Revision 14-4; Effective October 1, 2014

 

 

C—1010 Clearance of IEVS Reports by the Office of Inspector General (OIG) that Do Not Include IRS FTI

Revision 11-1; Effective January 1, 2011

 

 

C—1011 OIG IEVS Process

Revision 09-4; Effective October 1, 2009

 

TANF, SNAP and Medicaid

The IEVS module within the Automated System for Office of Inspector General (ASOIG) automates the distribution and clearance of IEVS data for OIG staff. OIG uses the IEVS module to process and clear IEVS reports within 45 days of the secure automated download of the IRS files to ASOIG.

 

C—1012 Review the Case Record

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and Medicaid

OIG staff research information for cases in the Texas Integrated Eligibility Redesign System (TIERS) through disposition inquiry, either by individual or case number in TIERS Historical Case Reports, located within the State Portal.

OIG staff research the complete action that occurred immediately prior to the time period listed on the IEVS. If the information is not found for the period in question, OIG staff review all actions from the period in question through the current action. Exception: If there are obvious gaps, OIG staff request the case record from Texas Works via an electronic mail message to the unit supervisor with a copy to the program manager. OIG will allow 10 workdays for receipt of the case record. OIG staff:

  • check the Texas Workforce Commission (TWC) inquiry for the most current quarter of income reported by the employer; and
  • document the IEVS clearance on the worksheet in the IEVS module.

 

C—1013 Request Verification

Revision 09-4; Effective October 1, 2009

 

TANF, SNAP and Medicaid

OIG staff request verification if the IEVS:

  • wage information was not reported and the case is active; or
  • information on wages was budgeted in the case but the IEVS discrepancy amount for an individual employer is more than $300 per month.

In these situations, verification is required to determine if the income is ongoing and impacts current benefits, and/or the income causes an overpayment.

OIG staff obtain verification by calling the employer, accessing Data Broker or sending a verification letter to the individual and payer. OIG staff allow the individual 10 days from the print date of the letter to provide verification. The request for verification letter informs individuals that the information is needed "to make a final decision on your eligibility."

 

C—1014 Non-IRS FTI IEVS Income Action Messages

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

OIG staff may create an income action message in the IEVS module for the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF) program and Medicaid programs, except for TP 40, TP 43, TP 44, TP 47 and TP 48, that requires action by Texas Works staff.

OIG creates an income action message when:

  • verification indicates income is ongoing and affects current eligibility or benefits; or
  • the individual fails to provide verification of ongoing income (OIG Claims Investigation staff complete an overpayment referral for the time period of the overissuance).

Texas Works staff must process non-Internal Revenue Service FTI income action messages according to procedures in C-1020, Clearance of IEVS Reports by Texas Works Staff that Do Not Include FTI.

OIG staff summarize findings in the comment section of the income action message. Detailed information regarding the income may be viewed on the automated worksheet within the IEVS module.

 

C—1020 Clearance of IEVS Reports by Texas Works Staff that Do Not Include IRS FTI

Revision 11-1; Effective January 1, 2011

 

 

C—1021 Regional IEVS Coordinator

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

When OIG staff create an action message in the IEVS module, regions have the flexibility to process the report by:

  • having a centralized process for clearing action messages (one designated individual or a group of staff), or
  • designating a regional IEVS coordinator to assign the clearance of action messages to Texas Works staff (supervisors or advisors) throughout the region.

The regional IEVS coordinator is responsible for:

  • the daily review of "IEVS TW Alert Detail" in the IEVS Reports Module;
  • assigning clearance of action messages to centralized staff or Texas Works staff throughout the region, depending on the region's option; and
  • monitoring the clearance of action messages.

 

C—1022 Non-IRS FTI IEVS Action Message Clearance Process

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

After checking IEVS, the regional coordinator assigns for clearance each action message to the appropriate unit supervisor or designated staff. Create a task for clearance of the action message for cases in TIERS. If clearance of the action message is assigned to individual units, the unit supervisor is responsible for assigning the clearance of the action message request to the appropriate advisor. The regional IEVS coordinator has two workdays after receipt to assign the action message.

If the IEVS regional coordinator assigns clearance of the action message to a supervisor/unit, the supervisor or clerk must assign the action message no later than the next workday. The advisor must complete the change within 10 days after the date it is assigned. The date of assignment is day zero.

If the regional coordinator assigns the clearance of the action message to other designated staff, the designated staff must complete the change within 10 days after the date of assignment.

Each worksheet with a message from OIG will indicate the type of action required. OIG staff process action messages if the household did not provide accurate information during the interview or application processing, or if the increase in income identified via IEVS caused the household income to exceed 130% Federal Income Poverty Limits (FPIL) for SNAP streamlined reporting (SR) cases.

