5. IEVS Recipient System · The PVS reports are only printed upon request through the Program...

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Update #16-24 Revised: 09/07/16 Common-Place Handbook page 5-1 IEVS Recipient System 5. IEVS Recipient System 5.1 Overview 5.1.1 History In February 2007, the State decided to eliminate the New Hire Registry NHR410 Recipient Abstract hard copy reports. The CalWIN Consortium requested to continue receiving the hard copy of the IEVS abstract reports because when comparing the hard copy with CalWIN, in some instances not all information was in CalWIN. Santa Clara County chose to continue to receive the IEVS NHR410 abstract hard copy reports for this reason. On February 16, 2007, the California Department of Social Services (CDSS) advised CalWIN counties that CDSS would cease producing the secondary output namely paper, tape, CD, etc. for the Payment Verification System PVS030 and PVS040 Recipient Abstract Reports. As an alternative to a secondary output, CDSS offered CalWIN counties an opportunity to access the PVS030 and PVS040 files via a secured server called Tumbleweed. Santa Clara chose to receive the secondary output as of April 6, 2007, through Tumbleweed. The PVS reports are only printed upon request through the Program Bureau. 5.1.2 Requirements The Income Eligibility Verification System (IEVS) is a computerized system which matches the applicant/beneficiary name and Social Security Number (SSN) with various state and federal welfare files. The IEVS recipient system is administered by the California Department of Social Services (CDSS) and provides income and other information at various times during the year, depending on the match type. All recipients will be reported to IEVS to confirm eligibility information. Persons whose income and resources are included in the eligibility determination must be included in the IEVS/PVS match process. The client’s SSN information is processed in the IEVS Recipient System when: An application is recorded in the Application Registration system A person with an SSN is added to the case

Transcript of 5. IEVS Recipient System · The PVS reports are only printed upon request through the Program...

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5. IEVS Recipient System

5.1 Overview

5.1.1 History

In February 2007, the State decided to eliminate the New Hire Registry NHR410 Recipient Abstract hard copy reports. The CalWIN Consortium requested to continue receiving the hard copy of the IEVS abstract reports because when comparing the hard copy with CalWIN, in some instances not all information was in CalWIN. Santa Clara County chose to continue to receive the IEVS NHR410 abstract hard copy reports for this reason.

On February 16, 2007, the California Department of Social Services (CDSS) advised CalWIN counties that CDSS would cease producing the secondary output namely paper, tape, CD, etc. for the Payment Verification System PVS030 and PVS040 Recipient Abstract Reports. As an alternative to a secondary output, CDSS offered CalWIN counties an opportunity to access the PVS030 and PVS040 files via a secured server called Tumbleweed. Santa Clara chose to receive the secondary output as of April 6, 2007, through Tumbleweed. The PVS reports are only printed upon request through the Program Bureau.

5.1.2 Requirements

The Income Eligibility Verification System (IEVS) is a computerized system which matches the applicant/beneficiary name and Social Security Number (SSN) with various state and federal welfare files. The IEVS recipient system is administered by the California Department of Social Services (CDSS) and provides income and other information at various times during the year, depending on the match type.

All recipients will be reported to IEVS to confirm eligibility information. Persons whose income and resources are included in the eligibility determination must be included in the IEVS/PVS match process.

The client’s SSN information is processed in the IEVS Recipient System when:

• An application is recorded in the Application Registration system• A person with an SSN is added to the case

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• A person’s SSN is changed in CalWIN.

5.1.3 Request for Online Action-SCD 1296

Unlike the applicant system, the EW cannot use the SCD 1296 to request information on-line. All it will display is “the client is unknown to the welfare system.” The SCD 1296 only works for client’s records in the applicant system.The record remains in the Applicant System for 90 days after all matches are completed, then the records are purged.

5.1.4 Sub-Systems

The Recipient System consists of eleven sub-systems:

• New Hire Registry (NHR)• Payment Verification System (PVS) Match• Jail Reporting System (JRS) Match • California Youth Authority (CYA) Match• Nationwide Prisoner Match (NPM)• Deceased Person Match (DPM)• Integrated Fraud Detection (IFD)/Earning Clearance System (ECS) Match• Asset Match - Franchise Tax Board (FTB)• Asset Match - Internal Revenue Service (IRS)• Beneficiary Earnings Exchange Record (BEER)• Fleeing Felon Match (FFM)

The following chart shows the frequency of the reports, who is responsible for processing the report and the discrepancy tolerance level in each aid program:

Sub-System Issuance Responsibility

Tolerance Level

CW CF MC

NEW HIRE REGISTRY (NHR410)

Monthly EW *N/A *N/A *N/A

PVS MATCH UIB, DIB, RSDI (PVS040)

Monthly EW *N/A *N/A $400 case total UIB/DIB *N/A on RDSI

JAIL REPORTING SYSTEM (JRS) MATCH

Monthly Investigator, EW and EE from IEVS unit

*N/A *N/A *N/A

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Note:Reports will not be forwarded to the county when the dollar amount is less than the tolerance level, except for ECS 155s.

5.1.5 Processing Recipient IEVS Reports

The review of the IEVS abstract/report is not considered complete until it is signed by the EW and/or CalWIN’s Create IEVS Applicant Review Document response window is completed.

CALIFORNIA YOUTH AUTHORITY (CYA)

Monthly Investigator, EW and EE from IEVS unit

*N/A *N/A *N/A

NATIONWIDE PRISONER MATCH (NPM)

Semi-annually in April and October

Investigator, EW and EE from IEVS unit

*N/A *N/A *N/A

DECEASED PERSON MATCH (DPM)

Semi-annually in April and October

Investigator, EW and EE from IEVS unit

*N/A *N/A *N/A

IFD/ECS MATCH (ECS 155)

Quarterly in March, June, September and December

EE from IEVS unit

$1000 $1000 $100 (active cases) $250 (inactive cases)

ASSET MATCH (FTB)

Annually in February

EE from IEVS unit

$50 $100 $100 (active cases) $250 (inactive cases)

ASSET MATCH (IRS)

Annually EE from IEVS unit

$50 $100 $100 (active cases) $1000 (inactive cases)

BEER Annually EE from IEVS unit

$4,800 $11,200 $12,000

FLEEING FELON MATCH (FFM)

Monthly Investigator, EW and EE from IEVS unit

*N/A *N/A Not Matched

* No tolerance level — all matches will be sent to the county.

Sub-System Issuance Responsibility

Tolerance Level

CW CF MC

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For Hard Copy Abstract Reports:

• The worker completes the “worker sign-off” section on the IEVS abstract once it has been processed.

