Share of Cost and Aid Code Changes/Corrections

Changes to beneficiary’s SOC can be made not only to current and future month(s), but past month(s) as well. Allowable changes are as follows:

SOC Changes for Prior Month(s)

Changes to SOC can be made in CalSAWS by updating the relevant Data Collection pages and running EDBC. CalSAWS will send an Update Eligibility (EW12) transaction to MEDS to modify the SOC, with certain limits, if the change is within eight (8) months from the current MEDS month. If the SOC change is required for a month prior to the eight (8) month period, a SCD 1296 must be submitted to request a online transaction to change the SOC on MEDS.

SOC Decrease for Prior Month(s)

Update the relevant Data Collection pages with information (e.g., earnings, additional MFBU member, etc.) that affects the SOC decrease. Run EBDC to re-evaluate affected months and accept and save results.
If the affected month(s) is within the eight (8) month period, CalSAWS will automatically send an Update Eligibility (EW12) transaction to decrease the SOC on MEDS.
If the affected month(s) is more than eight (8) months prior to the current month, complete an SCD 1296 requesting the MTO to perform a EW31 online transaction to decrease the SOC in MEDS.

SOC Increase for Prior Month(s)

SOC increase for prior months can only be made if the recipient has NOT YET BEEN certified on MEDS for the month(s) in question. Determine whether the client is certified on MEDS prior to attempting the SOC increase.

SOC certification can be viewed from the Primary Medi-Cal/CMSP Information (INQM), Special Program Information (INQ1, Q2, Q3), or the SOC Case Make-Up Inquiry Request (SOCR) screens.

If the first digit of the ELIG-STAT code on INQM, Q1, Q2, or Q3 screen is ‘5’, signifying that the SOC is uncertified, then no certification has taken place and the retroactive increase in SOC can be done.

The increase CANNOT be sent via a CalSAWS transaction. There are edits within CalSAWS to prevent the automatic transaction. EWs must complete an SCD 1296 requesting the MTO generate a Modify (EW30/EW31) transaction for each month in which the SOC must be retroactively increased.
CalSAWS history must also be corrected. Update the relevant Data Collection pages with information (e.g., earnings, removal of an MFBU member, etc.) that affects the SOC increase and run EDBC and accept and save results.

Reminder: SOC increase can ONLY be applied if the client has received an adequate and timely NOA with the correct SOC for the month(s) in question.

SOC Changes for Future Month(s)

There are no limitations to SOC changes for the future month as long as the following requirements are met:

An adequate and timely NOA has been sent to the client, and
The change is submitted to MEDS (via a CalSAWS batch or MTO online transaction) PRIOR to MEDS Renewal.

Aid Code Changes for Prior Month(s)

When the Aid Code in CalSAWS is changed from a SOC Aid Code (e.g., 37, 14) to a no SOC Aid Code (e.g., 34, 17) for a prior month: