TN 50 (09-13)

GN 02602.610 Scheduling an Interview for the Medicare Non-utilization Project (MNUP)

A. Scheduling an interview

The preferred method is to conduct an interview by telephone. A manager or designee should conduct the telephone interview.

Possible designees include:

  • Service Representatives,

  • Teleservice Representatives,

  • Claims Representatives,

  • Technical Experts,

  • Public Affairs Specialists, or

  • other position, as designated by management.

A manager decides whether a face-to-face interview is necessary, but it should only happen in rare situations. The manager’s decision to use a face-to-face interview depends on the facts of each individual case. The following are some examples of when a face-to-face interview may be appropriate:

  • beneficiary or representative payee, if any, requests a face-to-face interview;

  • beneficiary or representative payee, if any, may have conditions that impair effective telephone communication; or

  • integrity issues (e.g., unable to identify the beneficiary) are apparent during telephone interview.

B. Procedure for scheduling an interview

1. Sending the appointment letter

Before sending the appointment letter, complete the following actions:

  • Review the beneficiary’s Social Security records (e.g., Master Beneficiary Record (MBR), Number Holder Identification (NUMI) record, the Supplemental Security Income Record, etc.) prior to the interview; and

  • Identify any discrepancies between the records and resolve them during the interview (e.g., date of birth or address).

2. Determining which interview notice to send

Several notices are available for use when scheduling an interview for MNUP. These notices and their Spanish translations are available in the Document Processing System (DPS).

You must send an interview notice to the beneficiary. If the beneficiary has a representative payee, you must send the same notice to the representative payee.

Send one of the following interview notices of the scheduled appointment, based upon how you will conduct the interview (e.g., telephone):

  • Telephone interview - Use the SSA-L502 (Telephone Interview Letter) to schedule a telephone interview with the beneficiary and the representative payee, if any. For a sample SSA-L502, see NL 00701.136. Document the interview using the SSA-L502 on the MNUP website.

  • Home visit - Use the SSA-L501 (Home Visit Letter) to schedule an interview at the beneficiary’s residence with the beneficiary and the representative payee, if any. For a sample SSA-L501, see NL 00701.135. Document the interview using the SSA- L501 on the MNUP website.

  • Residence address request - Use the SSA-L505 (Residence Address Request) to schedule an interview at the beneficiary’s residence with the beneficiary and the representative payee, if any. Send the SSA-L505 to request the beneficiary's residence address when only the mailing address is available in our records. For a sample SSA-L505, see NL 00701.139.

Document the MNUP website with the appointment information. For more information about the website, see GN 02602.650.

3. Rescheduling the interview

If it is necessary to reschedule the interview:

  1. Call the beneficiary or the representative payee, if applicable, to reschedule the interview.

  2. Mail a new interview appointment letter to the beneficiary and the representative payee. The letter must provide the new time and date of the upcoming interview. If the new appointment is less than a week from the original appointment, an appointment letter is optional, but confirm that all parties will be available at the appointment time.

  3. Add a remark to the MNUP website to document the reason for rescheduling, the date and time of the telephone call, the date that you mailed the new appointment letter, and confirmation that the beneficiary and representative payee will be available.

    NOTE: Schedule a new appointment if the beneficiary or the representative payee asks to reschedule the interview. Use the requested time and date when rescheduling the appointment.

4. Beneficiary fails to keep the appointment

We will attempt to reschedule the appointment twice. After those attempts, include the following language in the appointment letter when scheduling the final (third) appointment:

“We have tried to schedule an appointment with you twice. Each time we rescheduled, you were not available. It is very important that you keep this appointment. If you do not keep this appointment, we may suspend your payments until we speak with you.”

If the beneficiary resides in a nursing home, call the nursing home to verify that the beneficiary is alive before suspending payment. If the nursing home alleges that the beneficiary is alive, begin representative payee development, if necessary. If the nursing home alleges that the beneficiary is deceased, see GN 02602.640 for policy to process the report of death.

If the beneficiary or representative payee fails to keep the third appointment, we must take the following actions:

  1. Send an advance notice to the beneficiary and the representative payee, if any, informing them of our planned action to suspend benefits. The advance notice must state the:

    • pending adverse action,

    • reason why we plan to suspend benefits,

    • evidence we used to make the determination, and

    • beneficiary has 10 calendar days (plus 5 days for mailing) to respond before we suspend benefits.