• When the worker has both an IEVS abstract report hard copy and CalWIN IEVS report, the worker must compare the hard copy data with CalWIN’s data in the View IEVS Recipient Report windows to make sure data coincides.

For CalWIN On-Line Reports

The worker must search and review for discrepancies. To record and/or identify discrepancies the following must be completed in order to meet the requirement of having signed the IEVS report:

Step Report(s) Action

1. IFD, NHR, NPM & PVS

Click Interface Activities on the Navigate CalWIN Window.

• Click the IEVS Data heading in the “Action” group box.• Select the Search IEVS Recipient Reports window. • Click [Open]. The Search IEVS Recipient Reports

window appears with your Office and Unit pre-filled.

2. IFD, NHR, NPM & PVS

Select your Report from the drop down field either IFD, NHR, NPM or PVS Report Type.

• Enter your search parameters with as much information as possible and click [Search].

• The Report information is displayed in the “Search Results” group box.

3. IFD, NHR, NPM & PVS

Select your case in the search results and click [Details] to view the details of a case, for:

• IFD continue at step 4• NHR continue at step 5• NPM continue at step 6• PVS continue at step 7

(Chart page 1 of 3)

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4. IFD The View IEVS - IFD Report response window appears with the General tab displayed. Select one or more of the following if applicable to the case:

• Select the Employment Data tab to view employment data.

• Select the SSI/SSP tab to view SSI/SSP information.• Select the Duplicate Aid Data tab to view duplicate aid

data.• Click [Discrepancy Letter] to print a discrepancy letter.• Click the [Response Document] to send a response

document back to IEVS with the information derived from your case. The Create IEVS Response Document response window appears.

• Select a Status.• Click Save. You return to the View IEVS - IFD Report

response window.

5. NHR The View IEVS - NHR Report response window appears.

• Resolve the IEVS CalWIN NHR Alert, it is not automatically resolved.

• CalWIN at the present time has no Verification letter. Use shelf stock form “Request for Employment Information” (SC 549) for the employer to complete, and/or manually generate CalWIN’s “Employment Questionnaire” (CSF 22) form for the client to complete.

• Document the processing of the NHR report on the Maintain Case Comments window in CalWIN in order to comply with regulations. The comments must include the date of review, the report run date, and the results of the review.

6. NPM • The View IEVS - NPM Data response window appears for viewing.

• Documents the processing of the NPM report on the Maintain Case Comments window in CalWIN in order to comply with regulations. The comments must include date of review, who processed the report and the results.

Step Report(s) Action

(Chart page 2 of 3)

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5.1.6 EW Responsibility Processing Recipient IEVS Reports

The EW MUST take the following steps:

• Resolve the IEVS CalWIN NHR Alerts, they are not automatically resolved.

7. PVS The View IEVS - PVS Report response window appears with the UI Data tab displayed. Select one or more of the following if applicable to the case:

• Click [Reduction Details] to view UI check reduction information. The View Check Reduction Details response window appears.

• Select the DI Data tab to view DI data. Click [Reduction Details] to view the DI check reduction information. The View Check Reduction Details response window appears.

• Select the RSDI Data 1 tab to view the first RSDI record. Select the RSDI Data 2 tab to view the second RSDI record. If there is no second record, this tab will be disabled.

• Click the [Response Document] to send a response document back to IEVS with the information derived from your case.

• Enter the necessary information in the “Programs Affected - Amount Overpaid/Overissued” group box, click the applicable check box in the “Type of Income for Affected Programs” group box, enter “Y” or “N” in the Did IEVS PVS match result in the discontinuance [Y/N] field, and select a Status.

• Click Save. You return to the View IEVS - PVS Report response window.

Note: When the value in the Status field is changed to “Approved, Discrepancy” and the window is saved, CalWIN sends the PVS response to IEVS in the nightly batch process. (“Approved, Discrepancy” for PVS is the only value that triggers the response to IEVS.) Once the file is sent to IEVS, CalWIN changes the value to “Processed, Discrepancy” on the Create IEVS Response Document window.

Step Report(s) Action

(Chart page 3 of 3)

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• Compare the IEVS Abstract hard copy data with CalWIN’s IEVS Report data in the View IEVS Recipient Report windows to make sure the data coincides. Take appropriate action in a timely manner according to the affected programs’ regulations. This may include contacting the client, making entries in the Data Collection Subsystem windows and/or requesting verification.

• Complete CalWIN’s Recipient Create IEVS Response Document window to send a response back to IEVS. Please note that the Status drop down field “Approved, Discrepancy” for PVS reports is the only value that triggers the response to IEVS.

• Document the processing of the IEVS Report on the CalWIN Maintain Case Comments window.

• Document the (NHR) and/or the Nationwide Prisoner Match (NPM) review on the Maintain Case Comments window of CalWIN. The IEVS NHR and NPM reports DO NOT have a CalWIN Response Document window. Therefore, the EW must document on the CalWIN Maintain Case Comments window in order to comply with regulations. The comments must include the report run date, the date of review, the outcome of the review (e.g., for NHR client already reported the job, income under 130% limit, alert set to make sure job is reported on next SAR 7) and the amount of overpayment/overissuance, if applicable.

5.1.7 Scanning

When applicable, all hard copies of the IEVS abstract reports that are processed should be signed by the EW and then scanned into the IDM system.

The CalWIN online IEVS reports remain in the CalWIN system; therefore it is NOT necessary to have them printed and scanned into the IDM system

5.2 CalWIN IEVS Recipient Reports

The CalWIN system sends demographic data on all recipients through an Interface system with California Department of Social Services (CDSS). When there is a match, CDSS sends a file back with the IEVS Recipient data.

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Exception:CDSS has made the decision that the IRS/FTB asset matches, fleeing felon match report and the BEER report will continue to be paper reports and will NOT be included in the CalWIN-CDSS interface process.

5.2.1 CalWIN Structure

The IEVS Recipient Report data is displayed by report type in CalWIN. The four report windows are:

1. NHR (New Hire Registry) Report

2. PVS (Payment Verification System) Report which includes:

• UI Data• DI Data• RSDI Data 1• RSDI Data 2

3. NPM (National Prisoner Match) Report which includes:

• Jail Reporting System Match• California Youth Authority Match• Nationwide Prisoner Match

4. IFD (Integrated Fraud Detection) Report which includes:

• General• Employment Data• SSI/SSP • Duplicate Aid Data

[Refer to “Processing Recipient IEVS Reports,” page 5-3.]

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5.3 New Hire Registry

5.3.1 Overview / Purpose

The New Hire Registry (NHR) is a monthly report which identifies CalWORKs, CalFresh, General Assistance and Medi-Cal recipients who are newly employed, rehired or who have recently returned to work.The match uses the employee’s Social Security Number (provided to EDD by the employer) against MEDS.

