County of San Diego Health and Human Services Agency HHSA MediCal Program Guide Social Security Number SSN Requirement Introduction Number Page 4111 1 of 2 Revision Date June 1 2020 BackgroundEvery person requesting MediCal who has a Social Security Number SSN at the time of application is asked to provide it regardless of immigration status The applicant can indicate if they have a SSN in Section D on the MC 13 Purpose041101A This section establishes procedures for the following Situations where the customer is unable to provide or does not have a SSN SSN validation process SSN validation error resolution procedures 1 Policy041101B As a condition of eligibility for fullscope MediCal benefits each customer must either provide acceptable verification of SSN or cooperate in obtaining a SSN The following customers are exempt from this requirement Infants under the Deemed Eligibility program Refugees under Refugee Medical AssistanceEntrant Medical Assistance RMAEMA program 2 Procedure 041101C SSN Verification Verification must be received within 60 days of the date of application but not necessarily prior to the approval of eligibility NOTE Human Services Specialists HSS must apply SB 87 regulations before requesting SSN verification from a customer and attempt to verify the SSN through the ex parte process outlined in MPG 4712 Acceptable SSN verification includes Social Security card SSA form series OA702 SSA award letter SSN notification letters for IRCA aliens Medicare card SSA check showing the applicants name and SSN with the letters A HA J T or M following the SSN Income Eligibility Verification System IEVS applicant report with a code A or W in the SSNVER field 041101D Cooperation VerificationAcceptable verifications of cooperation include Completed application for a Social Security card Form SS5 MC 194 referral form annotated by a SSA official indicating that a completed form has been submitted Form SSA2853 MESSAGE FROM SOCIAL SECURITY signed by an official of the hospital where the baby was born o Note this form is not required for newborns qualified for Deemed Eligibility Proof of their attempt to apply for the number when SSA has not accepted the SSN application because of lack of documentation as outlined in MPG 041102E County of San Diego Health and Human Services Agency HHSA MediCal Program Guide Social Security Number SSN Requirement Introduction Number Page 4111 2 of 2 041101E Restricted Benefits Noncitizens eligible only for restricted benefits are NOT required to provide a SSN as a condition of eligibility The HSS will leave the SSN field blank in CalWIN MEDS will issue a pseudoSSN for the MEDS record If a noncitizen Then eligible for restricted grant eligibility if all other eligibility requirements are met MediCal claims to submit a referral to the State MediCal investigator if there is reason to have a SSN but believe that they are withholding any information relevant to their MediCal refuses to provide it eligibility or SOC provides a SSN use the SSN on form MC221 to obtain an IEVS via 1428 for any other mandated purposes NOTE Under no circumstances should a HSS knowingly submit an incorrect or fraudulent SSN to MEDS Program ImpactsNo Impact to other programs References ACWDL 1701 MEDIL 1003 MPG Letter 750 0412 Sunset Date This policy will be reviewed for continuance by May 31 2023 Approval for Release Rick Wanne Director Eligibility Operations County of San Diego Health and Human Services Agency HHSA MediCal Program Guide Referral to Social Security Administration SSA Number Page 4112 3 of 2 Revision Date June 1 2020 BackgroundThis section describes the policies for referring customers to SSA for a Social Security number SSN PurposeThis section is rewritten in the new format Policies have been updated to remove references to Immigration Reform and Control Act IRCA aliens Procedures are moved to Processing Guide 31 Policy When to Refer to SSA Refer customers to SSA in the following situations when the Customer cannot provide an acceptable SSN verification Customer does not have a SSN SSN is not validated by SSA and the case review andor customer states the County information is correct Customers date of birth does not match SSA files and the customer has proof of the correct date of birth Who to Refer to SSA The following people will be referred to SSA if they meet the criteria outlined above United States US citizens Immigrants that can provide SSA with one of the following documents o AR 3 o AR 3a o I94 o I95 o I151 o I181ab o I184 o I185 o I186 o I551 o I688 o I688A o SW434 Failure to Cooperate in Applying for andor Providing the SSNExamples of failure to cooperate include but are not limited to when the customer States that heshe will not provide the SSN if available or will not apply for SSN on hisher own behalf or a childs Refuses to provide information to SSA that is accessible to himher Fails to return the MC 194 after heshe was instructed to applyreapply for the SSN County of San Diego Health and Human Services Agency HHSA MediCal Program Guide Referral to Social Security Administration SSA Number Page 4112 4 of 2 Fails to obtain and submit the documentation required by SSA within 30 days of the date that the original SSN application was submitted but not accepted by SSA for lack of documentation See Processing Guide 31 when the client has refused to apply for or provide the SSN Procedure Referral Procedures See Processing Guide 31 to refer the customer to SSA Form MC 194 Not Accepted Due to Lack of Evidence See Processing Guide 31 when SSA indicates on the MC 194 that the application for SSN was submitted but not accepted due to lack of evidence Form MC 194 Accepted by SSASee Processing Guide 31 when the customer returns the MC 194 indicating that the SSN application was accepted Responses to Request for SSNSee Processing Guide 31 when the customer responds to the requests for the SSN indicating that heshe has not received the SSN Program Impacts None References MediCal Eligibility Procedures Manual 4MIIA Sunset Date This policy will