9061 - Medicare Eligible - County Aid Code Termination Needed - Urgent

This alert is generated:

When the client is receiving State-only restricted scope Medi-Cal coverage for anti-rejection medication for up to two years following an organ transplant and now shows eligibility in M1/M7 or L6/L7 aid code. The recipient shows eligibility on MEDS in a State-Only restricted Medi-Cal aid code and this aid code cannot share eligibility with a companion full scope aid code in the primary or special segment simultaneously.
When a(n) batch/online transaction was submitted on one of the Group VIII Aid Codes (K2, K3, K4, K5, K6, K7, K8, K9, L6, L7, M1, M2, N5, N6, N7, N8) to a MEDS record that indicates eligibility for Medicare.

Action Required

Confirm Medicare eligibility/coverage that displays on [INQM]/[INQB] screen or IEVS report.
Review the client’s case for evaluation of Non-MAGI Medi-Cal eligibility and take the following actions:
- Update Medicare information and RSDI benefit amount in CalSAWS,
- Run EBDC and authorize the case to send the approval transaction to discontinue the current aid code (M1/M2, L6/L7, or 77) in MEDS and approve Non-MAGI MC. If the client does not submit required verifications for Non-MAGI MC, discontinue their MC benefit with a timely NOA in CalSAWS.
- Check MEDS in two working days. Submit an SCD1296 to discontinue the MEDS record if needed.