This early employment information is intended to reduce overpayments/ overissuances and incorrect SOC amounts resulting when clients fail to report their earnings. Therefore, no later than 45 days from the date the NHR report run date, the EW must:

• Compare the information in the report with the information in the case record, and

• Initiate appropriate action(s) if there is a discrepancy.

5.3.2 Employer Requirements

Legislation enacted in 1994 requires certain employers to report to EDD, individuals who have been hired or rehired, within 30 days of their employment if:

• The individual is age 18 or over, and• Anticipated wages are at least $300 per month.

Employers in the following industries are required to report information to EDD within 30 days of hiring or rehiring an employee, unless they have fewer than four employees:

• Landscape and Horticultural Services• Building Construction• Heavy Construction (other than Building Construction)• Construction Special Trade Contractors• Motor Freight Transportation and Warehousing• Water Transportation• Wholesale Trade - Durable Goods• Wholesale Trade - Nondurable Goods• Automobile Dealers and Gasoline Service Stations

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• Eating and Drinking Places• Holding and Other Investment Offices• Hotels and Other Lodging Places• Business Services• Auto Repair, Services and Garages• Motion Pictures• Health Services• Engineering, Accounting, Research, Management and Related Services

5.3.3 CalWIN “View IEVS - NHR Report”

The NHR report information is transferred monthly through an interface system from CDSS to CalWIN. The report will not be generated each successive month the individual is employed; therefore, if a report is not received in the following month it does NOT mean the individual is no longer employed.

The “View IEVS - NHR Report” displays the following information:

NO. DATA ELEMENT DESCRIPTION

1. NAME (last, first, middle initial)

Name of the recipient as known for the SSN matched.

2. DATE OF BIRTH MM/DD/YYYY

Date of birth per MEDS for this SSN.

3. SEX “M” (male) or “F” (female) per MEDS for this SSN.

4. SSN SSN per MEDS for this SSN.

5. CO The County Code should always be “43” for Santa Clara County.

6. AID CODE 2-digit aid code per MEDS for this SSN in the match month.

7. CASE NO. 7-digit case serial number in MEDS for this recipient in the match month.

8. FBU One digit FBU in MEDS for this recipient in the match month.

9. PER NO Person number in MEDS for this SSN in the match month.

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10. EMPLOYEE NAME Last name and first initial.

There may be differences in the spelling of the last name compared to the name in MEDS, but if the first initial is the same, the NHR match considers it to be the same person due to the SSN.

When the last name is different from the MEDS last name, check the SSN verification code (VC). If the VC is validated, the person listed may be illegally using the SSN of the MEDS recipient.

• A DA fraud referral may be necessary (i.e. the EW suspects a family member is working and using a child’s SSN).

• It may be necessary to clarify the person’s SSN by sending the client to the Social Security office with an MC 194.

11. EMPLOYER NAME & ADDRESS

The employer listed in the New Hire Registry for the SSN as matched with MEDS. The address as given by EDD for this employer.

IMPORTANT: Do NOT automatically discount employment information if the employer address is out of the area.The address on the NHR Report may be a corporate or payroll headquarters, or a parent company.

If the employer is a temporary agency or a chain, it is important to determine the actual work site location.

12. SEAN State Employer Account Number. This is not the same as the FEIN listed on IRS and FTB abstracts.

13. FEIN Federal Employer Account Number.

14. SIC/NAICS Standard Industrial Classification/North American Industry Classification.

15. HIRE DATE Hire date reported by the employer to EDD.

17. CAPTURE DATE Date the information was posted to the EDD New Hire Registry.

18. COUNTY County of the employer.

NO. DATA ELEMENT DESCRIPTION

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5.3.4 Processing NHR Reports

EWs must take the following actions when an NHR Report is received, as quickly as possible, but no later than 45 days after the report run date:

STEP ACTION

1. Receives a TMT for NHR processing and compares the information in the case record to that on the NHR abstract to determine if it affects the recipient’s eligibility or the amount of benefits. Use the following documents, as needed:

• SAWS 2Plus/CF 285• SCD 549A or SCD 549B• SAR 7/QR7• Paystubs• Other IEVS reports.

TMTs are not created for intake because review of all IEVS reports is part of the initial eligibility determination process.

2. If there is... Then the EW must...

No discrepancy between the information in the case and the NHR report,

Select the IEVS - NHR from the Case Comment Type on the CalWIN Maintain Case Comments window and document the report run date, review date and the outcome of the review (e.g., for NHR client already reported the job).

Information not reported or inconsistent with the information in the case file,

• Set up a CalWIN case alert to be reviewed when the SAR7/QR7 or RRR is due, whichever is sooner.

• Select the IEVS - NHR from the Case Comment Type on the CalWIN Maintain Case Comments window and document the report run date, review date and the outcome of the review (e.g. discrepancy exists between NHR and case information, alert set-up for follow-up).

• Ensure that the employment is reported and verification provided at the next SAR7 or RRR, whichever occurs first.

Note:

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5.3.5 Follow-Up on NHR Reports with Discrepancies

Follow-up on a discrepant NHR report should occur during the next report processing or at RRR, whichever occurs first.

Income Report Submit Month

The actions in the following chart should be taken for households with a SAR7/QR7 due:

IF THE CLIENT... THEN...

Provides all information/ verifications with SAR7/QR7 report

• Use the information to determine future month eligibility and take all appropriate budget actions.

• Calculate an over-payment and over-issuance, if appropriate, when a client failed to meet their MANDATORY mid-quarter reporting responsibilities.

[Refer to CalWORKs Handbook, “Budgeting [EAS 44-313],” page 44-1 and CalFresh Handbook “Semi-Annual Reporting Requirements,” page 24-1, for SAR rules.]

• Document on the CalWIN Maintain Case Comments window in order to comply with regulations. The comments must include the outcome of the NHR follow-up (e.g. discrepant or non-discrepant and the amount of overpayment/overissuance, if applicable.

Does not provide employment information or verification with SAR7/QR7 report

Follow the process for an incomplete SAR7.

[Refer to CalWORKs Handbook, “SAR 7 Returned Incomplete,” page 9-17, CalFresh Handbook “Incomplete SAR 7,” page 25-17 and GA Handbook “Incomplete QR 7 - “Y” Hold Procedures,” page 15-7, for more information on incomplete SAR7/QR7 processing.]

RRR Month

The following actions should be taken by the EW for households with an RRR due:

• Request employment verification with the RRR appointment notice.

• Use the information to determine future month eligibility and take all appropriate budget actions.

