9038 - Aid Code Changed to Indicate Limited Scope Due to DRA - Urgent

This alert is generated to notify the EW that MEDS has changed the reported Medi-Cal full scope Aid Code to a limited scope Aid Code (e.g., 34 to 58; M3 to M4) because the client is unable to provide or obtain the required citizenship or identity documentation (i.e., End of Reasonable Opportunity Period Code 9A - 9R).

The middle digit of the ELIG-STAT code for these individuals is “6,” indicating that MEDS has changed the eligibility reported by the EW.

MEDS will also store the original full scope Aid Code in the [INQE] screen, ORIG-AID field. Once MEDS is updated with the proper citizenship and identity documentation, it will restore the full scope Aid Code and reset the ELIG-STAT to a regular Medi-Cal eligible status.

Note: The full scope Aid Code reported by the EW will be used in the Recon process to eliminate discrepancies.

Action Required

The EW must review the case and EDBC Results to ensure that the change to limited benefits by MEDS is appropriate:

If YES, review Client Correspondence/Distributed Documents to ensure the correct NOA(s) is sent for the affected individual. Manually generate a change NOA, if necessary.
If NO, review and correct all information entered on the Citizenship Status Detail page, including the Medi-Cal Reasonable Opportunity Period (ROP) page section.
- Re-run EDBC.
- Check MEDS in two days to make sure the full scope Aid Code is restored. Submit an SCD 1296 to have the full scope Aid Code restored, if necessary.

9038 - Aid Code Changed to Indicate Limited Scope Due to DRA - Urgent

Action Required

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