Article 4 Section 11 Social Security Number Requirements Table of Contents TITLE MPG CITE Social Security Number Requirement Introduction 41101 Referral to Social Security Administration 41102 SSN Validation 41103 MEDS Impact 41104 Sample I Beneficiary Letter APPENDIX A SSN Notification Letter for IRCA Aliens APPENDIX B Information About When You Will Receive Your Babys Social Security Card SSA2853 APPENDIX C MEDS Alerts APPENDIX D County of San Diego Health and Human Services Agency HHSA MediCal Program Guide Social Security Number SSN Requirement Introduction Number Page 041101 2 of 18 Revision Date April 20 2017 Background Every 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 whether or not heshe has a SSN in Section D on the MC 13 Purpose 041101A This section establishes procedures for the following Situations where the applicantbeneficiary is unable to provide or does not have a SSN SSN validation process SSN validation error resolution procedures Policy 041101B As a condition of eligibility for fullscope MediCal benefits each applicantbeneficiary must either provide acceptable verification of SSN or cooperate in obtaining a SSN The following applicantsbeneficiaries would be exempt to this regulation Infants under the Deemed Eligibility program Refugees under Refugee Medical AssistanceEntrant Medical Assistance RMAEMA program 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 Workers must apply SB 87 regulations before requesting SSN verification from an applicantbeneficiary 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 County of San Diego Health and Human Services Agency HHSA MediCal Program Guide Social Security Number SSN Requirement Introduction Number Page 041101 2 of 2 041101D Cooperation Verification Acceptable 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 b 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 hisher attempt to apply for the number when SSA has not accepted the SSN application because of lack of documentation as outlined in MPG 041102E 041101E Restricted Benefits Aliens eligible only for restricted benefits are NOT required to provide a SSN as a condition of eligibility The worker will leave the SSN field blank in CalWIN MEDS will issue a pseudo SSN for the MEDS record If Then the worker must an alien eligible for restricted MediCal claims to have a SSA but refuse to provide it grant eligibility if all other eligibility requirements are met submit a referral to the State MediCal investigator if there is reason to believe that they are withholding any information relevant to their MediCal eligibility or SOC an alien 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 worker knowingly submit an incorrect or fraudulent SSN to MEDS Program Impacts No Impact to other programs References ACWDL 1701 MEDIL 1003 MPG Letter 750 0412 Sunset Date This policy will be reviewed for continuance on or by May 31 2020 041102 Referral to SSA A Workers should refer applicantsbeneficiaries to SSA in the following When to Refer situations to SSA 1 when the applicantbeneficiary cannot provide an acceptable verification SSN 2 when the applicantbeneficiary does not have a SSN 3 when the SSN is not validated by SSA and the case review andor beneficiary states the County information is correct 4 when the beneficiarys date of birth does not match SSA files and the beneficiary has proof of the correct date of birth B The following individuals will be referred to SSA if they meet the Who to Refer criteria outlined above to SSA 1 US Citizens 2 Aliens that can provide SSA with one of the I151 I94 I95 I184 I185 I186 I688A SW434 AR3 following I181ab I688 AR3a 3 IRCA aliens applying for amnesty C IRCA aliens with no SSA letter or SSN who request fullscope benefits IRCA Aliens must be referred to SSA as outlined below Referral Procedure Step Action 1 Provide the applicant an Application for a Social Security Card Form SS5 2 Applicant submits completed Form SS5 to INS 3 INS forwards Form SS5 to SSA 4 SSA assigns a SSN to the IRCA alien via SSN Notification Letter for IRCA Aliens NOTE A Social Security card will not be issued 5 IRCA Aliens must provide any of the following verifications within 60 days from the date of application SSA letter Proof of SSN application D To refer the applicantbeneficiary to SSA the worker will Referral Procedures Step Action 1 Give the client a completed MC 194 and a return envelope 2 3 4 Tell the client to take the MC 194 and verification of the items listed below to the SSA office age US citizenship or alien status identity NOTE Social Security requires a certified copy of the birth certificate and will not accept a hospital birth certificate Inform the applicantbeneficiary of the following a requirement to cooperate with SSA by making every reasonable effort to obtain any required documentation and submit it to SSA within 30 days b SSA will take approximately 46 weeks to process the application c SSN card will be mailed directly to the client d requirement to report address changes with the Post Office to avoid SSN card being returned to SSA for cancellation e requirement to provide SSN