Medicare Application Processing System (MAPS) users in the field office (FO) or subsidy appeals unit (SAU) may determine that an error on a MAPS application or redetermination affects the subsidy determination and cannot be corrected using normal procedures. The error(s) could be caused by scanning, keying, or incorrect information from the applicant. The manual correction process permits users in the FO and SAU to correct problems without using a work around. FOs and SAU users can use this process to correct an applicant's Social Security Number (SSN).

NOTE: MAPS must process a case to an award or a denial in order to use the manual correction process. Identified errors should be corrected within 60 days of the initial determination or hearing decision.

When you identify an error prior to subsidy determination, access the appropriate MAPS screen and make the correction via the “Edit Application” button. Make sure you submit the new data to the Subsidy Determination process.

REMINDER: Unlike a manual correction, prior to subsidy determination you can process more than one edit action for the same SSN. Each time you process an edit action, submit the case to subsidy determination.

Example of correcting an error before submitting the case to Subsidy Determination:

The pension amount shown on Carol Montoya's application is incorrect. The Claims Specialist (CS) notices the error before the application goes through the Subsidy Determination process. Therefore, the CS can correct the error via MAPS. The CS selects the ”Edit Application” button on the Development Worksheet screen (DWMP), accesses the unearned income (ATUI) screen and enters the correct pension amount. For additional DWMP MAPS instructions, see MS 03206.002 and For additional ATUI MAPS instructions see MS 03205.006.

To correct an error within 60 days after an initial award, denial, or fully favorable or unfavorable hearing decision, take the following actions:

1. 1. 

   Access the beneficiary's DWMP screen in MAPS. (or detailed information on the DWMP screen see MS 03206.002.

2. 2. 

   Select Manual Correction - From the Development Worksheet, select the “Manual Correction “button. The user then goes to the MCOR screen and completes this screen. (For additional MCOR MAPS instructions see MS 03204.004).

3. 3. 

   Make corrections - the system will create a new application by propagating all data from the prior application. Data may be over keyed as appropriate. If you change the SSN, some data will not propagate.

4. 4. 

   Over-key the “Report Date” field with a date equal to the month before the month of the effective date for the subsidy determination, if the correction will result in an increase in the subsidy amount,

5. 5. 

   Return to the DWMP screen. Review the determination effective date and ensure the date is equal to the first month of Extra Help entitlement. If the date is incorrect, use the “Edit” button.

6. 6. 

   Input the proper date in the “Report Date” field on the SCE/Manual Applications (DEDS) screen. See MS 03206.022 for additional information regarding the DEDS screen.

7. 7. 

   Save the changes.

8. 8. 

   Submit corrected information to the Subsidy Determination process.

The new application stays in pending status until it goes through the Subsidy Determination process.

NOTE: MAPS processes manual corrections cases as new applications. As a result, the system will request updated IRS data, which may create new verification issues and delay processing. To avoid this, show income and resources as verified. For additional MAPS instructions see MS 03206.006.

 

EXAMPLE 1: Effective date of a manual correction

Saul Jones' application was approved. Saul receives a 75 percent subsidy, effective January 1, 2014. In February 2014, a CS realizes that because of a scanning error, a large pension was not included in the income calculation. Saul should be receiving a lower subsidy amount. The CS accesses the MCOR screen via DWMP screen and completes the screen(s) using the correct income information. The “Report Date” is equal to the date of the input, and then the CS submits the corrected application for Subsidy Determination.

The 75 percent subsidy will terminate on February 28. The new subsidy amount of 50 percent will be effective on March 1. The system will issue a Notice of Planned Action to Saul.

NOTE: When using the manual correction process, a change to a lower subsidy amount is effective with the month after the month shown in the “Event Report Date” field of the MCOR.

EXAMPLE 2: Effective date of a manual correction

Mary Martin's application was approved and reflects a 25 percent subsidy, effective March 1, 2014. In April 2014, the CS realizes they entered earned income on the application in error. The CS accesses the MCOR screen via the DWMP screen, inputs February 1, 2014 in the “Report Date” field, selects “Continue”, and updates the screens using the correct income information. After reviewing the DWMP screen to ensure that the determination effective date is equal to March 1, 2014, the CS submits the new data to Subsidy Determination.

Mary will receive a Notice of Change and the new subsidy amount will increase to 75 percent effective March 2014.

NOTE: When using the manual correction process, an increase in the subsidy amount must be effective with the first month of Extra Help eligibility. Be sure that the “Report Date” field on the MCOR screen is equal to the month prior to first month of Extra Help eligibility.

EXAMPLE 3: A manual correction for a change to income information

Lolly Williams' application for Extra Help was denied effective January 1, 2014. On February 5, 2014, the CS recognizes that a scanning error posted the same income as earned and unearned income, resulting in the denial. Lolly has not filed an appeal.

The CS accesses the MCOR screen via the Development Worksheet, enters December 1, 2013, in the “Report Date” field, and checks the DWMP screen to ensure that the determination effective date is equal to January 1, 2014. The CS then enters the correct information, saves the application, and submits the case to Subsidy Determination. MAPS will issue a notice to Lolly containing the subsidy award information.

EXAMPLE 4: A manual correction for a change to resource information

Sherry Williams applied for Medicare Part D Extra Help and was denied effective November 2013 because of excess resources. Sherry filed an appeal.

After denying the appeal, the Subsidy Determination Reviewer (SDR) realizes that the resource information is incorrect. In MAPS, the SDR accesses the Development Worksheet and selects the MCOR screen. The SDR keys November 1, 2013, in the “Report Date” field, corrects the erroneous information, and submits the application for Subsidy Determination.

MAPS will issue a Notice of Award to Sherry.

GN 02602.000 Continuing Eligibility

HI 03040.000 Appeal of Medicare Part D Subsidy Determination

HI 03050.020 Redetermination of Eligibility for Medicare Part D Extra Help (Low-Income Subsidy)

SM 03005.170 Change of Address

SI 02306.010 Change of Address or Residence

MS 03206.014 MAPS Changing Event (DWCE)

MS 03206.002 MAPS Development Worksheet Main (DWMP)

MS 03204.004 Manual Correction Process Portal (MCOR)

MS 03206.022 MAPS Edit Determination Dates – SCE/Manual Application (DEDS)