Asset Verification Program (AVP)

MEDI-CAL

Asset Verification Program (AVP)

Release Date

05/23/2018

Section Heading

Purpose

To convert existing policy to the new webpage - No content changes.

To release a new policy.

Policy

The Asset Verification Program (AVP) aids in identifying undisclosed/unreported assets that may potentially exceed the Medi-Cal property reserve limit for specified Aged, Blind, and Disabled (ABD) beneficiaries. AVP data includes assets that may or may not have been reported by the beneficiary. AVP focuses on ABD individuals who are not receiving Supplemental Security Income/State Supplementary Payments (SSI/SSP).

Generally, ABD individuals do not qualify for Modified Adjusted Gross Income (MAGI) Medi-Cal and are therefore evaluated for the Non-MAGI Medi-Cal Program. Assets, such as real and personal property, are counted in the Non-MAGI eligibility determination process. A household’s countable assets must be within the property resource limit to qualify for Non-MAGI Medi-Cal. Any amount over the limit will make the Non-MAGI beneficiary ineligible. Note: Spousal Impoverishment rules may apply.

The AVP data includes:

Personal property information, such as account balances found for each adult beneficiary on the case.
Account information from open and/or closed accounts.
The beginning account balance for a 10-month consecutive period.
Liquid and non-liquid asset information.
ABD reported and unreported account information.

Background

Federal law (42 U.S.C. Section 1396w [Section 1940 of the Federal Social Security Act]) requires that the Medi-Cal Program have an electronic asset verification program in place to detect unreported assets for ABD beneficiaries who are not receiving SSI/SSP. Welfare & Institutions Code Section 14013.5 outlines the requirements of California’s ABD electronic asset verification program.

The Center for Medicaid Services (CMS) directed the California Department of Health Care Services (DHCS) to enhance its asset detection procedures. As a result, DHCS implemented the AVP to increase the Counties’ ability to identify undisclosed assets and prevent improper benefit issuances.

Definitions

Terms and Descriptions

Asset Match

There is a 100 percent match between the assets reported by AVP and the asset(s) contained in the LEADER Replacement System (LRS) case record.

AVP Listing

Monthly listing provided by DHCS that includes asset/account information of ABD beneficiaries.

Current Month AVP Data

The data month in which the report is received from DHCS, which is two months prior to the renewal due month (i.e. April is the current data month for a June renewal).

Previous Month AVP Data

Any months that are prior to the current AVP data month.

Property

Is defined as “real property” and “personal property.”

Personal Property - any kind of liquid or non-liquid asset
- Liquid - Money, checking/savings account, stocks, bonds, etc. (other than for business).
- Non-Liquid - Cars, jewelry, trucks, trailers, boats, etc.
Real Property - Land, buildings, mobile home(s) which are taxed as real property, mortgages, promissory notes, and deeds of trust, etc.

Property Reserve Limit

The amount of personal property a Medi-Cal household can have to qualify for Non-MAGI Medi-Cal.

Exempt Property

Property that is not counted in determining Non-MAGI Medi-Cal eligibility.

Requirements

Condition: AVP Population
Requirement:

AVP is restricted to ABD Medi-Cal beneficiaries.
SSI/SSP recipients are not included in the AVP.

Condition: Review Period
Requirement:

The AVP data will consist of a 10-month look-back (two months prior to the renewal due month) of asset information for accounts associated with the beneficiary.

Condition: Implementation of AVP
Requirement:

Implementation of AVP will be phased-in:

The initial AVP data will include Long Term Care (LTC) beneficiaries only.
The remaining ABD population will be phased-in gradually.

Verification Docs

Verification is required for any month where the asset exceeds the property reserve limit.

Attachments

N/A

DPSS ePolicy

NAVIGATION