• Calculate an over-payment and over-issuance, if appropriate, when a client failed to meet their MANDATORY mid-quarter reporting responsibilities. Refer to CalWORKs Handbook Chapter 44 and CalFresh Handbook Chapter 24 for SAR rules.

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• Document on the CalWIN Maintain Case Comments window in order to comply with regulations. The comments must include the outcome of the NHR follow-up (e.g. discrepant or non-discrepant and the amount of overpayment/overissuance, if applicable).

5.4 Payment Verification System (PVS)

5.4.1 Overview

Each month the PVS process takes recipient names, SSNs and birthdates from MEDS/CDB and performs a computer match against SSA and EDD records. When a match is found, an abstract (PVS040) is sent to the county.

In order to ensure IEVS data is accurate and received on all required individuals it is essential SSNs are entered correctly on MEDS/CDB.

On February 16, 2007, the California Department of Social Services (CDSS) advised CalWIN counties that CDSS would cease producing the secondary output namely paper, tape, CD, etc. for the Payment Verification System PVS030 and PVS040 Recipient Abstract Reports. As an alternative to a secondary output, CDSS offered CalWIN counties an opportunity to access the PVS030 and PVS040 files via a secure server called Tumbleweed. Santa Clara chose to receive the secondary output as of April 6, 2007 through Tumbleweed. The PVS reports are only printed upon request through the Program Bureau.

5.4.2 Format

PVS reports are divided into separate sections Tabs. Each separate benefit section shows match results.

Section headings Tabs indicate and separate the programs covered. The programs are listed in the following order:

• UI• DI.• RSDI -Data 1• RSDI-Data 2

Persons who receive more than one type of benefit will appear separately under each program.

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5.4.3 Match Found

A “Match Found” tab will be enabled.

It also identifies SSNs not submitted to SSA because they are not within a valid range.

If no matches are found, there will be no PVS report for the case.

There will be no PVS for RSDI recipients unless the client is new or the amount of benefits is being changed.

5.4.4 Active Persons

All individuals in the case who are active on MEDS are listed on the PVS040. Persons who receive more than one type of benefit will appear separately under each program.

5.4.5 Inactive

Inactive persons cannot be added to the IEVS Recipient System.[Refer to “Disqualified or Excluded Persons,” page 4-2 in the Common-Place Handbook.]

5.4.6 How Current is the Data?

The PVS040 will give you the following information about income received:

Source 2nd Prior Month Prior Month Current Month

RSDI Social Security None Received the amount listed

Will receive the amount listed

UIB/DIB Received the amount listed

Lists the amount received in the first 15 to 18 days of the month

Not listed

5.4.7 Primary Verification

PVS may be used as primary verification. This is the same as the applicant system. [Refer to “IEVS as a Verification,” page 3-6.]

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5.4.8 Secondary Verification

For CalWORKs, CalFresh and Medi-Cal, if the client disputes the information provided on the PVS040, further verification is required.

[Refer to “Resolving Abstract Report Discrepancies,” page 4-9 for additional information.]

5.4.9 Exploring Health Coverage

The PVS CalWIN abstract reports are income verifications processed by the case carrying EW.[Refer to “Processing Recipient IEVS Reports,” page 5-3.] The EW must also explore eligibility for other health care coverage. Use the following chart:

IF... AND... THEN...

The PVS040 report shows UIB benefits have stopped

There are still benefits remaining,

The EW should inquire about the client’s employment status.

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5.4.10 Time Frames

The EW must complete the case review within 45 days from the date the PVS report is received in CalWIN for CalWORKs, CalFresh and Medi-Cal.

The client is currently employed or had past employment and received a Medi-Cal card,

Ask the applicant whether they are or were covered by employer health insurance. If “no” write none, if “yes” complete the following CalWIN Subsystems:

Select the Display Individual Attributes Summary Subsystem:• Click on the [Health Care Information] tab,

complete and Save.

Select the Display Health Care Coverage Summary Subsystem. • Click Add or select the insured person and click

the Detail icon.• The Collect Health Care Coverage Detail

window appears, complete the window, and• Click on [Insured Individuals...] button. The

Collect Insured Individual Detail window appears, complete and Save.

Select the Display Medical Expense Summary Subsystem, if applicable, when the client has to pay for the medical insurance.• Click Add or select the insured person and click

the Detail icon.• The Collect Medical Expense Detail window

appears, complete the window.• Click the [Billing and Payment...] button. The

Collect Billing and Payment Detail window appears, complete.

• Click [Payment Details...] button, the Collect Payment Details window appears, complete and Save.

• Click the [Bill Discrepancies...] button if applicable from the Collect Billing and Payment Detail window, the Collect Hunt Vs. Kizer Benefits Denial Detail window appears, complete and Save.

IF... AND... THEN...

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The CalWIN PVS abstract report “run date” is the date the report is received. PVS reports are printed around the 1st or 2nd work day of each month and sent to the counties no later than the 5th of the month. This date begins the 45-day processing period.

5.4.11 Delays

A delay in this time frame may be allowed (in only up to 20% of the cases) when the EW and the client are attempting to resolve any discrepancies.

5.4.12 Response Document

Response documents are required for all recipient cases having a:

• Discontinuance of eligibility• Change of benefits• Share of cost due to IEVS data.

Enter the IEVS report data into CalWIN’s Create IEVS Response Document response window for the recipient report.

[Refer to “Processing Recipient IEVS Reports,” page 5-3.]

5.5 PVS Processing

5.5.1 “Continuing” Eligibility Process

The EW must review all PVS in CalWIN Recipient IEVS Report. The EW takes appropriate action and completes CalWIN Create IEVS Response Document response window, when appropriate, within the 45 day time frames set by the federal government.

[Refer to “Processing Recipient IEVS Reports,” page 5-3.]

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The continuing eligibility PVS process is as follows:

STAGE WHO ACTION

1. EW • The worker must go into CalWIN Interface Activities on the Navigate CalWIN window.[Refer to “Processing Recipient IEVS Reports,” page 5-3.]

Reviews the PVS CalWIN report comparing the information with case information on the:

• SAWS2 Plus, CF285, etc.• SAR7• “Referral To/From Social Security” (SCD 169 or SCD 1955)

Resolves any discrepancy between the PVS CalWIN report and the case record. This may involve contacting the client, EDD or SSA.

IF THERE IS... THEN EW...

A change in benefits due to PVS CalWIN reports information,

Selects Approved, Discrepancy in the Status field on the Create IEVS PVS Response Document window. [Refer to “PVS040 Response Document,” page 5-26] and the CA-150-IEVS Payment Verification System Reports]

No change in benefits due to PVS CalWIN reports information,

Selects Processed, No Discrepancy on the Create IEVS Response Document window. [Refer to “PVS040 Response Document,” page 5-26.] for example and the CA-150-IEVS Payment Verification System Reports]

Documents the report run date, review date, the outcome of the review (e.g. discrepant or non-discrepant) and the amount of overissuance/overpayment, if applicable on the Maintain Case Comments window in CalWIN.