Upon receipt of an action message, Texas Works staff must take the following action to clear the message based on the reason the message was issued.

If the ... then Texas Works staff ...
verification provided to OIG indicates income affects current eligibility,
  • send manual Form H1017, Notice of Benefit Denial or Reduction, to deny or reduce the benefits based on income or resources. If the advisor does not receive verification from OIG, then document that OIG has the verification. Copies of verification received by OIG may be provided to Texas Works staff upon request.
  • provide advance notice and process the denial or adjustment after the adverse action period expires.
individual fails to provide verification to OIG,
  • send a manual Form H1017 to deny the benefits for failure to provide the information. Note: A manual notice and denial is required because TIERS will not allow a denial for failure to provide information without previously issuing Form H1020, Request for Information or Action. In the comments section, document the information the individual failed to provide and what the individual can do to re-establish eligibility as specified in the instructions to Form H1017. If the individual fails to provide the requested information within the adverse action time frame, process the denial for failure to provide information.
  • if verification is provided within the adverse action time frame, send an email to the OIG claims investigator notifying the investigator about receipt of the information and forward a copy of the verification. Take action on the case based on new information.
  • determine the benefit/overpayment amount based on verification documentation included in the action message comments.

 

Notes:

  • The investigator's name and telephone number are listed on the automated worksheet in the IEVS module.
  • If Texas Works staff do not provide the case record upon OIG request, OIG staff will contact the regional director.

 

C—1023 TP 40 and Children's Medicaid Clearance Process

Revision 13-4; Effective October 1, 2013

 

Children certified for children’s Medicaid other than TP 45, which is certified for 12 months, receive six months of continuous eligibility, regardless of changes in family income or resources. A pregnant woman certified for TP 40 is continuously eligible regardless of income changes. There is no asset test for TP 40.

OIG staff will create action or information messages for these type programs only if the household did not provide accurate information during the interview or application processing.

At the children's Medicaid renewals, or before certifying a TP 40 recipient for another type program, advisors must inquire in the Income and Eligibility Verification System (IEVS) module to review the reports and handle any information that may affect ongoing eligibility.

Follow normal regional security procedures to request access. To access the ASOIG IEVS module, go to https://hhsportal.hhs.state.tx.us/wps/portal.

 

C—1024 Client Reapplies

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

If the individual reapplies after being denied for failure to provide information to OIG, advisors must obtain the verification requested by OIG before recertifying the case. Exception: If the individual can reasonably explain why the requested information cannot be obtained or provided, use the best available information. See C-920, Questionable Information.

 

C—1025 Appeals

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

If the advisor receives a request for an appeal based on action taken by:

  • OIG, contact the claims investigation supervisor in the region on the same day the request is received.
  • Texas Works as a result of an action message, the advisor files the appeal. Complete Form H4800, Fair Hearing Request Summary, and Form H4800-A, Fair Hearing Request Summary (Addendum). On Form H4800-A, Section 2, Materials Attached, indicate under Other Related Materials, that action messages generated by OIG need to be considered in the appeal. Enter the claims investigator's name and telephone number on Form H4800 and send OIG copies of Form H4800 and Form H4800-A. OIG provides the additional information to the hearing officer.

If OIG receives a request for an appeal based on action taken by the Texas Works advisor, OIG will notify Texas Works the same day.

 

C—1026 Non-IRS FTI IEVS Information Message Clearance Process

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

At the region's discretion, Texas Works staff may review the messages in the IEVS module before certification. Information messages serve as a case clue to Texas Works staff to identify potential resources not reported by the individual.

 

C—1030 Clearance of IEVS Reports by OIG that Includes IRS FTI

Revision 11-1; Effective January 1, 2011

 

 

C—1031 OIG Procedures

Revision 11-3; Effective July 1, 2011

 

TANF, SNAP and Medical Programs

The ASOIG Match module with the sources listed as FTI, Self or Earn contains IRS FTI that requires adherence to FTI safeguarding procedures.

IRS FTI is defined as any information included in ASOIG. This includes:

  • payee's account number,
  • tax year income reported,
  • payer's name and address,
  • payer's employer identification number,
  • pay amount, or
  • type of income.

More information about IRS FTI can be found by reviewing the training, "Safeguarding IRS Tax Sensitive Information," at http://mhmrweb02.mhmr.state.tx.us/cbt/enterprise/Training_login.asp.

 

C—1032 Review Case Record

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

OIG staff follow the procedures in C-1012, Review the Case Record.

 

C—1033 Request Verification

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

OIG staff follow procedures in C-1013, Request Verification. Page one of the IEVS verification letters (KC-63, KC-64, KC-65 and KC-68) is considered IRS FTI when the IEVS source is identified as such and staff must secure it according to IRS safeguarding requirements.

