*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
Effective: January 1, 2012 |
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29.05.20 - Processing IEVS Matches |
Archived: June 1, 2016 (Previous Version) |
IEVS match information was created for federally funded assistance programs such as MA. Although there is not an IEVS match for state-funded programs, apply the match resolution information received from an IEVS match to determine eligibility and overpayments for those programs as well.
For information on the types of IEVS matches, see Types and Frequency of IEVS Matches.
IEVS Match Resolution Time Limit.
IEVS Match Resolution Time Limit
Resolve IEVS matches within 45 days.
Exception: The time limit can be extended if waiting for information from a third party, such as a bank or an employer, and the information is not available within the 45-day period.
Note: In order to meet federal compliance, not more than 20% of IEVS matches statewide can be unresolved over 45 days.
Follow these steps to process an IEVS match:
Note: For information on the client’s responsibilities, see Client Cooperation with IEVS.
1. Review the IEVS match. The message states the following:
l The type of match received.
l The month the match was produced or the month the information is effective.
l The person matched.
l The person’s SSN.
Note: ”Info” messages from BNDX and SDXS/SDXI are informational and do not follow the IEVS match process.
2. Review information already on file to determine if the information contained in the IEVS match was already known.
l Review information for the benefit month the match affects.
l For UNVI and BEER matches, review information for the past 12 months.
l For WAGE matches, review each of the three benefit months in the quarter the information covers.
3. Verify the match information by initiating the IEVS Difference Notice on the Verification Log Update if there is a discrepancy between the match and the information on file. The IEVS Difference Notice contains a release of information form for the client to sign and return.
Exceptions:
l BNDX and SDXS/SDXI information is considered verified upon receipt unless there is reason to doubt its accuracy.
l Refer the case to fraud instead of sending the IEVS Difference Notice if the county allows fraud investigators to resolve matches. Fraud investigators are permitted to contact a third party directly without consulting with the client.
Do not consider the match resolved until the fraud investigator completes the investigation, reports the results, and eligibility is redetermined based on the information.
If there is not a discrepancy, or the IEVS match was in error, see Step Six to determine if the match needs to be reported based on IEVS Discrepancies to Report.
4. Enter verified match information into the MAXIS system and redetermine eligibility.
Note: Close eligibility providing a 10-day notice for all household members affected by the non-cooperation if a client does not cooperate with an IEVS Difference Notice.
l Take action immediately upon receiving verification. Resolve all matches within 45 days.
l Update all appropriate STAT screens for all months necessary.
l Determine the effect the match information has on eligibility. Approve new results as appropriate.
Note: Do not take adverse action as long as the client is cooperating, which is defined as the client signing the Difference Notice Form or providing the required verifications.
If the information from the IEVS match results in:
n No change: Detail the information in case notes.
n Future ineligibility: Close eligibility providing 10-day notice.
n Excess assets for past months: Determine the months of ineligibility and determine the amount of the MA overpayment. See IEVS Overpayment Process for more information.
n Excess assets for future months: Allow the client to reduce assets before the effective date of closure. If excess assets are not reduced terminate eligibility providing 10-day notice.
n Ineligibility or adverse action: Determine the amount of the MA overpayment. See IEVS Overpayment Process for more information.
n A spenddown: Determine if the client could have met one of the types of spenddowns based on income and medical bills. Also determine if an IEVS overpayment has occurred.
5. Refer the case to the county fraud unit, if appropriate, based on your county’s fraud referral process.
6. Update the Verification Log Update panels (IULA/IULB).
l Record the time spent on the IEVS match for each step of the process.
l Resolve the IEVS match using the appropriate coding.
Note: An IEVS message cannot be deleted until it is resolved. For clients who do not cooperate in the IEVS match investigation, the IEVS message will drop off at the time of the effective date of closure if it was coded as non-cooperation.
l MAXIS will initiate a message with instructions to terminate or deny eligibility and create a disqualification screen if the match is not resolved within 10 days from the date the IEVS Difference Notice is sent. See Client Cooperation with IEVS for more information on who must be disqualified.
Note: Be sure to case note enough information on the circumstances of the match to permit pursuing verification of the match upon reapplication.
7. Case note actions taken to resolve the IEVS match and any necessary additional information.
An IEVS WAGE match may be received in which the name of the wage earner is different from the client's name. This occurs because the SSN received from the Minnesota Department of Employment and Economic Development (DEED) matched the client's SSN. There may be a problem with the employer not using the correct SSN or a data entry error at DEED.
To resolve these matches take the following steps:
1. Check to see if the SSN has been verified by SSA.
l If the SSN has not been verified, go to Step Two.
l If the SSN has been verified, go on to Step Three.
2. The problem may have occurred because the system has the wrong SSN. Verify the SSN before you take further action. This can be done by:
l Completing an interface query to SSA.
l Sending the IEVS Difference Notice to the client, adding worker comments if necessary to explain the situation.
n Verify the earnings with the employer after receiving the signed release from the client.
n Resolve the IEVS match following the policy in Processing IEVS Matches if the earnings are those of the client.
n If the earnings are not for the client, go to Step Three.
3. Resolve the IEVS match in cases where the name of the wage earner on the IEVS report is not the client's with a "BP" action code (Wrong Person). Enter a case note to explain the discrepancy and the action taken.
Note: In the past, DHS notified DEED of IEVS discrepancies through a MAXIS interface to revise any incorrect records. DEED is no longer staffed to correct IEVS discrepancies, meaning that IEVS matches may continue to be received for the same client. Resolve any additional IEVS matches where the name of the wage earner on the IEVS report is not the client's with a "BP" action code.
When a case is transferred from one county to another, the IEVS match is also transferred.
l Resolve any matches prior to transferring the case. Enter a reason why the match could not be resolved in case notes if it is not possible to resolve the match.
l The new county resolves the match, including determining any overpayments.
l Counties must work together to determine whether or not fraud existed, and decide which county should take action.