3. EW Supv. Spot-reviews cases in CalWIN to ensure that CalWIN PVS reports processing is being done correctly and timely, and documentation is clear and consistent.

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5.6 RSDI Match

5.6.1 Match

RSDI information is prospective. There must be a complete match with MEDS/CDB for a report to be generated.

The RSDI match is made on:

• SSN• Name• Sex• Date of birth.

5.6.2 Payment Information

The benefit amount appearing on the PVS report in CalWIN is the amount paid in the prior month and the amount expected to be paid in the current month. After the receipt of an initial report of a recipient's benefit, no additional report will be generated until the benefit changes. A change could be an increase, decrease, or termination.

Example:If a beneficiary received $150 in October, and will receive $158 in November, the county will receive another report showing this change on or about November 8.

5.6.3 Description of the RSDI Match

The following is a description of the information contained in the RSDI Match:

SECTION DESCRIPTION

CASE INFORMATION AS REPORTED THROUGH MEDS INPUT

The match shows case record information as reported through MEDS/CDB.

MATCH FOUND There will only be an entry in this section if there is a match.

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INFORMATION SENT TO SSA

Shows the information on the recipient file from the MEDS/CDB file.

INFORMATION RETURNED FROM SSA

Shows the matched identification information returned by SSA. It may or may not show the beneficiary #.

IF.... THEN....

The match cannot be made because of a discrepancy,

SSA will return the same information received. The communication code message will identify when a match cannot be made and why.

SSA CLAIM NUMBER This is the SSN under which benefits are being paid. If benefits are being paid from another SSN account, the account number will be shown here. All individual claims will be shown.

BENEFIT AMOUNT The previous month's benefit level. If nothing appears in this box, it does not mean an absence of benefits in that month. It only means this is the first month PVS has notified SSA regarding this individual’s RSDI income.

SECOND BENEFIT AMOUNT

The benefit amount of the present month. If a change has occurred it will show here. A printout will only be generated on a first inquiry, or automatically when a change in data has occurred. The EW can assume the amount being received is continuing for the individual until another printout is received.

ENTITLEMENT The month and year the individual first began receiving benefits on this claim. The initial check may not have been issued timely. Discrepancies between the clients reporting and the abstract must be verified.

REMINDER: For CalWORKs, retroactive payments are counted as income in the month received. For CalFresh, only the current months benefits are counted as income, the retroactive payment is counted as property in the month received.

PREMIUM PAYER CODE Shows who is making the premium payment for Medicare. It will generally be the individual or the State. “Self” indicates the beneficiary is making their own payment. The State's payer code is 050. The code indicates Buy-In is in effect. The EW is to assume Medicare Buy-In is effective in the third month of eligibility although State Buy-In will not be reflected here for some further period of time. Buy-In can also be verified via the MEDS INQB screen.

SECTION DESCRIPTION

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5.7 UIB Match

5.7.1 Match

UIB information is retrospective.

The UIB match is made on the SSN only.

5.7.2 Payment Information

The information appearing on the PVS report includes about 15 to 18 days of the prior month and the entire month before.

Example:Information received by the county on or about November 8 will contain UIB and DIB payments made approximately between September 1 and October 17.

BUY-IN AMOUNT The amount of the individual's Medicare Buy-In payment. If the beneficiary pays their own Medicare Buy-In payment and has the amount withheld from the RSDI benefit, the premium amount reduces the amount of the SSA benefit. However, this reduction will not be reflected in the benefit amount in BENEFIT or SECOND BENEFIT amount.

PAYMENT STATUS MESSAGE

This message gives the status of the individual's claim. Typically, it will indicate an open or closed claim or the reason for the change to the benefit amount.

COMMUNICATION MESSAGE

Additional information about mismatched names, duplicate inquires, or incorrect SSNs, etc.

SSA OTHER STATE CONFLICT

Identifies a client who moved from California to another state, or from another state to California.

SECTION DESCRIPTION

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5.7.3 Description of The UIB Match

The following is a description of the information contained in the UIB Match:

SECTION DESCRIPTION

INFORMATION SENT TO EDD

The MEDS individual case member identifying information sent to EDD for matching.

INFORMATION RETURNED BY EDD

Match identification information returned by EDD, and matched by SSN.

Gives the most current field office.

Shows any other SSN the recipient may be known under at EDD.

DATE OF LAST CLAIM ENTERED EDD FILE

The date of the most recent (last) claim filed for the SSN.

BEGIN DATE OF CLAIM This is the date eligibility for benefits under the current claim began. There may be a one week waiting period before benefits are actually paid.

EXTENSION EFFECTIVE DATE

This is the date an extension was filed and the effective date of the extension.

MAXIMUM BENEFITS Maximum amount of UI benefits which may be distributed.

WEEKLY BENEFITS Maximum weekly benefit amount should be used in budgeting unless the reduction is an allowable deduction.

REMAINING BENEFITS Remaining benefits left on this particular UIB claim.

CHECK ISSUED This date is the date the field EDD office authorized the UI benefit amount. See below for clarification.

IF the field... THEN...

Shows a date, The date under “Check Issued” is the date the benefit was authorized.

Is blank, The date under “Check Issued” has been removed and no longer provides information about issuance date.

This is the date the check is authorized; NOT the date the check is received. The beneficiary will receive the check 1-5 days later. For computational purposes assume 3 days.

REMINDER: If there is a break in benefits, the worker should inquire if the client was employed.

AMOUNT Shows the amount of the weekly UI benefit issued to the individual.

CHECK NUMBER The warrant number of the check issued.

WEEK ENDING Gives the week ending period for the UI benefits issued.

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5.8 DIB Match

5.8.1 Match

DIB information is retrospective.

The DIB match is made on the SSN only.

5.8.2 Description of the DIB Match

The following is a description of the information contained in the DIB Match:

TREASURER CLEAR DATE

Dates entered here do not give us any information, except the warrant was cashed.

REDUCTION AMOUNT The amount of reduction to the UIB payment.

REDUCTION REASON Codes explaining the reason for the reduction.

(REDUCTION REASONS)

Description of reduction codes.

1) Earnings 2) Benefit Reduction/Penalty 3) Workers Compensation 4) Work Share 5) Recomputation Down 6) Full Overpayment Offset 8) Partial Overpayment Offset 9) Pension Payment A) Child Support B) Voluntary Withholding

SECTION DESCRIPTION

INFORMATION SENT TO EDD

The MEDS individual case member identifying information sent to EDD for matching.

