Medi-Cal Approval with Hunt v. Kizer SOC Adjustment

Case Situation

Disabled individual has been receiving regular Medi-Cal with SOC and Medicare benefits. Client is receiving RSDI and has provided a copy of an unpaid medical bill to adjust the SOC.

On the Customer Options Detail page:
1. Select Full Medi-Cal Hierarchy from the Type drop down list.
2. Complete other required fields
On the Medi-Cal Condition List page select Active from the Medical Condition Category drop down list and complete all required information on the Medical Condition Detail page
On the Income List page select Social Security from the Income Category drop down list and update necessary information on the Income Detail page.
On the Medicare Detail page:

Enter Medicare part A&B information, MBI number and HIC number.
Complete all necessary fields.

5. On the Hunt v.Kizer Expense Detail page complete required fields.

Complete other Data Collection pages relevant to the case.
Run EDBC, review budget and eligibility results on the Medi-Cal EDBC Summary page and Accept and Save results.
1. To view the budget with the applied Hunt v. Kizer expenses, click on the MC Income hyperlink,
  the Medi-Cal EDBC - MC Income page displays.
2. On the Medi-Cal EDBC - MC Income page, to view the expense applied amount click on the Hunt v. Kizer expenses, Applied Amount hyperlink, the EDBC Person Line Item Detail - HvK Applied Amount page displays showing correct amount applied toward the SOC and remining amount.

Note: CalSAWS, has EDBC logic to apply Hunt v. Kizer expenses to adjust the SOC and auto generates an approval NOA. Additionally, a monthly batch will trigger EDBC for Medi-Cal programs with available Hunt v. Kizer expenses until the total expense amount is exhausted.

Transactions Generated by CalSAWS to MEDS

Add (EW20) transactions for the current and future months are sent to MEDS. As CalSAWS considers each authorized month a closed period of eligibility, a TERM-DT and a TERM-REAS of ‘99’ will be displayed on the INQM screen. Eligibility for the future month will appear under the Pending column until MEDS renewal.

Refer to MC Chapter 35: Court Orders, Section Hunt v Kizer for detailed information.

Refer to CalSAWS "Quick Guide Hunt v. Kizer", for additional processing instructions.

Medi-Cal Approval with Hunt v. Kizer SOC Adjustment

Case Situation

Transactions Generated by CalSAWS to MEDS

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