Identification Number:
EM-18036
Intended Audience:All RCs/ARCs/ADs/FOs/TSCs/OCO-CSTs
Originating Office:ORDP OISP
Title:Payment of Retroactive Increase in the District of Columbia’s State Supplement Amount for September 2018 -- One-Time-Only Instructions
Type:EM - Emergency Messages
Program:Title XVI (SSI)
Link To Reference:See Reference at the end of this EM.
 
Retention Date: February 19, 2019

A. Purpose
The purpose of this EM is to provide background and guidance regarding retroactive District of Columbia (DC) state supplement payments that will issue on September 2, 2018.

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 2016 in an amount equal to, or greater than, what they paid in 2015 (creating a “shortfall”). The DC will issue a retroactive payment to residents in state supplement optional supplementation (OS), OS-A and OS-B, in September 2018 to make up for the 2016 shortfall and meet the 2017 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 01415.049D.

    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 09/02/2018. The retroactive payment will include $33.30 per month for individuals and $66.60 per month for couples ($33.30 per month for each member of the couple) for January 2017 through December 2017.

      The retroactive payment will not include the $33.30/$66.60 increment for months that the SSI recipient was ineligible for payments in calendar year 2017.

      The retroactive payment will be issued following the computation run on 08/25/2018.

      EXCEPTION: Initiating an event in the SSI Claims System (formerly MSSICS) during the period from 08/18/2018 through 08/24/2018 and transmitting the change(s) to the SSR will cause the system to issue the 2E payment covering the period from 01/2017 through 12/2017 on the date of the input. Non-SSI Claims System cases processed via 1719b input during the period from 08/18/2018 through 08/24/2018 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 during 8/18/2018 through 8/24/2018 supplement period if the SSR has updated prior to the computation run, or following the computation run on 8/25/2018. The notice will address the change in the State supplement rate for January 2017-December 2017. 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 01415.049 Federally Administered Optional Supplementary Payment Programs for 01/17 Payment Levels
        EM-18036 - Payment of Retroactive Increase in the District of Columbia’s State Supplement Amount for September 2018 -- One-Time-Only Instructions - 08/20/2018