INFORMATION RETURNED BY EDD

Match identification information returned by EDD, and matched by SSN.

FIELD OFFICE Gives the most current field office.

SECTION DESCRIPTION

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CROSS REFERENCE

Shows any other SSN the recipient may be known under at EDD.

BEGIN DATE OF CLAIM

This is the date eligibility for benefits began.

MAXIMUM BENEFITS

Maximum amount of DIB which may be distributed.

WEEKLY BENEFITS Maximum weekly benefit amount used in budgeting unless the reduction is an allowable deduction.

REMAINING BENEFITS

Remaining benefits left on this particular DIB claim.

CHECK ISSUED The date the check is authorized; NOT the date the check is received. The beneficiary will receive the check 1-5 days later. For computational purposes assume 3 days.

AMOUNT The amount of the DI benefit issued to the client.

CHECK NUMBER The warrant number of the check issued.

TREASURER CLEAR DATE

Dates entered here do not give us any information, except when the warrant was cashed.

REDUCTION AMOUNT

The amount of reduction to the DI benefit.

REDUCTION REASON

Codes explaining the reason for the reduction.

(REDUCTION REASONS)

Description of the reduction reason codes.

1) Partial Wages 2) DI Voluntary Plan Reduction 3) Workers Compensation 4) WCVR 5) Recomputation Down 6) Full Overpayment Offset

8) Partial Overpayment Offset A) Child Support B) Benefit Garnishment C) Prepayment Reduction D) Unallocated Sick Leave - Wage E) Sick Leave - Wage F) Simultaneous Coverage

SECTION DESCRIPTION

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5.9 PVS040 Response Document

5.9.1 Overview

The EW must complete the CalWIN Create IEVS Response Document window regardless of whether the information has impact or not. [Refer to “Processing Recipient IEVS Reports,” page 5-3.]

5.9.2 Processing the Response Document

The response document is completed through CalWIN. The Create IEVS PVS Response Document window must be processed.

The worker:

• Clicks on the [Response Document] button on the View IEVS - PVS Report window which brings up the Create IEVS PVS Response Document window.

• Enters the Status and any other applicable information.• Saves the data, which sends it through an interface to the state.

[Refer to “Processing Recipient IEVS Reports,” page 5-3.] for instructions on how to access PVS report.]

5.10 Jail/Prison Matches

5.10.1 Jail Reporting System (JRS)

The California Department of Social Services (CDSS) developed the Jail Reporting System (JRS) Match as a result of Senate Bill 1556, Chapter 10 to Part 2 of Division 9 of the W & I Code. This legislation requires city and county jails throughout California to report to the state (CDSS), persons who are or were incarcerated for more than 30 days.

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Once a month, the information is matched against the MEDS Master Eligibility File to determine if individuals have received cash aid, CalFresh or Medi-Cal while incarcerated. The initial match criteria used is the Social Security Number (SSN). Criteria for the secondary match include name, aliases, birthdates and sex.

The state sends the Jail Reporting System (JRS) Matches to the District Attorney’s Office, Public Assistance Fraud Division.

5.10.2 California Youth Authority (CYA)

The CYA matches are completed using the California Youth Authority files and matching against the MEDS Master Eligibility file for beneficiaries for the month of incarceration plus one prior month.

Note:The age of persons who are confined by the California Youth Authority can range from age 10-25 years old.

Once a month, the information is matched to determine if individuals have received cash aid, CalFresh or Medi-Cal while incarcerated. The initial match criteria used is the Social Security Number (SSN). Criteria for the secondary match include name, aliases, birthdates and sex.

The state sends the CYA Matches to the District Attorney’s Office, Public Assistance Fraud Division.

5.10.3 Nationwide Prisoner Match (NPM)

The NPM is a semiannual match run in April and October of each year. This match is run nationwide as opposed to the JRS and CYA matches which are only within California. The NPM file is run against the JRS file to eliminate any duplicate prisoner information. This match uses the SSA Prisoner Update Program System (PUPS) database to match against CalFresh, CalWORKs and Medi-Cal recipients.

The match criteria for the NPM is the SSN which has been verified for the inmate by PUPS.

The state sends the NPM Matches to the District Attorney’s Office, Public Assistance Fraud Division.

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Note:CalWIN does not have a response document window. for the Nationwide Prisoner Match (NPM) the review must be documented on the Maintain Case Comments window of CalWIN. The comments must include the date of review, who processed the report and the results.

5.11 JRS, CYA, NPM, DPM and FFM Process

JRS, CYA, NPM, DPM and FFM match information is only an indication that fraud MAY be occurring. Therefore, the following actions are required to fully process match information:

STAGE WHO ACTION

1. Investigator Receives JRS, CYA, NPM, DPM and FFM match reports.

Establishes the match is valid. (i.e. information is appropriate, it appears to be the same individual as on the case record, checks CalWIN record for aid received, clarifies incomplete or inconsistent match information with the jail/CYA/prison, etc.).

Sends a “Public Assistance Fraud Match” (DA 1) and response document to the EW.

NOTE: If the case is a Medi-Cal only, the investigation will be completed by a state Department of Health Services Investigator.

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2. Eligibility Worker

Compares the information provided with the period the individual has received assistance, including cash aid, CalFresh and Medi-Cal.

Immediately send a letter to the client requesting the client contact us within 10 days to discuss the matter.

IF THE CLIENT... THEN...

Does not respond, For CalWORKs and CF HHs

• Take no action until the SAR 7 Submit Month UNLESS the information should have been reported on the prior SAR 7. a. If it should have been reported on the prior SAR 7, discontinue benefits with a timely NOA for failure to provide essential information.

• Set an alert on the case to make sure the information is reported on the next SAR 7.

• If the information is not reported on the SAR 7 and no explanation is given, the SAR 7 is considered incomplete. Discontinue aid with a 10-day NOA due to an incomplete SAR 7.

Exception: FFM Match Report Discontinue benefits at the end of the month of discovery with a timely NOA for failure to provide essential information.

For GA HHs

• Discontinue benefits with a timely NOA for failure to provide essential information.

For Medi-Cal

• Discontinue adults with a timely NOA for failure to provide information.

STAGE WHO ACTION

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IF THE CLIENT... THEN...

Provides all information/ verifications and there is no discrepancy,

• Discusses the information in person with the payee/recipient and asks the recipient to describe their situation on a “General Affidavit” (SCD 101).

• Determines the impact, if any, on future month eligibility and takes all appropriate case actions (i.e. determines if other family members remain eligible, recomputes budget, discontinues aid with an appropriate Notice of Action [NOA], etc.)

Provides information and there is a discrepancy,

If the client denies the information on the match, continue the assistance for the affected household member. Further investigation will be done by the DA investigator.

