FCR Conference Call: Qs and As on DEERS-FCR Quarterly Match
May 8, 2006
Two conference calls were held to discuss the DEERS/FCR Quarterly Match: March 15th at 2:00 pm ET and March 16th at 11:00 am ET. Below are the questions and answers compiled from these calls.
Question: What is DEERS?
Answer: Defense Enrollment Eligibility Reporting System. It maintains information on the military service person, known as the "sponsor" and dependents enrolled in TRICARE. DEERS is the database used to confirm enrollment and eligibility for health care benefits through the military.
Note: Once an active duty military member and family members have been enrolled in DEERS, they have medical benefits. These medical benefits do not automatically include dental or vision care. (Dental coverage may be available at an additional cost to the service member.)
Question: What is DMDC?
Answer: Defense Manpower Data Center. It collects, archives, and maintains accurate, readily available manpower and personnel data, as well as financial databases for Department of Defense. States should not send the National Medical Support Notice (NMSN) to DMDC. DMDC is a data processing center. DMDC cannot enroll children based on receipt of a NMSN. The only response DMDC can give is to indicate whether the child is enrolled or not. Per PIQ 06-02, the DMDC match eliminates the need to send an NMSN to DMDC.
Question: What Is TRICARE?
Answer: TRICARE is the name of the Department of Defense managed health care program for active duty military, active duty service families, retirees and their families, and other beneficiaries.
Question: If the DMDC match identifies that a child is eligible for enrollment, what should the state do?
Answer: Do not send an NMSN to DMDC. DMDC cannot enroll children. Follow the guidance provided in Working with the Military as an Employer: A Quick Guide and refer the CP to the nearest RAPIDS center (RAPIDS stands for Real-Time Automated Personnel Identification Card System and refers to the program through which individuals receive ID cards and through which all personnel changes are made.) This guide is on the OCSE website.
Question: What is a RAPIDS center? How can a CP find the nearest one?
Answer: It is where the CP needs to go to enroll the child in DEERS. Please refer to the RAPIDS Center Locator Site: http://www.dmdc.osd.mil/rsl/appj/site.
Question: What useful information do states receive from the DMDC match?
Answer: The match identifies children who are enrolled in DEERS, children who are eligible for enrollment in DEERS, and children who were terminated from previous medical coverage in DEERS.
Question: How are records selected from the FCR for submittal for the DMDC match?
Answer: A "case-related group" is created for purposes of this match that contains an active child record and at least one active adult case participant that is associated with that child in a IV-D case on the FCR. No participant can have a Family Violence Indicator (FVI). The child cannot be older than 23 years of age. At least one of the participants in the "case-related group" must have a verified SSN.
Note 1: If a case participant has more than one verified SSN, a separate "case-related group" is created for each verified multiple SSN, which is checked separately by DMDC for a possible match. This means that DMDC may match on one of the multiple verified SSNs and not on the other for the same person.
Note 2: If there is more than one NCP, PF, or CP on the IV-D case, then a separate "case-related group" is created for each adult/child relationship. This means that if there are two NCPs on a IV-D case, it is possible for DMDC to identify the NCP as the child's sponsor on the "case-related group" that contains the first NCP, and 'Other' on the "case-related group" that contains the second NCP.
Question: How does DMDC perform the match?
Answer: First, DMDC checks whether the adult case participants are in the military. DMDC uses a "point in time" extract from the DEERS database that contains military personnel who are active duty, retirees, and "special" civilians. Second, DMDC uses a different extract from the DEERS database to check on children. The child's record in DEERS contains an indicator of who the child's sponsor is or was in addition to the dates of coverage. Due to privacy concerns DMDC cannot furnish the name of the 'Other' sponsor. DMDC uses the SSN provided by the FCR, which may be verified or unverified, when they check for a match in the DEERS database extracts.
Note: If the FCR SSN does not match the DMDC SSN for a person, no match is made. It is possible that it is the same person, but DMDC's match process cannot pick this up because DMDC needs an exact SSN match. This applies to both the adult case participants and the children.
Question: What checks are performed before returning the results to the states?
Answer: The FCR checks if any changes occurred in the interim between when the file was sent to DMDC and received back that should prevent a match from being returned to the state. OCSE checks if the NCP, PF, or CP SSN is still active in the FCR case related group. If an adult case participant was deleted in the interim period, the values in the deleted participant's record are replaced by spaces. If none of the adult case participants are still active, or if the child record has been deleted, no records are sent to the state. If the case has been closed, or if an FVI has been set on any of the case participants in the interim period, no records are returned.
Question: What are the reasons that some of the adult fields are blank?
