Form 2426, Pending Extension Request/Overdue Case Update

Effective Date: 12/2004


PDF: 2426.pdf


Updated: 12/2004


  • To request an extension on a pending case that you can predict will not be completed within the required time frame.
  • To update state office on a pending case that is already 30 days past due or more.
  • To update state office on an annual renewal that is already 30 days past due or more.
  • To assist in tracking overdue cases and pending cases for which an extension has been approved.


  • Enter the individual’s name, date of birth, and Medicaid number.
  • Indicate whether you are requesting an extension for a pending case (note that extensions only apply to pending cases, not active cases).
  • Indicate whether this is an active case or a pending case. If it is a pending case, indicate the date due and whether or not an extension has previously been granted by state office.
  • Provide a clear explanation for the delay (e.g., child hospitalized for last two months, etc.).
  • Indicate the status of all initial/renewal activities. Each item must be completed with either a date that the activity was done, or a date/time frame in which you expect the activity to be done. For any activity not yet complete (e.g., awaiting MD signature, awaiting medical necessity decision, etc.), you must provide a date (i.e., 7/15/99) or a time frame (i.e., in two weeks) in which you plan to follow up about the activity.
  • This form must be signed by the case manager and kept in the individual’s master file. A copy of the form is mailed or faxed to the state office program specialist.

Some Things to Remember

  • MDCP is required to complete reviews on cases annually. We are not permitted to alter this requirement and must justify delays on any late renewals.
  • MDCP families wait a tremendously long time to have their names released from the waiting list. We must be able to explain to the Health Care Financing Administration (HCFA) and other interested parties any lengthy delays in the applicant’s ability to access MDCP services and Medicaid.
  • Remember that 30 days past due on a pending case means that the name has already been released for what HCFA considers to be ample time to get families enrolled. We have to be able to avoid or reduce these delays when possible and to provide adequate explanations when we cannot.
  • When an annual case is long overdue and all the of eligibility renewal pieces are not completed in a timely manner, we run the risk of funding a child (through both Medicaid and MDCP) who in reality may no longer meet the eligibility criteria.
  • By providing the update information to state office, you help keep us informed of the barriers to renewals and enrollments and help us to provide better program explanations of delays. In addition, we may identify areas in which we can be of assistance in expediting the enrollment or renewal process.
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