Professional Documents
Culture Documents
X Attachments:
COMMENT/CLARIFICATION/CHANGE
.. The intent of the attached Department of Public Social Services (DPSS) Call-Out us to re-emphasize
existing policy and procedures regarding the Social Security Number (SSN) requirements for applicants
and beneficiaries applying for full-scope Medi-Cal (MC). Although there have not been any program
changes, the attached document is an excellent case processing reference guide.
.. Policy: The SSN should be provided by the applicant at the time of application, if available. When the
individual does not have a SSN, benefits must be approved, if otherwise eligible. The SSN requirements
are to be met within 60 days from the date of application.
.. Medi-Cal shall not be denied, delayed or discontinued unless the applicant/beneficiary refuses to
cooperate, apply or provide for self, or a child over one year old.
.. Verifying SSN via MEDS; the applicant’s SSN is considered verified if:
See page 4 for additional information and procedures regarding verifying the SSN via MEDS, including
important information regarding the Burman Hold Status.
.. Samples of MEDS and LRS screens with the subsequent actions, are attached.
.. Staff must document in the LRS Journal any action taken and / or any correspondence given to
the applicant / beneficiary.
( ) New Polley
( ) Revision
(X) Conversion of existing policy - no concept changes
( ) To release a new form
The subject policy has been approved for release to staff via the DPSS Policies Website.
Avallable at Staff may access this policy through the MyDPSS Website:
MyDPSS - DPSS Policies Link - Program Policies - Medi-Cal Program
Cleared and (X) BAS (X) BCTS (X) BPP (X) BSO (X) BWS
Approved
Administrative Memorandum MPD 07-07, dated 11/14/07.
Replaces or MCP 17-1 O MEDS Verification Codes: Social Security Number, dated
Cancels 3/7/17.
MCP 18-40 MEDS Verification Codes: Social Security Number, dated
9/17/18.
Contact Info Administrative staff may contact the Health Care Reform Section at
(562) 908-3089.
RM:SC:HF
CA:ag
. Purpose Policy Background Release Date:
Definitions Requirements Verification Docs 3/10/2020
Procedures Forms Examples
System Screens References Obsolete Docs Contact
MEDI-CAL
Social Security Number Requirement
Purpose ( ) To release a new policy
( ) To release a new form
(X) To convert existing policy to new writing style only – No concept changes
( ) Revision of existing policy and/or form(s).
The purpose for this Administrative Directive is to reinforce policy regarding the Social
Security Number (SSN) requirement for applicants/beneficiaries applying for Medi-Cal
(MC) benefits only.
Newborns are also not required to provide a SSN until infant turns age one. In
addition, individuals without Satisfactory Immigration Status (SIS) eligible for full-scope
or restricted MC benefits are also exempt from providing the SSN.
Background Title 22, California Code of Regulations, Section 50168, states that counties must
obtain verification of the SSN or evidence that an application for a SSN has been
made, within 60 days from the initial MC application date, but not necessarily prior to
approval of eligibility.
1
Deferred Action for Also referred to as the Dream Act, is a type of
Childhood Arrivals administrative relief from deportation where a non-U.S.
(DACA) citizen is permitted to temporarily remain in the United
States.
Electronic Document An electronic document system that manages the
Management System creation, storage and control of documents submitted to
(EDMS) the county as verification of information needed for
eligibility purposes.
Electronic Verification The process of sending self-attested information to the
(e-Verified) Federal Data Service Hub (FDSH) for verification. If the
attested information is e-Verified by the FDSH, then there is
no need to request physical verification (e.g. copy of SSN
card, check stubs) from the applicant/beneficiary.
Ex-Parte The process of reviewing all information available to the
County that is relevant to the beneficiary’s MC eligibility,
such as LRS, MEDS, EDMS, Income and Eligibility Verification
System (IEVS) abstracts, and Systematic Alien Verification
for Entitlement (SAVE) to determine ongoing MC eligibility
without having to contact the beneficiary or request
verifications.
Federal Data Service An e-Verify system that is used to compare and verify
Hub (FDSH) information with other federal and State systems during the
eligibility determination process.
Income and Eligibility An electronic system which matches applicant name and
Verification System SSN against federal and State income and asset data files.
(IEVS)
MC Eligibility Data The State system that contains data and eligibility
System (MEDS) information for various health and public assistance
programs, including MC.
Senate Bill (SB) 75 A State law which grants children under 19 years of age
eligibility for full-scope MC benefits, regardless of
immigration status, if otherwise eligible to MC.
SB 104 A State law which grants individuals ages 19 through 25,
eligibility for full-scope MC benefits, regardless of
immigration status, if otherwise eligible to MC.
Systematic Alien An e-Verify process used to verify immigration status of
Verification and applicants when required for health and public assistance
Entitlement (SAVE) programs, including MC.