card or letter upon receipt f failure to cooperate with SSA andor comply with these requirements will affect MediCal eligibility Set a control to check within 60 days from the date of application If received not received Then SSN requirements are met no further action necessary follow directions outlined in MPG Article 4 Section 112h below E When SSA indicates on the MC 194 receipt that the application for Form MC 194 SSN was submitted but not accepted due to lack of evidence the Not Accepted worker will due to Lack of Evidence Step Action 1 Evaluate if the client is making every reasonable effort to obtain the required documentation and submit it to SSA 2 If necessary assist the client in obtaining the required documentation as indicated in MPG Article 4 Section 7 3 Provide the client with a new completed Form MC 194 4 Advise the client to obtain the required documentation reapply for the SSN return the new Form MC 194 to the worker within 30 days 5 Set a control to check in 30 days for form MC 194 6 Note the above information in Case Comments 7 Review case on 30th day for receipt of MC 194 If received not received Then follow instruction outlined in Section F below discontinue the affected individuals for failure to cooperate with SSA F Form MC 194 Accepted by When the applicantbeneficiary returns the MC 194 indicating that the SSN application was accepted the worker will SSA G Responses to OCC 8870 Step Action 1 Refer the client to SSA again instructing the client to indicate to SSA that this is a duplicate application 2 Advise the client to provide the second Form MC 194 to the worker within 10 days 3 Narrate in Case Comments that the client is cooperating in efforts to obtain or provide the SSN 4 Review case on the 10th day for receipt of the MC194 If Then received go to step 5 not received discontinue affected person 5 Set a control check for another 90 days for SSN 6 Review case one month prior to the month that the SSN is due for receipt of SSN card If Then received SSN requirement is met and not further action is necessary not received repeat steps 3 thru 6 from Section F H Examples of failure to cooperate include but are not limited to Failure to Cooperate in Applying for andor Providing the SSN the client states that heshe will not provide the SSN if available or will not apply for SSN on hisher own behalf or a childs the client refuses to provide information to SSA that is accessible to himher the client fails to return the MC 194 after he or she was instructed to applyreapply for the SSN the client 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 When the client has refused to apply for or provide a SSN the worker will Step Action 1 Narrate in Case Comments the clients refusal to cooperate 2 Enter applicants refusal to comply with SSA requirements in CalWIN Demographic Screen SSN Field 3 CalWIN will show this applicant as ineligible The persons remain ineligible until they cooperate in applying for the SSN and provide the application receipt Form MC 194 or providing acceptable verification of the SSN to the worker 041103 Social Security Number Validation A Overview B Validation Error Resolution DHCS has initiated a process in which the SSNs of MediCal beneficiaries are matched against SSAs records This process is called validation The process has two parts the validation process and the referral process Part Function Validation Process a daily match of all invalidated SSNs currently on MEDS Referral Process ongoing matching of persons referred to SSA for either a replacement SSN card or an initial application includes those persons who could not be validated in the daily process NOTE The referral process will update MEDS on a daily basis To resolve invalidated SSNs the worker will 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 The worker must check for 1 incorrect SSN ie SSN belongs to another family member 2 transposition of a number in the SSN 3 incorrect digits in the SSN 4 incorrect spelling of the first name andor last name 5 use of maiden name instead of married name 6 use of nickname or the use of two surnames for any of the children 7 incorrect sex andor date of birth If Then the worker must the worker finds errors in either the CalWIN or MEDS record correct the information in CalWIN submit 1428 to MEDS operator to have the MEDS record corrected no errors are found in either the CalWIN or MEDS record contact the beneficiary to verify the information by a requesting to view SSN card b questioning the beneficiary if he or she used another name when applying for a SSN c requesting date of birth verification to 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 sex 4 year and month of birth If any of these fields do not match SSA notifies DHCS of those SSNs which were not validated Specific data elements that caused the mismatch are not identified Workers must 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 the record returns as validated state files will be updated accordingly beneficiary indicates that the worker has the correct information worker must then refer the beneficiary to SSA as outlined in