Makes a referral to the DA, regardless of whether the payee/recipient admits or denies these allegations, including:

• The original affidavit (SCD 101)• A copy of the DA 1 • The response document.

Include any other inconsistent/conflicting information noted in the case file.

Contacts the DA investigator if there is a discrepancy, and/or further clarification or if an extension of the due date is needed.

3. DA Investigator

Conducts an investigation to gather facts proving or disproving the allegations.

Makes a referral for the OP/OI computation to IEVS, if applicable.

4. EE from IEVS

Computes/processes any resulting overpayments and/or overissuances

Returns the case to the DA Investigator.

5. DA Investigator

Completes the IEVS response document and statistical reporting to the state.

STAGE WHO ACTION

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5.12 Deceased Person Match (DPM)

The Deceased Persons Match (DPM) is an automated match verification system which is run twice a year, in April and October. CalWORKs and CalFresh recipients are matched against the Social Security Administration (SSA) Death Master file in order to ensure that:

• Deceased persons are not being aided in the CalWORKs and CalFresh Programs, and

• CalWORKs and CalFresh benefits are not issued to individuals using the Social Security Number of a deceased person.

The match criteria for the DPM is the Social Security Number (SSN), last name, first name, middle initial and date of birth.

The DPM information is sent to the District Attorney - Public Assistance Fraud Division. The DA must send a response to the state on every match received. The form must also be scanned into the IDM system.

SECTION DESCRIPTION

RUN DATE The printing/processing date

PROCESS DATE The month and year of the match

INFORMATION SENT TO SSA

Shows recipient information sent to SSA

INFORMATION RETURNED BY SSA

Shows information returned from the SSA Death Master File (DMF) record and indicates the source of the data. The “DMF” under source file indicates that the data came from the SSA DMF. This section gives the recipients SSN, name, sex, date of birth and date of death.

NOTE This information will only appear for the following reasons:

• If data was previously sent to the county• If the date of death has changed from the prior abstract.

This will not appear on a new abstract.

Description of Deceased Person Match:

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5.13 Integrated Earnings Clearance/Fraud Detection System (IFD)

IFD 440 abstracts are received by the IEVS unit quarterly. They are assigned to Eligibility Examiners (EE) and reviewed. The IFD 440s must be reviewed within 45 days. The IFD is a recipient system which matches:

• Employer reported wage data from EDD with the wages budgeted by counties for individuals whose data is submitted to CalWIN on the Welfare Recipient File

• Clients receiving duplicate aid in our county or other counties and states• Clients receiving SSI and benefits in our county.

The information received on the IFD 440 is seven to nine months old.

Note:Persons who worked for the federal government, are self-employed or who worked in another state are not included in this match. Those individuals will be listed on the BEER recipient matches.

The Interfaces Quarterly IFD 440 reports are generated on-line through CalWIN. The IFD 440 reports are viewed in the Interface Activity Subsystem by going into IEVS Data and selecting the Search IEVS Recipient Reports window.

Information Systems extracts the IFD 440 report and applies filter(s) to develop a list in Excel format for review assignment.

5.13.1 Processing IFD Open Cases

The following process is to be used to review IFD open cases:

FINDINGS WHO ACTION

No Discrepancy

IEVS EE

• Updates the Create IEVS IFD Response Document in CalWIN.• Documents action in the Maintain Case Comments window in

CalWIN.

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5.13.2 IFD on Closed Cases

When the IEVS Unit receives an IFD 440 on an already closed case, the processing time frames is 90 days after the report run date.

5.14 Asset Match - Federal Tax Board (FTB)

The annual FTB Asset match is a match of Medi-Cal Eligibility Data System (MEDS) beneficiary information against FTB’s interest and dividend file. The income information includes those submitted to FTB by banks, insurance companies, financial and investment institutions based in California or which have offices in California.

Potential Discrepancy

IEVS EE

Reviews the IFD 440 and determines there is a potential discrepancy.

Receives case and compares the IFD 440 to the case record, and determines whether or not to review for overpayment computation or if there is no impact.

IF... AND... THEN...

There is NO Impact,

• Updates the response document in CalWIN for that case disposition.

There is an IMPACT

The information is not in the case,

• Updates the response document in CalWIN for that case disposition.

• Sends to SIU for Investigating the Case.

There is an IMPACT

The information is in the case,

There is a possible Administrative Error.

• Updates the response document in CalWIN for that case disposition.[Refer to “Response Document,” page 5-18 and “Processing Recipient IEVS Reports,” page 5-3.]

FINDINGS WHO ACTION

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The county is required to process match reports on all open cases with reported income from assets of $50 or more. Information is 12 to 23 months old and shows only the interest and dividend unearned income from assets, not the account balances which is usually more. Matches are made on the SSN and last name.

If the case is closed, and the income from the asset is less than $250, no further action is required.

The Eligibility Examiner (EE) from the IEVS unit is responsible for processing all annual FTB Asset Matches for the recipient system. They will review the case record for all matches and determine if the asset has been reported.

5.14.1 Processing FTB Asset Match Abstracts

Use the following chart to process FTB asset match abstracts for all programs:

STAGE WHO ACTION

1. IEVS EE

Reviews the case record to determine if the asset was reported. The match will show the last 36 months of Medi-Cal usage data at the bottom.

IF THE ASSET WAS... THEN...

Reported, Write “no impact” on the asset match. Sign, date and scan report into the IDM system.

Not reported, • Scan the copy of the asset match into the IDM system.

• Sends the district office liaison an SCD 1605 form indicating “IEVS Unit is Investigating This Case”.

2. EW Determine if any further action is needed when the case is returned from the EE.

IF THE RD IS... THEN

Not due, • Take no further action unless notified by the EE at IEVS.

• Set an alert for the RD due month to make sure to discuss and resolve the discrepancy at that time.

Due, Resolve the asset discrepancy with the client before aid is continued. Contact IEVS, if necessary, to facilitate this process.

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5.15 IRS Asset Matches

The annual IRS Asset Match provides information on unearned income reported to IRS such as out-of-state accounts, lottery winnings, stocks and bonds, and any other income information not found in FTB files. The MEDS beneficiary file is

3. EE from IEVS

Obtains asset verification.

IF AFTER INVESTIGATION ELIGIBILITY...

THEN...

Is not affected, Sends an Alert to District Office liaison notifying him/her that there is NO discrepancy.

May be affected, Sends an alert to the district office liaison giving sufficient information to discontinue the case because the:

• Client has failed to cooperate, or• Client is not eligible.

The alert lists the reason for ineligibility.

Return the case to the district office caseload.