 

C—1034 Types of IRS FTI Action/Information Messages

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

There are three different types of action/information messages that OIG may create in the IEVS module for SNAP, TANF and Medicaid programs, except for TP 40, TP 43, TP 44, TP 47 and TP 48 that require action by Texas Works staff.

OIG creates when
Income Action Message

Note: Action messages created based on IRS FTI are limited to those matches with a source listed as "Self" or "Earn."

  • verification indicates income is ongoing and affects current eligibility or benefits; or
  • the individual fails to provide verification of ongoing income (OIG claims investigation (CI) staff complete an overpayment referral for the time period listed on the IEVS module).
Resource Action Message
  • verification indicates a resource affects current eligibility (OIG completes overpayment referral); or
  • the individual fails to provide verification of ongoing resources (OIG-CI completes an overpayment referral for the time period listed on the IEVS if the report indicates resources affect prior eligibility).
Resource Information Message
  • the resource is ongoing and is under limit or inaccessible;
  • the resource is ongoing and the case is denied; or
  • the individual did not provide the verification and the case is denied.

 

OIG staff summarize findings in the TW comments section of the IEVS worksheet. Detailed information regarding the income may be viewed on the automated worksheet of the IEVS module.

 

C—1040 Clearance of IEVS Reports by Texas Works that Includes IRS FTI

Revision 11-1; Effective January 1, 2011

 

 

C—1041 Regional IEVS Coordinator

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

The regional IEVS coordinator and Texas Works staff use the same procedures and time frames found in C-1021, Regional IEVS Coordinator, to process action messages with IRS FTI.

When an IEVS is generated based on IRS FTI, the action or resource message will be on a screen clearly labeled with a FTI warning. All information on the IEVS module (payer name, account number, pay amounts, etc.) is considered IRS FTI. While printing of IEVS module worksheets with Texas Works or TW messages is not prohibited, staff must secure these worksheets according to safeguarding requirements.

 

C—1042 IRS FTI IEVS Action Message Clearance Process

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

Texas Works staff take the following action to clear the action message.

If the ... then ...
verification provided to OIG indicates income/resource affects current eligibility,
  • send manual Form H1017, Notice of Benefit Denial or Reduction, to deny or reduce the benefits based on income or resources. If the advisor does not receive verification from OIG, then document that OIG has the verification. Copies of verification received by OIG may be provided to Texas Works staff upon request.
  • provide advance notice, and process the denial or adjustment after the adverse action period expires.
individual fails to provide verification to OIG,
  • send a manual Form H1017 to deny the case. Note: A manual notice and denial is required because the TIERS will not allow a denial for failure to provide information without previously issuing Form H1020, Request for Information or Action. In the comments section, document the following message:

    "You failed to provide information to the Office of Investigator General. Contact [OIG investigator's name] at [investigator'sphone number] if you have questions. You may reapply for benefits and will be required to provide the information previously requested."

    "Usted no presentó información a la Fiscalía General. Si tiene alguna pregunta, comuníquese con [OIG investigator's name] al [investigator's phone number]. Puede volver a solicitar beneficios, pero tendrá que presentar la información que se le pidió anteriormente."

  • if the individual fails to provide the requested information within the adverse action time frame, manually process the denial for failure to provide information. Note: A manual notice and denial is required because TIERS will not allow a denial for failure to provide information without previously issuing Form H1020.
  • if verification is provided within the adverse action time frame, send an overpayment referral to the OIG claims investigator indicating receipt of verification and forward a copy of verification, if appropriate. Take action based on the verification provided.
  • determine the benefit/overpayment amount based on verification documentation included in the comments section of the IEVS worksheet.

Reminder: Texas Works staff must not enter any IRS FTI into TIERS (including individual TW comments). Documentation in TIERS case comments is limited to the following language: "IEVS match, action message generated from IEVS requesting denial."

Notes:

  • The investigator's name and telephone number are listed on the online version of the automated worksheet in the IEVS module.
  • If Texas Works staff do not provide the case record in 10 days, OIG staff will contact the regional director.

 

C—1043 Client Reapplies

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

If the individual reapplies after being denied for failure to provide information to OIG, the advisor must verify the IRS FTI. If the individual indicates the verification was provided to OIG, contact the OIG investigator. If the individual self-discloses the information on the application, the information is no longer considered IRS FTI.

If the individual does not have the resource or income for which OIG requested information, the advisor must request verification of the IRS FTI using a manual Form H1020, Request for Information or Action. If the advisor attaches a verification form, such as a bank verification form or Form H1028, Employment Verification, do not include any IRS FTI on the verification form. File the manual Form H1020 in the case record and secure the case according to the IRS safeguarding requirements because the case record now contains IRS FTI.

