Commonwealth of Virginia Single Audit Report for the Year Ended ...

Management Plan for Corrective Action for Department of Medical Assistance Services
DMAS/DSS added language in the Medicaid Eligibility Policy manual last fall
(September 2010) to clarify that the individual's Social Security Number (SSN) must
be verified with the Social Security Administration (SSA). At the time of application
or when the SSN is provided, the local social service worker must verify the SSN
through SOLQ-I or SVES (data matches with SSA), prior to enrollment in MMIS. By
requiring local agency staff to verify the SSN through either SOLQ-I or SVES, we
hope to obtain more accurate information at the time of application and reduce the
number of SSNs that fail to match with SSA records when our file is sent for
comparison. The policy manual further states that if the SSN is not verified, then the
individual cannot be enrolled in Medicaid.
Once enrollment takes place, the individual's SSN will then be sent to SSA for official
verification. DMAS sends a monthly file to the SSA around the 21st of each month. If
the SSN is matched and verified by SSA, then the MMIS is updated to show that
verification has taken place.
SSA also returns a file listing SSNs that didn't match and the information is processed
and reported by the MMIS on the SSN and Citizenship Update Report (RS-O-485A).
The report is posted on the DSS Intranet in the Management Reports section. The file
received back from SSA provides information about why the SSN verification failed.
Per our policy requirements, local agency staff is expected to review the report to
determine if any client in their caseload was rejected. If the SSN is not verified, then
the worker must attempt to resolve the discrepancy.
If it is determined that the discrepancy is the result of worker error (transposition of
numbers, name or date of birth data entry error), then the worker must correct the
information in the MMIS and/or ADAPT so that a new data match with SSA can
occur.
If the discrepancy is not the result of worker error, then the individual must be given
ten days to resolve the issue or provide written verification from SSA of the
individual's correct SSN. If the issue is not resolved by the individual during that
time frame, the case is closed.
The corrective action for the procedural process is complete and our ongoing
monitoring strategy is to improve the accuracy of SSNs. We continue to have a
number of SSNs that that fail the SSA verification match each month, so we know that
workers are either not verifying prior to enrollment or they are not working with the
monthly reports to complete all corrections. We are continually monitoring the
reports to see what progress is being made and trying to determine if there are other
changes that we can make to strengthen the process. Ultimately, the accuracy of
SSNs is dependent upon local agency staff following the policy requirements that are
in place; however, as has been stated before, DMAS has no authority to enforce or
sanction locally-operated DSS offices. The Department will continue to explore
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