4. EW Documents on the CalWIN Maintain Case Comments window what actions were taken.

Enters the following information on the NOA when a case is discontinued:

• Name of asset• Account number (if applicable)• Amount of interest known• Action needed by the client.

Sends an alert to IEVS within five (5) working days of completion.

When IEVS is investigating the case and the client reveals assets to the EW rather than the investigator, the EW must:

• Take appropriate action immediately• Call IEVS with the information• Send copies of all verifications provided by the client to IEVS.

If the EW assigned to the task has information or knowledge which disagrees with IEVS findings, contact IEVS to resolve the difference.

STAGE WHO ACTION

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matched against the IRS’s Unearned Income File. The IRS and FTB asset matches are cross matched before sending them to the IEVS Unit in order to avoid duplication.

IRS ASSET MATCH RECORDS ARE NOT AVAILABLE TO EW STAFF DUE TO CONFIDENTIALITY REQUIREMENTS.

EEs from IEVS will compare the information in the case record with the Asset Match information.

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5.15.1 Processing IRS Asset Matches

Use the following chart to process IRS Asset Match abstracts for all programs:

STAGE WHO ACTION

1. Specialized IEVS EE

Review the case record to determine if the asset was reported. The match will show the last 36 months of Medi-Cal usage data at the bottom.

IF THE ASSET WAS... THEN...

Reported, 1. Documents on the CalWIN Maintain Case Comments window the actions taken and the dates the IRS and FTB Asset Match reviews were completed.

2. For non-converted cases, if applicable:

• Signs/documents actions taken on the Maintain Case Comments window.

• When applicable signs and dates each case on the back of the physical case, and

• Records that a IRS or FTB Asset Match review has been completed.

• A copy of the IRS and FTB Asset Match CANNOT be scanned into IDM due to confidentiality.

3. Records all information in the IEVS Report System for tracking and control.

Not reported, 1. Sends the client (case payee or responsible reporting party) form CW 63 requesting the asset information within 10 days.

2. Sets-up a 10 day follow-up Alert.

1) Sends the district office liaison an SCD 1605 form indicating “IEVS Unit is Investigating This Case”.

REMINDER: A copy of the IRS asset match can NOT be scanned into IDM.

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2. EW Determines if any further action is needed when the case is returned from the EE.

IF THE RD IS... THEN

Not due, • Take no further action unless notified by the EE at the IEVS Unit.

• Have the SCD 1605 scanned into the IDM system.

• Set an alert for the RRR due month to make sure to discuss and resolve the discrepancy at that time.

Due, Resolve the asset discrepancy with the client before aid is continued. Contact IEVS, if necessary, to facilitate this process.

3. Specialized IEVS EE

Obtains asset verification.

IF AFTER INVESTIGATION ELIGIBILITY...

THEN...

Is not affected, Notify the district office liaison through ALERT system that there is no discrepancy.

May be affected, Complete the “Communication Between IEVS Workers and Eligibility Worker” (SCD 1604) form giving sufficient information to discontinue the case because the:

• Client has failed to cooperate, or• Client is not eligible.

The SCD 1604 will list the reason for ineligibility.

STAGE WHO ACTION

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5.16 BEER Match

5.16.1 BEER

Beneficiary Earnings Exchange Record (BEER) is a match from Internal Revenue Service (IRS) files. The information is 12 to 24 months old. The matching process involves a three-step activity that may result in names different than those on MEDS. For example, a maiden name may appear.

Match criteria:

• The recipient’s SSN is matched against the Social Security wage file

4. EW Documents what action has been taken on the bottom of the SCD 1604, signs and dates.

Scans the completed SCD 1604 into the IDM system and sends an e-mail to IEVS within five (5) working days of completion.

Documents on the CalWIN Maintain Case Comments window what actions were taken. Enters the following information on the NOA when a case is discontinued:

• Name of asset• Account number (if applicable)• Amount of interest known• Action needed by the client.

Clears all eligibility factors when a case has been discontinued/closed at the request of the IEVS EE for failure to cooperate or failure to report assets, and the client reapplies (for CalWORKs this includes previously requested information).

When IEVS is investigating the case and the client reveals assets to the EW rather than the investigator, the EW must:

• Take appropriate action immediately• Call IEVS with the information• Send copies of all verifications provided by the client to IEVS.

If EW assigned to the task has information or knowledge which disagrees with IEVS findings, contact IEVS to resolve the difference.

STAGE WHO ACTION

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• The matched SSNs are then matched against the Federal Employer Identification Number (FEIN) files to eliminate duplicates that would have been included in the IFD/ECS process

• Unduplicated SSNs are then matched to MEDS using the SSN, date of birth and sex.

BEER RECORDS ARE NOT AVAILABLE TO EW STAFF DUE TO CONFIDENTIALITY REQUIREMENTS.

Designated IEVS EEs will compare the information in the case record with BEER records.

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5.16.2 Processing BEER Matches

The following process is to be used to review the BEER match:

STAGE WHO ACTION

1. Specialized IEVS EE

IF... THEN...

No Discrepancy or Potential Discrepancy has occurred,

• Documents on the CalWIN Maintain Case Comments window the results and the dates the “BEER” reviews were completed.

• Records the results on the Response Document page. This information will be transmitted to the State Fraud Unit as instructed.

• For non-converted cases, if applicable, signs the back of case record that a “BEER” review has been completed and documents on the Maintain Case Comments window.

• Retains all confidential documents in the designated locked room and destroyed per IRS destruction guidelines.

• Sends all documents for IDM with the exception of the actual abstract which is deemed to be confidential.

Discrepancy has Occurred,

Documents on the CalWIN Maintain Case Comments window and/or when applicable signs the back of case record that a “BEER” review has been completed.

Completes necessary paperwork if O/P has resulted and has paperwork scanned into the IDM system.

Notifies district office via SCD1604 with instructions about the assets or income which affect eligibility.

Upon completion of a discrepancy case all paper work is sent to the IEVS Supervisor for review and Supervisor sends all paper work to clerical with appropriate IDM instructions.

2. EW • Sends a timely Notice of Action (NOA) which contains all of the pertinent information regarding the O/P or ineligibility.

• Discontinues case if applicable.• Clears all eligibility before the case can be restored, regardless if

restoration is in continuing or intake.

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5.17 Fleeing Felon Match

In July 1998, CDSS began implementing the Fleeing Felon Match (FFM). This match is run on a monthly basis using the Department of Justice’s Wanted Persons File (WPF). The information is matched against the MEDS Master Eligibility File to determine if individuals have received cash aid or CalFresh.

The state sends the National Prisoner Matches (NPM) reports to the District Attorney’s Office, Public Assistance Fraud Division.

Revised: 09/07/16 Update #16-24