Identification Number:
GN 02602 TN 65
Intended Audience:See Transmittal Sheet
Originating Office:ORDP OISP
Title:Continuing Eligibility
Type:POMS Transmittals
Program:Title II (RSI),Title XVI (SSI),Medicare
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part GN – General
Chapter 026 – Posteligibility
Subchapter 02 – Continuing Eligibility
Transmittal No. 65, 11/26/2019

Audience

PSC: BA, CA, CCRE, CS, DS, ICDS, IES, ILPDS, IPDS, ISRA, PETE, RECONR, SCPS, TSA, TST;
OCO-OEIO: BIES, BTE, CR, CTE, FCR, FDE, PETL, RECONR;
OCO-ODO: BTE, CCE, CR, CST, CTE, CTE TE, DSE, PETE, PETL, RCOVTA, RECOVR;
FO/TSC: CS, CS TII, CSR, CTE, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

OISP

Effective Date

Upon Receipt

Background

Based on the recommendation from the PC Quality Vision work group, we updated this section to clarify the PC responsibilities for developing proof of age and to remove references to the SSA forms that are now obsolete.

Summary of Changes

GN 02602.210 Date of birth alerts

Section A:

  • We added language regarding the POA indicator being missing on the MBR or coded with an A for alleged.

Section B.1.a

  • We added instructions to review the CFUI and the EVID screen if the POA is in file.

  • We removed the reference to the SSA-3621 form and replaced it with the BEN1 screen/DOB1 screen.

  • We removed reference to the SSA-101 and replaced it with the A 101 or EF 101.

Section B.1.b

  • We removed the reference to the SSA-3621 form and replaced with the DOB1 screen.

  • Added a Note to address DOB changes effect on the citizenship start date.

Section B.2

Added a Note to address tolerance rules in GN 00302.030.

GN 02602.210 Date of birth alerts

A. Introduction

Date of birth (DOB) alerts are generated for E's B2's, and B5's when they are age 64, 64 and 6 months, or 64 and 9 months and the Proof of Age (POA) indicator on the MBR is missing or is coded with an A for alleged. See MS 06307.027.

B. Procedure

Review the record to determine the necessary action. Although developing proof of age may be the only action, other actions may be needed (e.g., development for a Certificate of Election or for RIB/Spouse dual-entitlement claim for a claimant in LAF S4: No Child in Care.)

IF.......... AND.......... THEN..........
1. POA is in file (i.e. review the CFUI, and the EVID screen) a. it agrees with the MBR Complete the BEN1 screen/DOB1 screen to add appropriate proof code to MBR. See MS 06307.027 for guidance.

 
When applicable, annotate the A101 or EF101 with the correct DOB proof code, your initials, mod and date.
 
Determine the beneficiary's eligibility to HI/SMI (HI 00801.006) and refer to a BA for HI/SMI coding if appropriate.
b. it does not agree with the
  MBR
Complete the (DOB1) screen to correct the DOB. Add the appropriate proof code to the MBR and proceed as indicated above, if appropriate. NOTE: If the DOB changes, the citizenship start date may also be effected (e.g., A person is a US born citizen, and the DOB is coded incorrectly as 02/06/1953 A, when it should be 02/09/1953 B. When action is taken to update the DOB, the citizenship start date should also be changed to 02/09/1953.
2. POA not in file Determine the DOB in accordance with the instructions provided in GN 00302.001ff and proceed as indicated in 1.a. or b. above. NOTE: Use POA tolerance rules if applicable, per GN 00302.030.

GN 02602 TN 65 - Continuing Eligibility - 11/26/2019