The State Agency must direct its protest to the CMS Regional Office (RO) and CMS Central
Office (CO).
EXCEPTION: If the beneficiary for whom the state received the PW accretion resides in an auto-accrete
state and is in current SSI pay status on the SDX, but the Medicare Claim Number (also
referred to as HICN – Health Insurance Claim Number) is missing from the unearned
income field, the state must ask the SSA Field Office (FO) to use the following force
finder procedures: SM 02001.040 MBR/SSR Interface Edits, Alerts and Diaries; and SM
01301.325 Query.
The state should follow up with the FO if the Medicare Claim Number is not established
within 90 days.
NOTE: The CMS RO, in the course of the PW investigation, may also ask the FO to establish
the Medicare Claim Number in the unearned income field via the force finder procedure.
See HI 00815.082 - SSA Field Office Procedures for Resolving Individual State Buy-In Problem Cases
Due to Problem with SSR-MBR Interface. See HI 00815.088 - Servicing DO/BO Processing of CMS-1957.