MPG Article 4 Section 113c C To resolve invalidated SSNs or discrepancies in the SSN information Referral Error the worker will Resolution Step Action 1 Check each beneficiary report to identify the discrepancies 2 Contact the beneficiary to confirm the SSA information for any difference name sex date of birth or SSN 3 View the appropriate documents and submit a changecorrection on CalWIN and MEDS if heshe agrees with the SSA information 4 Refer the beneficiary to SSA if the beneficiary does not agree with the SSA information using Form MC 194 with both the State and SSA data for each discrepant item indication that it is a second referral based on refusal of the beneficiary to accept the SSA data record NOTE Before this final referral the worker must emphasize to the beneficiary the need to provide convincing proof of the specific data items in question to SSA D SSA may respond with any of the following when they return Form MC Second MC 194 for a beneficiary that has been referred to SSA a second time 194 Returned 1 SSA is revising its record to match the State record for each discrepant item 2 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 If SSA is not revising its record the worker must Step Action 1 Investigate the unrevised items further by contacting beneficiary or completing a fraud referral 2 Update CalWIN and MEDS records with investigation results 3 Discuss findings with SSA to resolve any discrepancy between SSN and CountyState records 041104 MEDS Impact A MEDS will receive information from all of the validation processes Overview This information will be compared to the MEDS database and the following exception message will be generated Transaction Number Purpose SS30 SSN citizenship and identity validation B If the SSA and MEDS information is not consistent enough to validate Referral the SSN the following will occur Processing 1 MEDS beneficiary record is updated to reflect that situation 2 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 information is consistent recipient record is updated to show that the SSN was validated SSA and MEDS information is not consistent enough to validate the SSN beneficiary record is updated to reflect that situation also C Referral alerts are issued when Referral Referral alerts will appear in CalWIN as MEDS Exceptions for a listing of these messages see Appendix D D The steps below outline the validation process Validation Process Step Action 1 DHCS submits invalidated SSNs to SSA 2 The following MEDS information is sent to SSA for validation SSN County ID sex date of birth 3 SSA submits validation information 4 SSA validation information is matched to MEDS records 5 The SSN is coded as either validated or not validated in the SSNVER field on MEDS 6 Any changes between the time the validation file was created and the time the returned file is processed will initiate the validation process If Then the MEDS Name the alias name rather than the current MEDS Cross Reference beneficiary name is sent to SSA on the validation File has a name record identified as the SSA alias name NOTE the SSA alias name is used even though it may have been submitted by a previous County E Workers must follow the steps outlined below for SSN changes SSN Changes Step Action 1 Complete a MEDS inquiry to see if the SSN is validated If Then SSN is validated go to step 2 SSN is not validated go to step 3 2 Submit a request for SSN correction to MEDS liaison W414 via 1428 with the following attached Screen print of MEDS Inquiry Verification of new SSN 3 Narrate the SSN change in Case Comments 4 Image the verification for the new SSN 5 Update the person new SSN in CalWIN NOTE Validated records for SSI recipients cannot be corrected at County level F Workers must follow the steps outlined below for date of birth changes Date of Birth Changes Step Action 1 Complete a MEDS inquiry to see if the SSN is validated If the Then SSN is validated go to step 2 SSN is not validated go to step 3 2 Follow directions outlined in MPG Article 4 Section 114g below 3 Narrate the new date of birth in Case Comments 4 Image the verification for the new date of birth NOTE Validated records for SSI recipients cannot be corrected at County level G Workers must follow the steps outlined below for cases where Date of Birth beneficiary have reported a date of birth change and the new date of Changes birth was entered in CalWIN Previously Reported Step Action 1 Complete a MEDS inquiry to see if the MEDS record is in hold or discontinued status If the Then case is closed and in a hold go to step 2 status case is in discontinued go to step 3 status 2 Request an online EW40 transaction via Form 1428 DSS using the originally reported date of birth Continue to step 4 3 Request an online EW20 transaction via Form 1428 DSS the date of birth used should be the one originally reported the eligibility effective date should be the first month the MEDS record shows in discontinued status Continue to step 4 4 Send the beneficiary an informational notice advising them of the possibility of seeking reimbursement from the provider for medical services