Self-Attestation A formal declaration by an applicant/beneficiary that
information is true and correct.
Permanently Residing PRUCOL is a public benefits category created by the
Under Color of Law federal courts that grants full-scope MC eligibility to
(PRUCOL) immigrants residing ”under the color of law.” For a person
to be residing “under the color of law,” the United States
Citizenship and Immigration Services (USCIS) must know of
the person’s presence in the U.S. and provide the person
with written assurance that enforcement of deportation is
not planned. PRUCOL is not recognized as an immigration
status by the USCIS.
2
Trafficking and Crime Allows full-scope eligibility for undocumented individuals
Victims Assistance who are victims of trafficking, domestic violence and other
Program (TCVAP) serious crimes, if otherwise eligible.
Violence Against Allows abused noncitizens or child of a U.S. citizen or Legal
Women Act (VAWA) Permanent Resident to apply directly on their own, for
lawful immigration status without the assistance of the
abusive spouse or parent.
Requirements U.S. citizens and immigrants claiming SIS, requesting full-scope MC benefits, must
provide a SSN, or verification of applying for a SSN within 60 days from the initial date
of application. Failure to comply will result in the discontinuance of MC benefits.
However, the following immigrant populations without SIS are exempt from the SSN
requirement and may receive full-scope benefits, if otherwise eligible.
• SB75;
• SB104;
• DACA;
• PRUCOL/Category 16;
• TCVAP; and
• VAWA.
Immigrants without SIS and not part of the populations above may receive
restricted/limited scope benefits, if otherwise eligible.
Verification The following chart provides acceptable forms of verification when an applicant or
Documents beneficiary does not have a SSN or SSN is unknown:
3
Note: If the SSN card is provided by the applicant or SSN card is on file, it may be used
as verification of SSN.
The SSN requirement must be met within 60 days from the initial date of application.
This requirement may be met by verifying the SSN via the FDSH, MEDS or following the
Senate Bill (SB) 87 process and requesting acceptable verification. Pending the
60-day verification period, staff must approve full-scope MC benefits if applicant is
otherwise eligible. Prior to initiating any negative action, eligibility staff must attempt
to verify the SSN via the FDSH or MEDS and follow the two-contact (applicants) or
SB 87 (beneficiaries) process.
Staff must first attempt to e-Verify the SSN via the FDSH when the applicant self-attests
the SSN. If the SSN is e-Verified by the FDSH, then there is no need to request
additional verification from the applicant, unless there is a discrepancy with other
sources such as MEDS.
The SSA Verification (SSN-VER) field (see System Screen section) in MEDS indicates the
SSN verifier code. The Social Security Verifier Desk Guide (Attachment I) provides the
MEDS SSN verification codes and the required action. The applicant’s/beneficiary’s
SSN is considered verified if:
Applicants/beneficiaries with an unverified SSN for more than 60 days will be placed
in Burman Hold status. To prevent individuals being placed in a Burman Hold status,
staff must follow instructions outlined in Attachment I, MEDS Social Security Number
(SSN) Verifiers, to correct or remove an unverified SSN code. When verifying a SSN via
MEDS, the verification must be clearly documented on the LRS journal.
Staff must follow the steps in the following chart at application when the applicant
does not have a SSN, SSN is unknown, or the SSN is not e-Verified or verified via MEDS.
Step Activity
Conduct an ex-parte review for the applicant’s SSN. This includes
reviewing all available resources, which include:
1
a. All program cases (active and inactive);
b. MEDS;
4
c. IEVS; and
d. SAVE.
a. Send a Verification Check List (VCL) with a 10-day due date, notifying
the applicant that they must provide the SSN or acceptable
verification. VCL must include the MC 194.
3 b. Prior to issuing a second VCL, a telephone contact must be attempted
if a phone number is available.
c. If the applicant fails to provide the SSN verification, the MC 194
completed by SSA, or contact staff by the date given on the VCL, a
second VCL must be sent to the applicant with a due date of the end
of the 60-day period.
Verification of an application for SSN or evidence of the SSN must be
confirmed by viewing:
If the applicant fails to respond within the 60-day timeframe, the individual is sent the
appropriate Notice of Action (NOA) to discontinue his/her benefits following existing
operational procedures.
Beneficiaries - SB 87 Process
Staff must use the SB 87 process when a case is approved, and the beneficiary must
meet the SSN requirement. For infants turning age one, staff may refer to AR 5513
Deemed Eligibility and The Newborn Referral Process, dated 1/17/2018.
Step Activity
Ex-Parte Review all available resources to verify SSN (i.e. e-Verify, previous
Review case, journal entries, EDMS, MEDS, IEVS, and SAVE).
5
Attempt to contact the applicant/beneficiary to obtain SSN
Direct
information over the phone. Document in the LRS journal the
Contact
contact date, method of contact and result of the contact.