When the individual provides the information requested on the verification form, the information on the verification form is no longer considered IRS FTI. The file copy of Form H1020 remains IRS FTI and must be kept in the case record for the duration of the retention period.

If the advisor is requesting additional information that does not contain IRS FTI, the advisor may issue a second Form H1020 through TIERS or request the information on a manual Form H1020.

Note: If the advisor completes a manual Form H1020 because the only required verification is IRS FTI, TIERS will not allow a denial based on failure to provide verification, since Form H1020 was not generated via TIERS. The advisor may generate Form H1020 indicating a manual Form H1020 was provided to the individual. Do not provide the notice generated from TIERS to the individual. The advisor must document in the case comments the reason for generating an electronic pending notice and reference the manual Form H1020 that was issued.

If the individual fails to provide the information, issue a manual Form H1017, Notice of Benefit Denial or Reduction, to deny the case for failure to provide information.

 

C—1044 Appeals

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

If the advisor receives a request for an appeal based on action taken by:

  • OIG staff, contact the claims investigation supervisor in the region on the same day the request is received. OIG will process Form H4800, Fair Hearing Request Summary.
  • Texas Works, as a result of the clearance of an action message, the advisor files the appeal. Complete Form H4800 and Form H4800-A, Fair Hearing Request Summary (Addendum).
    • On Form H4800-A, Section 2, Materials Attached, indicate under Other Related Materials that action messages generated by OIG need to be considered in the appeal.
    • Document the claims investigator's name and telephone number on Form H4800 and send OIG a copy of Form H4800 and Form H4800-A. OIG provides the additional information to the hearing officer using the instructions in the annual review of the Internal Revenue Service safeguarding requirements memo.

If OIG receives a request for an appeal based on action taken by the Texas Works advisor, OIG will notify Texas Works the same day. Texas Works staff must file Form H4800.

 

C—1050 Additional IRS FTI Sources and Security Issues

Revision 11-1; Effective January 1, 2011

 

 

C—1051 Retention and Distribution of IRS FTI

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

Retain IEVS reports for three years for SNAP and four years for TANF. Staff may log and destroy the IEVS module records using IRS safeguarding requirements as soon as they are no longer needed, as they are available in ASOIG.

The following list of forms must be retained for five years from the date of the last entry on the form:

  • Form H1861, Federal Tax Information Destruction Log
  • Form H1862, Federal Tax Information Transmittal Memorandum
  • Form H1863, Federal Tax Information Removal Log
  • Form H1864, Federal Tax Information Fax Transmittal
  • Form H1865, Federal Tax Information Transmittal Log

 

C—1052 Discovery of Existing IRS FTI in HHSC Offices and Records

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

Advisors review information in each case record to identify any IRS FTI as cases come up for recertification or review. Examples of IRS FTI include, but are not limited to hard copies of old IEVS alerts, manual Form H1020, Request for Information or Action, and notices requesting verification of IRS FTI. If IRS FTI is found in the case record, the advisor evaluates whether retention periods have been met per IRS FTI retention periods addressed in C-1051, Retention and Distribution of IRS FTI. If information can be destroyed, complete Form H1861, Federal Tax Information Destruction Log, before destroying the information. If the information needs to remain in the case record to support documentation or verification, secure the case record in a two-barrier secure environment until the case can be purged. Regions may elect to separate IRS FTI and place it in a secure centralized location. If the local office does not file the IRS FTI in the case record, note in the case record that IRS FTI exists and is located in the centralized location.

 

C—1053 Purging Records

Revision 13-4; Effective October 1, 2013

TANF, SNAP and TP 08

When Texas Works staff purge case records, review the records for IRS FTI. If information can be removed from the actual file, completeForm H1861, Federal Tax Information Destruction Log, and destroy the information. If the record indicates that IRS FTI is filed separately in a secure location, destroy the IRS FTI when the file is purged. Refer to the IRS FTI retention periods addressed in C-1051, Retention and Distribution of IRS FTI.

Follow regional or local office procedures for storage and purging of IRS FTI.

 

C—1060 Reporting a Security Incident Regarding Internal Revenue Service (IRS) Federal Tax Information (FTI)

Revision 14-4; Effective October 1, 2014

Upon discovery of an actual or possible compromise of an unauthorized inspection or disclosure of IRS FTI, including breaches and security incidents, the individual making the observation or receiving the information must immediately contact the HHSC IRS coordinator. The individual sends a secure email to HHSC_IRS_FTI_Safeguards@hhsc.state.tx.us.

The HHSC IRS coordinator will report the incident by contacting the office of the appropriate special agent-in-charge, Treasury Inspector General for Tax Administration (TIGTA), in addition to the IRS Office of Safeguards, as directed in Section 10.2 of IRS Publication 1075.