FAQs for Financial Institutions

1.    Q.  What is asset verification?

A.  Asset verification is the process of finding undisclosed assets for certain Medicaid applicants and recipients. This is accomplished by matching the data available for Medicaid beneficiaries with account information held by many different financial institutions doing business in a state. In some states, to supplement information disclosed by the Medicaid applicant/recipient, account history requests are automatically directed to financial institutions to obtain 3- or 60-month account histories.

 

2.    Q.  Does the asset verification process apply to all Medicaid applicants/recipients?

A.  The asset verification process focuses on validating Medicaid’s Aged, Blind, and Disabled population. The ABD group is a medically expensive population, so Medicaid programs want to ensure they are paying health claims only for those members of the ABD population who qualify for such benefits.

 

3.    Q.  What is the name of HMS’s asset verification application?

A.  The HMS asset verification system is called IntegriMatch. It is a secure, web-based application for eligibility support and comprehensive case tracking. A Medicaid eligibility worker (requester) or a financial institution user (responder) can access the IntegriMatch application from his/her work computer with a pre-assigned secure login and password.

 

4.    Q.  How often do financial institutions do data matches with HMS?

A.  Financial institutions perform quarterly data matches with HMS.

 

5.    Q.  What entities are included in the definition of a financial institution?

A.  The federal Medicaid asset verification statute defines a financial institution as that term is defined in the Right to Financial Privacy Act: any office of a bank, savings bank, card issuer (as defined in section 103 of the Consumers Credit Protection Act (15 U.S.C. 1602(n)), industrial loan company, trust company, savings association, building and loan or homestead association (including cooperative banks), credit union, or consumer finance institution in the United States or any of its territories. In some cases, however, a state statute may vary this definition for purposes of a particular state-specific asset verification program.

 

6.    Q.  What federal law requires state Medicaid programs to perform electronic asset verifications with financial institutions?

A.  The relevant statutory provisions are in Section 1940 of the Social Security Act, 42 USC 1396w.

 

7.    Q.  Is asset verification data matching for ABD Medicaid applicants/recipients similar to data matching for child support?

A.  This is not applicable in the State of Mississippi.

In the State of Wisconsin, the answer is yes, if you are currently working with Informatix Asset verification for the ABD Medicaid population will use file formats, transfer methods, and quarterly timeframes that are similar to the current child support data match infrastructure.

 

8.    Q.  How will a financial institution know how to respond to the data match request? Are there different ways to respond?

A.  The answer to this question depends in part upon the content of applicable State law in the jurisdiction where the financial institution does business. Generally, financial institutions will be authorized to proceed using the “Matched Accounts” method, by which the financial institution matches the individually identifying information in the initial request file against all open accounts maintained at that institution, and then furnishes account balances to the State Medicaid Agency (or its contractor) only with respect to the account owners whose identities have been matched. A second process, sometimes referred to as the “All Accounts” method, may also be defined as an option under some state laws. This method, which would be an available option only where permitted by law, involves the financial institution submitting to the State Medicaid Agency (or its contractor) a data file identifying the ownership and balances of all open accounts maintained at that institution.

 

9.    Q.  Where do financial institutions send their signed Data Use Agreement?

A.  Send signed Data Use Agreements to:
HMS Operations
c/o Informatix
1760 Abbey Rd
East Lansing, MI 48823-7394

 

10.  Q.  What is the appropriate contact number for technical questions regarding the data match setup?

A.   Direct all technical questions about the data match setup to the asset verification data match support line: 800-409-7699. More information about the data match process can be found in the Asset Verification Financial Data Match Specifications handbook.

 

11.  Q. What is the appropriate contact number if a financial institution has questions about the asset verification program (such as how the program works generally, federal and/or state asset verification requirements, or the Data Use Agreement)?

A.   Each state has its own asset verification services help line:

For the State of Mississippi, direct all questions regarding the asset verification program, federal or state requirements, or the Data Use Agreement to 855-AVS-1NMS (855-287-1667).

For the State of Wisconsin, direct all questions regarding the asset verification program, federal or state requirements, or the data use agreement to 855-AVS-1NWI (855-287-1694).

In addition, any financial institution may submit email inquiries here.

 

12.  Q.  Can financial institutions obtain reimbursement for participating in the asset verification program?

A.   Reimbursement rules differ from state to state. Fees are listed in each state’s specific asset verification program law.

 

13.  Q.  If needed, can a financial institution test HMS’s secure site for the asset verification program?

A.  Yes, the HMS website is available for testing by a financial institution. If this is desired, the financial institution should email us. An HMS FI Relations Specialist will respond within 24-48 business hours.

 

14.  Q.  What benefits does HMS’ secure website offer financial institutions?

A.  By using HMS’ secure website, the financial institution can easily access requests and respond with the necessary information in a short amount of time. The website is efficient and easy to use.

 

15.  Q.  Which Medicaid members will be included in the data requests sent to the financial institutions?

A.   All new Medicaid applicants and members scheduled for renewal will be included in the data request, as well as other individuals whose assets must be considered in connection with determining the applicant/recipient’s eligibility (e.g., spouse or parent).

 

16.  Q.  Can a financial institution modify how it receives data requests (in other words, via fax or the secure website)?

A.   Yes, at any time a financial institution can change the method by which asset verification requests are delivered.

 

17.  Q.  What information is required from the financial institution in order to receive data requests via the secure site?

A.  To ensure proper receipt of data requests, a financial institution will be asked to provide their primary and backup contact information (including names, phone numbers, and email addresses) for up to three persons.

 

18.  Q.  How will a financial institution know when a new data request has been sent?

A.  If a financial institution has signed up to respond to data requests via HMS’ secure site, an email will be sent to the primary and backup email addresses the financial institution has provided to HMS. The email will contain a link to the secure site where the financial institution user may log in and complete the request.

If a financial institution has signed up to receive data requests via fax, new data, when needed, will be requested by fax.

 

19.  Q.  What if the financial institution user logs into the website, but does not accept the security terms?

A.  The user will not be allowed to move on unless s/he agrees to the security terms. If the user rejects the security terms, s/he will be redirected to the login screen.

 

20.  Q.  Does the financial data request require all balance and interest information for the dates listed?

A.   Yes, the financial institution must complete all requested fields listed for each Medicaid applicant/recipient (as well as any other individual whose assets must be considered in determining the eligibility of the applicant/recipient).

 

21.  Q.  What if the financial institution maintains an account for the particular Medicaid applicant but the account number in the request is incorrect?

A.  In the drop down box, the financial institution user should choose “Account Not Found” and click “Save.” The next page will allow the user to add another account for the applicant/recipient. At that time, the financial institution user should provide the correct account number and fill in the remaining fields. Other accounts may be added at this time for the applicant/recipient.

 

22.  Q.  How many accounts can a financial institution user add for one Medicaid applicant?

A.  There is no limit. The user should provide every account maintained by the applicant/recipient at the financial institution—whether the account is open or closed.

 

23.  Q.  What if the financial institution does not have any record of particular Medicaid applicant or of his/her account listed in the request?

A.   If the financial institution has no record of the Medicaid applicant or his/her account, the user should select “Account Not Found” in the drop down box and then click “Save.”