The adoptive a. Once the adoption is finalized, remove the SSA verification and
parents complete a name change in MEDS. This will trigger the MEDS
change the SSN verification process with the SSA.
child’s name b. The child’s CIN is to remain the same.
6
Examples SS-5 Application for a Social Security Card
Legal AJren
5 CIT IZENSHI IP □ U.S. 0itizen □ Allowed To
(<l>eckOne) WOr1<
13 MMIDO/YYYY
14 TODAY' S 15 DA Y TIIME PHO NE
DATE NUMBER Area Code t-lu mber
DATE
DC L DATE
Form SS.5 (118-201 1) et ,(118-201 1) Deslray Prier Edmon.s Page5
7
System To Update SSN Status in LRS
Screens
Staff must go to Individual Demographics in the local navigator:
Step Action
1 Select “Edit” for applicant/beneficiary.
LR s Cas~ Nam e
Case Number
[lJ Jo11rnc1I ® lh•lp ml R, ...ouu , •._ [II] PcttJ1• Mr1p11111<J ~ Jm.HJt••, ~ 0( I,;.; lm.ttJt ... ~ I OIJ Out
case Info • Empl. Child ca re Resource Fiscal Specia l Reports Client Admm
Los Angeles Services Datab21nk Un its corres.p Tools
PROD
case Number:
w;;;;:;s
C=::JBI ► Root Questions
Person search
.., Non Financial
- contact
-
Root Questions 10/17/1966
Applicant Case XXX-XX-XXX
lmlrv1dual Demographics
Vital StatlstlCS
l'.;;1}:;omplete
Household Status
Relationship M&foi!iM
Step Action
2 Go to the SSN Status under the Individual Demographics Detail Page.
2.a Select “Edit.”
SSN Status -
Current Social Security Number:
XXX-XX-XXX
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Step Action
3 Review the applicant SSN in the SSN Detail Page for accuracy.
3.a Update the “Verified” drop-down menu.
3.b Enter “Begin Date.”
3.c Select “Save and Return.”
SSN Detail
*- Indicates required fields Save and Return
FSi:B?M
'-----'□
FSi:B?M
To Verify the SSN in MEDS
References N/A
Contact Administrative staff may contact the Health Care Reform Section at 562-908-3089.
9
ATTACHMENT
A SSN verified via SSA Numerical Identification System No action required, SSN verified.
(NUMIDENT) data match - SSA birthdate exactly
matches MEDS.
W SSN identified as verified via prior SSN verification No action required, SSN verified.
process.
B SSN verified via SSA NUMIDENT data match - SSA Refer the applicant/beneficiary to
birthdate exactly matches MEDS/surname did not the local SSA office with a MC 194
match. to clarify the last name.
SSN verified via SSA NUMIDENT data match - SSA Refer the applicant/beneficiary to
E
birthdate not available for exact MEDS match check. the local SSA office with a MC 194
to verify the date of birth.
SSN verified via SSA NUMIDENT data match - SSA Refer the applicant/beneficiary to
F birthdate not available for exact MEDS match the local SSA office with a MC 194
check/surname did not match. to verify the date of birth and last
name.
SSN identified as verified via State Verification and Review the SSN verifier in MEDS to
* Exchange System (SVES) SSN verification process, but SSN determine if the SSN has been
verification code subsequently removed by worker. validated.
SSN identified as verified via SVES SSN verification Review the SSN verifier in MEDS to
# process, but SSN verification code subsequently determine if the SSN has been
removed SSI/SSP update. validated.
Review SSN in MEDS and compare
with SSN in LRS.
The SSN verifiers cannot be used to validate due to SSN Refer the applicant/beneficiary to
N, O,
verification failed SSA NUMIDENT data match on the local SSA office with a MC 194
P-Q
birthdate. to verify the SSN.
The SSN verifiers cannot be used to validate due to SSN Refer the applicant/beneficiary to
S, T, verification failed SSA NUMIDENT data match on the local SSA office with a MC 194
U, V, surname or given name. to verify the name discrepancy for
this SSN.
X SSN identified as verified via prior SSN verification Refer to MEDS Liaison.
process, but SSN verification subsequently removed.
Refer the applicant/beneficiary to
SSN identified as unverified via prior SSN verification the local SSA office with a MC 194
Y
process. to correct the name and/or date
of birth discrepancy.
SSN failed SSA NUMIDENT data match - given name Refer the applicant/beneficiary to
! the local SSA office with a MC 194
missing.
to correct the name discrepancy.
Must compare case
documentation with MEDS to
SSN verification failed SSA NUMIDENT data match - identify error. Refer the
%
probable transcription error identified. applicant/beneficiary to the local
SSA office with a MC 194 to correct
any discrepancies.