received for which they may have made payment see Appendix A for a sample letter APPENDIX A Sample Beneficiary Letter DEPARTMENT Letterhead Sample Beneficiary Letter Date Dear Beneficiary Name You were eligible to receive a MediCal card for the months of You did not receive a MediCal card because you reported a new date of birth to your worker Because of an error in the system this new date of birth was rejected by the computer system which issues the MediCal cards You will soon be receiving a MediCal card for the months of The MediCal records will have your old date of birth listed The MediCal cards issued with your old date of birth are good and can be accepted by your doctor or other MediCal provider If you have received services from a doctor or other MediCal provider give the provider a MediCal identification label for the month of service If you paid for the medical services the provider may be able to reimburse you after you provide a MediCal identification label You may want to take this letter with you when you give the provider the MediCal identification label This will let the provider know why you are late in providing the MediCal identification label The provider will also know it is all right to submit a claim with a date of birth different on the MediCal identification label than the one you may have reported If you have any questions please call ACCESS at 18662629881 Sincerely HUMAN SERVICE SPECIALIST NAME Human Service Specialist APPENDIX B SSN Notification Letter for IRCA Aliens SSN Notification Letter for IRCA Aliens LEGALIZATION OFFICER US IMMIGRATION NATURALIZATION SERVICE 3041 65TH STREET SACRAMENTO CA 95820 NAME DATE As part of your application for legalization under the Immigration Reform and Control Act of 1986 you also applied for a Social Security Number SSN The number assigned to you is shown above If you are granted temporary lawful resident status you will be notified by separate correspondence to pick up both your temporary resident card and your Social Security card at your Immigration and Naturalization Service INS Legalization Office In the meantime you may use the number shown above whenever you are asked for your Social Security Number APPENDIX C Form SSA2853 Form SSA2853 provides evidence that the parent applied through the hospital for a SSN for the newborn at the same time that the hospital personnel obtained information for birth registration under the Californias Newborn Automatic Number Assignment NANA program INFORMATION ABOUT WHEN YOU WILL RECEIVE YOUR BABYS SOCIAL SECURITY CARD IMPORTANT IF YOU HAVE NOT NAMED YOUR BABY A SOCIAL SECURITY CARD CANNOT BE ISSUED You should receive your babys Social Security card in about 11 weeks In your State it takes about 10 weeks before the information about your babys birth is provided to the Social Security Administration After the birth is registered Social Security is given a computer tape which we use to issue your baby a Social Security card The card will be mailed to you in about 1 week after we are notified by the State of your babys birth If you are filing for Welfare or other public assistance benefits for your baby you will need the following information completed before you leave the hospital This certifies that a Social Security number was requested for Name of Child Signature of hospital official Date NOTE Notify your caseworker when you receive your babys Social Security card Form SSA2853 689 Destroy Prior Editions APPENDIX D MEDS Alerts Transaction Number Message Text Status 4801 SSN VERIFIED VIA SSA NUMIDENT DATA MATCH Action 4802 SSN VERIFIED VIA SSA NUMIDENT MATCH TO DECEASED RECORD Action 4803 SSN VERIFIED VIA TITLE IIXVI MATCH DID NOT MATCH SSA Action 4804 SSN VERIFIED VIA TITLE II MATCH DID NOT MATCH SSA Action 4805 SSN VERIFIED VIA TITLE XVI MATCH DID NOT MATCH SSA Action 4806 SSN VERIFICATION FAILED SSATITLE IITITLE XVI DATA MATCH Urgent 4807 SSN VERIFICATION FAILED SSATITLE II DATA MATCH Urgent 4808 SSN VERIFICATION FAILED SSATITLE XVI DATA MATCH Urgent 4809 VERIFICATION FAILED SSA NUMIDENT DATA MATCH Urgent 4811 SSN MATCH ATTEMPT IDENTIFIED PROBABLE TRANSCRIPTION ERROR Urgent 4810 SSN NOT RECOGNIZED AS A VALID SSN ISSUED BY SSA Urgent 4812 MEDS DOB DOES NOT MATCH SSA DOB VERIFY CLIENT BIRTHDATE Urgent 4813 MEDS SURNAME DID NOT MATCH SSA VERIFY CLIENT SURNAME Urgent 4814 GIVEN NAME SURNAME AND DOB DISCREPANCIES IDENTIFIED Action 4815 GIVEN NAME AND BIRTHDATE DISCREPANCIES IDENTIFIED Action 4816 SURNAME AND BIRTHDATE DISCREPANCIES IDENTIFIED Action 4817 GIVEN NAME AND SURNAME DISCREPANCIES IDENTIFIED Action 4818 BIRTHDATE DISCREPANCIES IDENTIFIED Action 4819 GIVEN NAME DISCREPANCIES IDENTIFIED Action 4820 SURNAME DISCREPANCIES IDENTIFIED Action 4821 SSN VERIFICATION NOT POSTED DUE TO LATER MEDS CHANGES Action 4822 VERIFIED SSN REMOVED FROM MEDS RECORD DURING VER PROCESS Urgent 4823 BIRTHDATE CHANGED ON MEDS DURING VERIFICATION PROCESS Urgent 4824 SSN VERIFICATION NOT POSTED DUE TO CINMEDS Urgent ID CONFLICT 4825 NAME USED FOR SSN VERIFICATION DIFFERENT FROM MEDS NAME Action 2196 INAPPROPRIATE DATA CHANGE FOR IDENTITY VERIFIED CLIENT Urgent