    Establish a diary for 15 calendar days. For more information about the required content of advance notices in title II cases, see GN 03001.015 and NL 00601.030

  2. After 15 calendar days (10 days plus 5 days for mailing) have passed from the date you mailed the advance notice and you have not received a response, suspend the beneficiary’s benefits. Place the record into ledger account file (LAF) S9 with a reason for suspension or termination code (RFST) of whereabouts unknown (WHEREU).

  3. Add the following message to the MBR:

    “MNUP interview needed. Payments suspended for failure to keep MNUP interview appointments. Immediately remove suspense once MNUP interview is conducted.”

  4. After the MBR shows the LAF code as S9, update the LAF code in the “Medicare Non-Utilization Project (MNUP)” section on the MNUP website to show that you suspended the beneficiary’s benefits.

  5. Send the beneficiary a final notice that complies with the requirements applicable to notices of initial determination regarding the suspension. For information about the required contents of the final notice, see GN 03001.015 and 20 CFR 404.904

    When you suspend benefits for failure to keep the appointment, immediately refer the case to the Office of Inspector General (OIG) using form e8551 (Reporting Form for Programmatic Fraud). Annotate in remarks the date you referred the case to OIG on the MNUP website.

    Provide as much information as available on the e8551. For more information on referring a potential violation using the e8551, see GN 04124.001.

    NOTE: When completing the e8551 form for the MNUP, select program option “Medicare Non-Utilization” and place the term MNUP in the description.

5. Beneficiary resides outside the country

We will not select beneficiaries with a foreign address on the MBR to participate in MNUP.

A beneficiary must use a foreign mailing address if he or she will be outside the United States (U.S.) for more than 3 months unless the address is an:

  • Army or Air Force Post Office (APO),

  • Diplomatic Post Office (DPO),

  • Fleet Post Office (FPO), or

  • address of a representative payee who is remaining within the U.S.

If the beneficiary lives in a foreign country and the representative payee lives in the U.S., a change of representative payee may be appropriate.

Once you have secured the exact foreign address and phone number where the beneficiary resides, develop as follows:

  1. Determine the correct field office (FO) – A domestic Social Security office serves beneficiaries who live in Canada, British Virgin Islands, or Samoa. Identify the new FO code and transfer the case to the new servicing FO via the TRANSFER facility on the MNUP website. This removes the case from your list and posts the case on the new FO’s list. Consider your case cleared if the transfer was successful.

    NOTE: American Samoa is an unincorporated territory of the U.S. Samoa, an independent country, is officially the Independent State of Samoa, which the Manila Foreign Service Post (FSP) services.

  2. When the beneficiary lives outside the U.S., except for Canada, the British Virgin Islands, or Samoa, send an e-mail to the Office of Earnings and International Operations (OEIO) at ||OCO OEIO MNUP that includes the following information:

    • MNUP Case (subject)

    • Name of beneficiary

    • SSN

    • New address

    • New phone number or contact number

    • Estimated date of the change. This will serve as an indicator for the SSA-21 (Supplement to Claim of Person Outside the United States).

    • Type comment, “Please verify if beneficiary is alive or deceased. If deceased, please secure acceptable proof of death in the Claims File Records Management System (CFRMS) and input date of death via Post-entitlement Online System (POS).”

      NOTE: Please be aware that development between OEIO and the FSP takes additional time.

      Take the following actions in conjunction with the MNUP interview request:

      If

      then, OEIO will

      the beneficiary is alive,

      (OEIO necessary action)

      1. confirm the beneficiary lives at the furnished address,

      2. input the applicable change of address. This action ensures we code the foreign address correctly, and

      3. reply to the FO by email to inform them of your findings.

       
       

      If

      then, the FO will

      the beneficiary is alive,

      (FO necessary action)

      1. annotate the MNUP website after you receive OEIO’s email reply that the beneficiary is alive,

      2. update the new foreign address and telephone number in the “Medicare Non-Utilization Information” section of the online worksheet,

      3. update the LAF in the “Medicare Non-Utilization Project (MNUP) Information” section of the MNUP website to show that the beneficiary has returned to current pay,

      4. update remarks on the worksheet(s) that the beneficiary is alive, living in a foreign country, and was contacted by OEIO, and

      5. annotate the case status as “COMPLETE.”

        This action clears the case from your list.