POMS Reference

This change was made on Jun 6, 2018. See latest version.
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GN 03314.090: Disclosure Without Consent to State and Local Agencies to Administer the Medicaid Program and the State Children’s Health Insurance Program (SCHIP)

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  • Effective Dates: 01/17/2017 - Present
  • Effective Dates: 06/06/2018 - Present
  • TN 2 (01-17)
  • GN 03314.090 Disclosure Without Consent to State and Local Agencies to Administer the Medicaid Program and the State Children’s Health Insurance Program (SCHIP)
  • A. Disclosure policy
  • 1. Medicaid program
  • Medicaid (Title XIX of the Social Security Act) is a federally funded program that pays for medical assistance for certain individuals and families with low income and resources. We may disclose certain non-tax return information, including verification of Social Security Numbers (SSN), to State and local agencies for their administration of the Medicaid program. Disclosure is permissible under the health maintenance and income maintenance routine use cited in a number of our systems of records, including but not limited to the following:
  • * 60-0058—Master Files of SSN Holders and SSN Applications System;
  • * 60-0090—Master Beneficiary Record;
  • * 60-0103—Supplemental Security Income Record and Special Veterans Benefits System; and
  • * 60-0269—Prisoner Update Processing System.
  • We may also disclose certain tax return information covered by the Earnings Recording and Self-Employment Income System (60-0059) system of record, to State agencies that administer the Medicaid program pursuant to Section 6103(l)(7) of the IRC.
  • For information on the verification of SSNs, see GN 03325.003.
  • For information on the verification of SSNs, see GN 03325.002.
  • For information on disclosure of tax return information, see GN 03314.002 and GN 03320.015.
  • 2. SCHIP
  • SCHIP (Title XXI of the Social Security Act) is a federally funded program that provides health insurance coverage to children of families who earn too much to qualify for Medicaid, but still meet certain income threshold limits. The Federal Department of Health and Human Services established the general guidelines for SCHIP administration. However, each State is responsible for establishing specific eligibility requirements and determining the types of services available under SCHIP. We may disclose certain tax return information and non-tax return information, including verification of SSNs, to State agencies that administer SCHIP. Disclosure authority for SCHIP administration is the same as stated in GN 03314.090A.1. in this section.
  • B. Procedure for handling requests
  • State agencies that administer the Medicaid program and SCHIP receive certain tax return and non-tax return information from us primarily through electronic data exchanges, as authorized under data exchange agreements with us. Consult the regional office Data Exchange Coordinator or Privacy Act Coordinator to determine if we have a data exchange in effect with a particular State agency for its administration of the Medicaid program and SCHIP. For more information regarding the handling of requests from State and local agencies, see GN 03314.001E.