Medicaid Policy
Medicaid Policy
All individuals who receive Medicaid assistance, FEP or Food Stamps are included in the Income and Eligibility Verification System (IEVS) computer matches. The frequency of the match depends on the type of income and the source of the match. Any individual, who was not on a match list when he applied, will be in the next match after his case is approved. The individual's SSN will be checked with all IEVS sources. Each match is described below.
Department of Workforce Services (DWS) Matches
Wages and Work Registration - Employers in Utah must report employee wages to DWS at the end of each quarter. Eligibility Workers have on-line access to work registration records and wage match records. Use these on-line matches to check information on all members of households applying for Medicaid. Update this information for members of recipient households at each review.
Unemployment Compensation Benefits (UCBs) - This on-line access matches SSNs of individuals to SSNs of DWS UCB claimants. Then it compares UCB payment amounts to the amount we have on the Medicaid record. This match is run each week for all members of open cases.
Other information - Eligibility workers have online access to new hire information, wage match and UCB payment records. Use this on-line access to verify information on both applicants and recipients. Update the information at each review.
Social Security Administration (SSA) Matches
There are several types of matches with SSA. The electronic verification search finds these and provides links to the benefit records. These compare both income and SSNs. Use any of the matches described below to verify SSNs and benefits. (See Sec. 221 and 223.) Covered quarters are also available from SSA.
SSNs Only (Numident). This verifies SSNs. This third-party, on-line query system matches Medicaid records with Social Security records of all SSNs ever issued. Once a person's SSN is correctly verified by the on-line SSA match, there is no need to verify the SSN a second time.
Citizenship and Identity - State Children’s Health Insurance Program – Internet (SCHIP-I or SCHIP) is a Web-based application enabling State agencies to submit data requests to the Social Security Administration (SSA) and receive a citizenship verification real-time via the Internet. This verifies information regarding a person’s claim of U.S. citizenship or nationality. A positive match also meets the identification requirement. The person’s SSN and other identifying information interfaces with the Social Security Administration database and returns a response in real time about the person's citizenship or National status. See Sec 205 and Table IV.
Social Security Payments and Other Pensions. The electronic verification search matches with Social Security Administration to find benefit information for people receiving Social Security retirement, disability and survivor's benefits.
SSI Records (SDX). The electronic verification match will show if someone is receiving SSI benefits.
Medicare eligibility information. The electronic verification match will show if an individual is eligible for Medicare. Link to the SOLQ (SSA). It shows Social Security benefit information (OASDI) and Medicare eligibility. The HI indicates Part A eligibility and the SMI shows Part B eligibility. Effective dates are shown on this screen.
Wages, Self-Employment and Farm Income Amounts (BEERS). This is a match of earned income. The records contain all earnings on which FICA was paid in the past year. Some of the sources are wages, self-employment and earnings from farms.
PARIS (Public Assistance Reporting Information System) match
This computer match system runs every three months. It uses individual name and Social Security number to match with other states' public assistance records to find individuals who are enrolled in assistance programs in other states. This helps identify individuals who have moved to another state without reporting it, and those who have recently moved to Utah, but have not reported that to the state they left. It also provides benefit information from the Veteran's Administration and federal payments for military or civilian retirement.
If the match finds information about Veteran's benefits, military or federal civilian retirement that is different than reported information, or that was previously unknown, request verification from the individual. Make any changes that are needed upon receiving verification. Refer an overpayment, if appropriate, for prior months.
If information shows an individual enrolled in Utah is also enrolled in another state's assistance program during concurrent months, request verification of where the individual is living. If the individual has left the other state and lives in Utah now, contact the other state to verify assistance has ended. If the individual has moved from Utah to the other state, request verification and close the case if the individual has moved to the other state. If the individual does not respond to the request, close the case for failure to provide verification.
Internal Revenue Service (IRS) Match
This match compares lists of individuals with lists of all people whose IRS tax records include unearned income. IRS unearned income can include, but is not limited to:
Interest, Dividends, and Royalties
Winnings from Gambling, Contests, other Prizes and Awards
All Payments from and Deductions for Pensions and IRAs
Royalties
Unemployment Compensation
Taxable Grants and Agricultural Subsidies
Capital Gains
Rents
Stocks and Bonds
Bartering
Tax Refunds from Prior Years
Profit and Loss from a Business