9532 - Over 3 Edwards Months - Medi-Cal Determination Overdue - Critical

This MEDS Renewal message is generated at the end of the 3rd month (and every month thereafter) in which a recipient has received 38 Aid Code Medi-Cal benefits. Edwards benefits are continuing for the 4th (or more) consecutive month.

The alert indicates that the EW:

• Has not yet completed the SB87 Medi-Cal redetermination; or
• Did not successfully update MEDS on the outcome of the SB87 redetermination.

Sample Alert

Possible Screens to Resolve This Alert

The INQM screenThe INQM screen indicates more than 3 months of Edwards exception eligibility. The INQE screen indicates the original aid code, which is the latest aid code prior to the Edwards exception eligibility.

Action Required

• The EW Supervisor must consult immediately with the EW and monitor progress until the Edwards Aid Code is properly terminated.
• The EW must take IMMEDIATE action to complete the SB87 process and either:
  • Establish client’s eligibility for Medi-Cal under another Aid Code, OR
  • Terminate eligibility under Aid Code 38 (if ineligible for ongoing Medi-Cal).

Note: Do NOT use TERM-REAS code “99” when submitting SCD 1296 to request Aid Code 38 terminated on MEDS.

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