2502 - Recipient in Hold Status - Alert

This alert can be received either through the daily process or the quarterly Reconciliation process. Other daily or Recon alerts are also generated to provide cause of a record being placed on Hold status. The alert is generated due to one of the following:

A transaction has been generated (either by the CalSAWS nightly batch process or via the MTO) to negatively change MEDS history (i.e. from no SOC Aid Code to a SOC Aid Code or terminating for a history month), OR
A transaction has been generated to retroactively increase the SOC amount for a history month.

Neither of these transactions is allowable since that is considered an adverse action. Once no-SOC Medi-Cal benefits have been authorized for a given month, MEDS cannot be changed to reflect a SOC amount or Aid Code cannot be removed/terminated. Once a SOC amount has been established on MEDS for any given month, it cannot be retroactively increased (even if it is incorrect).

The only allowable retroactive increase in SOC allowed by the MEDS system is:

If a SOC amount is established on MEDS and the SOC has not been met, e.g., ‘ELIG-STAT’ Code on MEDS reflects no certification, the SOC can be retroactively increased provided the recipient has been given a legal/timely NOA.

CalSAWS prevents any retroactive increase in SOC transactions. If the SOC amount must be increased retroactively, the EW must complete an SCD 1296, requesting the MTO generate an EW30 (Modify) transaction online

Action Required

The EW will also receive another CEWA (County Eligibility Worker Alert) with this alert, either ‘2063’ or ‘6005’. MEDS has placed a Hold on the recipient’s record for the future MEDS month.

Corrective action must be taken to release the future month Hold or future Medi-Cal benefits will not be established and after two months MEDS will automatically discontinue the beneficiary.

2502 - Recipient in Hold Status - Alert

Action Required

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