Identification Number:
SI 02305 TN 67
Intended Audience:See Transmittal Sheet
Originating Office:ORDP OISP
Title:Redeterminations of Eligibility and/or Payment Amount
Type:POMS Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part SI – Supplemental Security Income
Chapter 023 – Posteligibility Events
Subchapter 05 – Redeterminations of Eligibility and/or Payment Amount
Transmittal No. 67, 09/05/2019

Audience

OCO-OEIO: CAQCR, CR, FCR, FDE, RECONE;
FO/TSC: CS, CS TXVI, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

OISP

Effective Date

Upon Receipt

Background

This is a Quick Action Transmittal. These revisions do not change or introduce new policy or procedure.

 

Summary of Changes

SI 02305.010 Scheduled RZs

Section B

Revised the first paragraph to remove the internal SSA link. The first paragraph now reads, “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.”

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.


SI 02305 TN 67 - Redeterminations of Eligibility and/or Payment Amount - 9/05/2019