Manual NOAs

Manual Generation of the NOD02

MAGI MC notices are automatically generated in CalSAWS. However, in the following instances, a manual NOA (NOD02) should be created:

Restricted-scope to full-scope (when trying to generate the NOA in the same month action was taken).
If the expected NOD02 does not auto-generate; this includes approval, denial, change, and termination actions.

The following conditions apply when generating a manual NOD02:

Reason codes cannot be mixed on a single NOA (i.e. denial of retroactive MC and approval for MAGI MC).
A separate NOA will need to be generated if the same reason code is needed for two (or more) people in a household with different budgets (i.e. different tax filing households).
MAGI NOAs should have the Month spelled out for all dates.
- Example: May 01, 2016, not 5/01/2016.

MAGI Medi-Cal Discontinuance Notice of Action

The Department of Health Care Services (DHCS) has instructed counties that the client must be informed of MAGI MC discontinuance for the following reasons:

Being over income for the appropriate MAGI MC program due to:
- A change in income,
- A change in household size,
- Your age is above the age range allowed, where program eligibility is based on age and income.
Not eligible for Consumer Protection Programs (CPP), including Continuous Eligibility For Children (CEC), Transitional MC (TMC), Continuous Eligibility for Pregnant Woman (CE), etc; and
Having no potential eligibility for Non-MAGI MC programs after ex parte review or declining a Non-MAGI MC evaluation.

When an EW discontinues a case or individual from MAGI MC for being: over income, ineligible for any other CPP, or Non-MAGI MC program, the EW must print a MAGI MC discontinuance NOA manually. Follow the steps below to send a MAGI MC discontinuance NOA.

Printing a MAGI MC Discontinuance NOA

From the DEBS Forms Library on the SSA Intranet:
1. Search for the form MC_239_A_Disc_2.
2. Select the correct language:
  1. MC_239_A_Disc_2_en (English)
  2. MC_239_A_Disc_2_sp (Spanish)
In the MC_239_A_Disc_2 Document:
1. Enter the client case information.
2. Enter name(s) of affected individuals.
3. Enter the discontinuance date.
4. Use the check boxes to select the reason for Discontinuance.
  1. A change in income
  2. A change in household size
  3. Your age is above the age range allowed, where program eligibility is based on age and income.
Print 2 copies
1. The 1st copy is to scan to IDM.
2. The 2nd copy is to send to the client.
Delete erroneous discontinuance NOAs in CalSAWS.

Notice of Action Reason Codes

Medi-Cal Notice of Action Reason Codes for approval, change, denial, discontinuance, and retroactive NOAs can be found in Reference Materials on the SSA intranet.

Failure to Complete the Non-MAGI Screening Packet

A snippet is required on the MAGI discontinuance NOA when an individual is discontinued for MAGI under all of the following set of circumstances:

The client is determined over income, over the age limit, or otherwise ineligible for MAGI Medi-Cal (for reasons other than failure to respond or failure to provide verification)
The client is potentially eligible for Non-MAGI
The client fails to complete the Non-MAGI Screening packet

Individuals who are losing MAGI eligibility and do not complete the Non-MAGI Screening Packet must be informed of both the specific reason they are ineligible for MAGI, and the specific reason the Non-MAGI evaluation could not be completed.

In the above circumstance, Eligibility Workers (EWs) must send the appropriate MAGI discontinuance NOA and include the following language in free form text:

“We sent you a letter about other Medi-Cal programs, also called ‘Non-MAGI’ Medi-Cal. We asked you to reply to the letter and tell us more about your income and property so we can see if you can get Non-MAGI Medi-Cal. You did not give us the information we need. If you want to give us the information, please call us, visit your local county office, or reply to the letter.”