errors

FIS will correct (adjust) out-of-balance conditions which occur during the benefit redemption or settlement process as a result of a system error.

Client-Initiated

A client-initiated benefit adjustment must be requested within 90 calendar days of the original error transaction. Within 15 days of the date of the CalFresh adjustment request, FIS MUST investigate the request, render a decision, and, if warranted, move funds to the client’s account. For cash aid, the amount of days is determined by the QUEST® operating rules. If the client’s request is determined to be valid, the account is credited within 15 calendar days.

If the client’s request is denied, FIS will notify the County through an interface with CalSAWS.

• CalSAWS will generate the appropriate cash aid NOA “EBT Adjustment Denial” (M16-705) to the client with information regarding the denial and the right to apply for a Fair Hearing within 90 calendar days of the date of the notice. No aid pending is provided.
• For CalFresh client-initiated benefit adjustment denials, the EW must send a manual NOA “EBT Account Adjustment” (TEMP NA 1238) to the client with information regarding the denial and the right to apply for a Fair Hearing within 90 calendar days of the date of the notice. No aid pending is provided.

Retailer/Commercial Initiated

For retailer or commercial-initiated adjustments, FIS provides a claim activity report to the county through an interface with CalSAWS. The EBT claim information is displayed on the Search EBT Claim Data window. CalSAWS automatically generates and sends the “CF EBT Account Adjusted” notice (Temp NA 1232) and/or “Cash Aid EBT Adjustment Notice” (M16-701) to the client within TWO (2) days of receipt of the claim activity report, which explains the action being taken.

The client has a right to appeal the benefit adjustment and request a Fair Hearing. If the client disputes the adjustment and requests a Fair Hearing within 15 calendar days from the date of the notice, no further action is taken by FIS until the Fair Hearing decision is rendered.

If the...	Then...
Fair hearing decision is rendered in the client’s favor,	No further action is required. Note: A NOA is not required.
Adjustment is upheld by the Fair Hearing decision,	FIS will debit the client’s account immediately for the total amount of the adjustment.
Client does not request a Fair Hearing within 15 calendar days from the date of the notice,	FIS will debit the client’s account for the total amount of the adjustment.
Client requests a Fair Hearing after the 15the calendar day but within 90 calendar days from the date of the notice,	The Fair Hearing request shall be granted but the adjustment process will continue resulting in a debit against the client’s account.

For a retailer or a commercial institution-initiated CalFresh or cash benefit adjustment, if at the time the first debit attempt is made, the client’s account does not contain sufficient benefits to cover the total debit amount of the adjustment, FIS will attempt daily to make the adjustment until the end of the next calendar month.

If the adjustment cannot be completed by that time, the adjustment is canceled. No debit adjustment will occur unless the account contains a sufficient balance of the total amount of the adjustment.

Notice of Action (NOA) for Retailer- or Commercial-Initiated Claims

The NOA must be sent within two days and must specify:

• That a retailer or commercial institution has requested a debit adjustment from the recipient’s account;
• The full amount and type (debit) of the adjustment, including the date, time and location of the erroneous transaction;
• That the adjustment amount may be debited from the current balance or from the next future month’s benefits;
• Where the recipient may call to dispute the adjustment and request a Fair Hearing; and
• That the recipient has the right to postpone the adjustment debit pending the outcome of a Fair Hearing, provided that the hearing is requested within 15 calendar days from the date of the notice.

The client has 90 calendar days from the date of the notice of adjustment to request a Fair Hearing.

Note: A notice to the client is not required if an adjustment initiated by a retailer or commercial institution results in a credit to the client’s account.

Procedure

The following procedure must be followed when an account adjustment is made:

1. The CalSAWS system receives the “Claim Activity File” from FIS on a daily basis.

If the account is...	Then the CalSAWS system...
Credited,	Takes no further action.
Debited,	Generates TEMP NA 1232 and/or M16-701.

2. The Client files for a Fair Hearing on ANY of the benefit adjustment issues.
3. The Appeals EE:
   1. Receives the Fair Hearing request.
   2. Enters appropriate code on the Adjustment Status Update screen in the EBT Terminal to notify FIS that an appeal has been filed.
   3. Follows normal procedures to initiate a Fair Hearing.
   4. Represents the County in the Fair Hearing.
4. The ALJ:
   1. Hears the case.
   2. Renders a decision.
   3. Forwards the decision to the Appeals Unit.
5. The Appeals EE receives ALJ’s decision and follows these guidelines.

If the ALJ...	Then the EE...
Upholds the client’s claim,	Enters the appropriate code in the Administrative Terminal for FIS to credit the EBT account, if the account was previously debited.
Denies the claim,	Enters the appropriate code in the Administrative Terminal for FIS to debit the EBT account, if the account was not previously debited. Forwards any other related paperwork to the EW of record.

6. The EW receives and has paperwork scanned into Imaging.

All adjustments MUST remain within their specific program account. A CalFresh adjustment can only be transacted against a CalFresh account and a cash adjustment can only be transacted against a cash account.

Related Topics

 

EBT Forms