be reviewed for continuance by May 31 2023 Approval for Release Rick Wanne Director Eligibility Operations County of San Diego Health and Human Services Agency HHSA MediCal Program Guide Social Security Number Validations Number Page 4113 1 of 3 Revision Date June 1 2020 BackgroundThe Department of Health Care Services DHCS has initiated a process in which the Social Security numbers SSNs of MediCal beneficiaries are matched against Social Security Administrations SSA records This process is called validation The process has two parts the validation process and the referral process Process Function Validation A daily match of all invalidated SSNs currently on the MediCal Eligibility Data System MEDS Referral Ongoing matching of people referred to SSA for either a replacement SSN card or an initial application Includes those people who could not be validated in the daily process Note The referral process will update MEDS on a daily basis PurposeThis section is rewritten in the new format No policies or procedures are changed though procedures are moved to Processing Guide 32 PolicyValidation Error Resolution To resolve invalidated SSNs compare the invalidated data with the case record to determine where the error is To compare the invalidated data with the case record data to determine if errors were made in the information forwarded to the state check for Incorrect SSN for example SSN belongs to another family member Transposition of a number in the SSN Incorrect digits in the SSN Incorrect spelling of the first andor last name Use of maiden name instead of married name Use of nickname or the use of two surnames for any of the children Incorrect gender andor date of birth If Then Errors are found in Correct the information in CalWIN either the CalWIN or Submit 1428 to MEDS operator to have the MEDS record MEDS record corrected No errors are found in Contact the beneficiary to verify the information by either the CalWIN or Requesting to view SSN card MEDS record Questioning the beneficiary if heshe used another name when County of San Diego Health and Human Services Agency HHSA MediCal Program Guide Social Security Number Validations Number Page 4113 2 of 3 applying for a SSN Requesting date of birth verification to compare with the month and year shown on the report The SSADHCS data match compares SSN in the following method and order 1 First six letters of the last name 2 First letter of first name 3 Gender 4 Year and month of birth If any of these fields do not match SSA notifies DHCS of those SSNs that were not validated Specific data elements that caused the mismatch are not identified Continue to check data elements after discovering inaccuracies to prevent duplicate invalidated SSN reports All corrections will be processed through MEDS and will be included in the next State Validation file submittal to SSA If the Then Record returns as validated The State files will be updated accordingly Beneficiary indicates that the worker has the Refer the beneficiary to SSA as outlined below correct information Referral Error Resolution See Processing Guide 32 to resolve invalidated SSNs or discrepancies in the SSN information Second MC 194 Returned SSA may respond with either of the following when they return Form MC 194 for a beneficiary that has been referred to SSA a second time SSA is revising its record to match the State record for each discrepant item SSA is not revising its record for at least one item but may be revising other items If SSA is revising their record no action is necessary See Processing Guide 32 if SSA is not revising its record Procedure See above Program ImpactsNone References MediCal Eligibility Procedures Manual 4MIIA Sunset Date This policy will be reviewed for continuance by May 31 2023 County of San Diego Health and Human Services Agency HHSA MediCal Program Guide Social Security Number Validations Number Page 4113 3 of 3 Approval for Release Rick Wanne Director Eligibility Operations County of San Diego Health and Human Services Agency HHSA MediCal Program Guide MediCal Eligibility Data System MEDS Impact Number Page 4114 1 of 2 Revision Date June 1 2020 BackgroundMEDS will receive information from all the validation processes This information will be compared to the MEDS database and this exception message will be generated SS30 SSN citizenship and identity validation PurposeThis section is rewritten in the new format No policies or procedures are changed though procedures are moved to Processing Guide 33 PolicyReferral ProcessingIf the Social Security Administration SSA and MEDS information is not consistent enough to validate the Social Security Number SSN the following will occur An alert is added to the MEDS beneficiary record MEDS Name Cross Reference File is also updated to include the name and birth date from the referral record If the Then the MEDS beneficiary record Beneficiary information is consistent Is updated to show that the SSN was validated SSA and MEDS information is not consistent Has an alert added to show the error enough to validate the SSN Referral Alerts Referral alerts are issued when Followup action is needed for MEDS Information obtained from the referral may be useful to the worker Referral alerts will appear in CalWIN as MEDS Exceptions For a listing of these messages see Desk Aid 107 Procedures Validation Process See Processing Guide 33 for the validation process SSN Changes See Processing Guide 33 for SSN changes Date of Birth ChangesSee Processing Guide 33 for date of birth changes Date of Birth Changes Previously ReportedSee Processing Guide 33 for when the beneficiary has reported a date of birth change and the new date of birth was entered in CalWIN County of San Diego Health and Human Services Agency HHSA MediCal Program Guide MediCal Eligibility Data System MEDS Impact Number Page 4114 2 of 2 Program ImpactsNone References MediCal Eligibility Procedures Manual 4MIIA Sunset Date This policy will be reviewed for continuance by May 31 2023 Approval for Release Rick Wanne Director Eligibility Operations