Retention Date: 12/18/2024
A. Purpose
The purpose of this EM is to provide background and guidance regarding retroactive District of Columbia (DC) state supplement payments that will be issued on February 2, 2024.
B. Background for DC’s Retroactive Increase in the State Supplement Amount
The Code of Federal Regulations (CFR) Title 20 – Employees Benefits, Part 416, Subpart T, paragraph 2096 (referred to as 20 CFR 416.2096) says in order to be eligible to receive Medicare reimbursement, any State that makes supplementary payments after June of 1977 must continue to make the supplementary payments (referred to as state supplement pass-along) at a level equal to or greater than the payments made in the previous year.
The DC can meet the requirements of state supplement pass-along in one of two ways:
1. the payment level method; or
2. the total expenditures method.
· The DC has elected to meet the pass-along requirement through the total expenditures method. This method requires the DC to make state supplement payments in an amount equal to, or greater than, the amount paid in the preceding calendar year.
· The DC failed to make state supplement payments in 2022 in an amount equal to, or greater than, what they paid in 2021 (creating a “shortfall”).
· The DC will issue a retroactive payment to residents in state supplement optional supplementation (OS), OS-A and OS-B, in January 2023 to make up for the 2022 shortfall and meet the 2023 pass-along compliance. OS-A and OS-B includes Supplemental Security Income (SSI) recipients and couples who reside in Certified Adult Foster Care Homes.
For more information related to the state supplement rates for the DC, see SI 01415.055D.
C. How to identify the Social Security Payment (SSP) on the Supplemental Security Record (SSR)
· The retroactive payment for the DC will post to the Payment History (PMTH) segment on the SSR as a 2E payment dated February 2, 2024.
· The retroactive payment will include $136.21 per month for individuals and $272.43 per month for couples ($136.20 per month for each member of the couple) for January 2023 through December 2023. Effective January 1, 2024, the rates will revert to $674.16/$784.16 for individuals and $1,704.32/$1,924.32 for couples.
· The retroactive payment will not include the $136.21/$272.43 increment for months that the SSI recipient was ineligible for payments in calendar year 2023.
· The retroactive payment will be issued following the computation run on January 27, 2024.
EXCEPTION: Initiating an event in the SSI Claims System during the period from January 20 through January 26, 2024 and transmitting the change(s) to the SSR will cause the system to issue the 2E payment covering the period from January 2023 through December 2023 on the date of the input. Non-SSI Claims System cases processed via 1719b input during the period from January 20 through January 26, 2024 will cause the system to issue the 2E payment on the date of the input.
D. How to handle public inquiries
Notices addressing this matter will be issued following the computation run on January 27, 2024. The notice will address the change in the State supplement rate for January 2023-December 2023. Assure SSI recipients who receive the retroactive payment that the payments are legitimate and owed to them. Also, explain that it will not result in an overpayment.
Direct all program–related and technical questions to your RO support staff or PSC OA staff. RO support staff or PSC OA staff may refer questions or problems to their Central Office contacts.
Reference
SI 01415.055 Federally Administered Optional Supplementary Payment Programs for 01/23 Payment Levels