TN 67 (09-19)

SI 02305.010 Scheduled RZs

A. Policy

1. Scheduling Criteria

RZs are scheduled for recipients in current payment status and in N01 payment status who are 1619(b) eligible.

Scheduled RZs are based on an error profiling system that determines the case's likelihood of a change in circumstance.

RZs are required to reinstate benefits and pay any withheld benefits for class members in the Martinez court case settlement . (For information on Title XVI Post-2006 Martinez Settlement Relief Processing, see GN 02613.875). The profile code is “S” (High Error Profile) and the selection indicator in the case redetermination data (CRZD) field on the SSR is “J” . (For parts of the CRZD Segment on the SSID Record, see SM 01501.002.)

2. Frequency

Following is the frequency with which RZs are scheduled:

  • Annually if a change in circumstance is likely.

  • Once every 6 years if a change in circumstance is unlikely.

NOTE: The once every 6 years RZs will not be selected in FY 2008.

RZs are not scheduled if the recipient is in a medical institution and limited to a $30 payment cap, unless there is likelihood of ineligibility or erroneous payments.

RZs are not scheduled for Title VIII, Special Veteran Benefits (SVB) cases.

3. Medicare Part D Subsidy Redeterminations

Instructions on the selection and processing of Medicare Part D Redeterminations are located in HI 03050.011.

4. Who Conducts RZs

Field office personnel conducts RZs.

B. Procedure

Obtain the pending listing of scheduled RZs from the MI Central Page. The instructions for RZs and LIs are available in the Redeterminations/Limited Issues (RZ/LI) User Guide on the MI Central Page.

Scheduled RZs will also be controlled on the Workload Management System (WMS). See MSOM T16WMS 002.001 through MSOM T16WMS 008.001 for detailed information about WMS.

FOs can also retrieve a list of cases through StaRZ and StriPEs. However, do not use StaRZ and StriPEs for workload control purposes.

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SI 02305.010 - Scheduled RZs - 09/05/2019
Batch run: 09/05/2019