Answer: Some of the adult fields would contain spaces if an NCP, PF, or CP is not associated with the child on the FCR. This may be because the adult participant type is not applicable. For instance, the PF fields are blank when there is no PF associated with the child. Blank fields also may appear for an adult participant type that should be associated with the child. This would occur if the NCP, PF, or CP record was submitted to the FCR but the SSN was missing and could not be identified by the FCR. Additionally, the adult fields may be blank if the state deleted the participant in the interim period since the initial file was sent to DMDC.
Note: If the state deleted an adult case participant in the interim period, the DMDC sponsor code might still point to that participant even though spaces appear in that participant's response fields.
Question: What are the reasons for Sponsor Code 4, 'Other'?
Answer: First, a sponsor code of 'Other' could be returned if the SSN we have on FCR is not the same as the one in DEERS. The person may be the same, but no match could be made because the SSNs did not match exactly. Second, if the NCP is not registered on the FCR, then that person might be the sponsor but no SSN match could be made. Third, the 'Other' sponsor could be someone other than the NCP, PF, or CP, such as a grandparent or a stepparent. Lastly, if the child is old enough to be in the military, the adult child may be the military member and sponsoring himself/herself.
Question: What is the reason for children up to 23 years of age being included in this match?
Answer: Children are eligible to receive coverage through TRICARE up to the age of 23.
Question: Why do the responses show different results for siblings that share the same parents? Why are some children showing coverage and others not?
Answer: The most likely reason is that an exact SSN match could not be made for the children showing no coverage. In this situation, the caseworker should review each child's record to see if the SSN is verified. If not, contact should be made with the CP to obtain the child's correct SSN. A less likely reason is that some of the children have not been enrolled in DEERS. In this situation, the CP needs to be referred to the nearest RAPIDS center.
Question: What changes have been made to the record specifications?
Answer: The description of the Medical Coverage Indicator fields for adult participants has been corrected. These fields provide an indication of whether or not the NCP, PF, or CP is in the military. This change impacts locations 267, 381, and 495 of the FCR DMDC/Proactive Match Response Record. The values of "Y" or "N" indicate whether the NCP, PF, or CP is in the military as active duty, retiree or special civilian. "Y" means the participant is in the military, and "N" means the participant is not in the military. A space indicates that the adult participant is not associated with the child in the "case-related group."
Note: OCSE initially thought that the "Y" meant that the NCP, PF, or CP had medical coverage and "N" meant the NCP, PF, or CP did not have medical coverage. If someone is in the military, that person is entitled for medical coverage. An "N" however, does not automatically mean an adult does not have coverage. It is possible, for example, for an "N" to appear in the CP's medical coverage field, but the CP has coverage from the NCP or another military member (e.g., new spouse.)
Question: What if states have not automated this process?
Answer: States may request software to print the results of the DMDC match. This software allows the states to print the matched results in three reports: children currently enrolled, children eligible for enrollment, and children terminated from previous coverage. States that have processed all of the responses from the prior quarter's DMDC match may request a fourth print program from OCSE that highlights only the data that has changed.
Note: It is critical that states have processed all of the responses from the prior DMDC match before requesting "Report 4" software. If not, the state will lose track of responses not yet updated into the state system. It is also critical that the state maintained the responses from the prior match. The software for "Report 4" compares the data from the current responses to the prior responses in order to identify changes.
Question: How can states get a copy of these software programs?
Answer: Please contact your State Technical Support Liaison. An updated version of the initial print program will be sent automatically to the states that already received a copy for the December 2005 match. The updated version contains the changes relevant to the adult case participants' Medical Coverage Indicators.
Question: Can states get credit on the OCSE-157 as a result of this match?
Answer: If there is a provision for health care in the child support order and states verify through this match that the child is enrolled in TRICARE, the states CAN count this on line 21a of the OCSE-157. Once an eligible child becomes enrolled in TRICARE, states can count that child on line 21a, if there is a provision for health care in the child support order. If there is not a provision for health care in the order, states will need to obtain an order for health care before they can count the child on line 21a. Line 21a identifies IV-D cases that are open on the last day of the fiscal year for which medical support was ordered and provided at any time during the fiscal year.
Note: It is not necessary for the medical coverage to be provided by the person who was ordered to provide coverage. Line 21a may include children for whom medical coverage is being provided by someone other than the person ordered to provide coverage. If a child is receiving coverage by an 'Other' sponsor, that child may be counted.
Question: What are the main points that states should focus on?
Answer: States should update the medical coverage indicators in the state system for children who are enrolled in DEERS. States should follow up with the NCP or CP for children who are eligible for enrollment. States also should follow up with the NCP or CP for the children who have been terminated from previous enrollment to see if new medical coverage has been obtained.
Note: States may need to review and modify an order if health care was not initially ordered.