Medicaid Policy
Medicaid Policy
The eligibility agency will use electronic data matching to verify factors of eligibility before asking the individual to provide additional information or documentation. Individuals must verify factors of eligibility when:
the information is not available electronically, or
the electronic data is not reasonably compatible with the client’s statement.
The following rules apply when asking the individual to provide verification.
The agency will give individuals a written request for verifications.
Individuals will have at least 10 days from the date the agency gives or mails a request for verifications to the individual to provide verifications. Individuals must return verifications to the agency by the due date.
Verifications needed to complete an application must be returned no later than the last day of the application period. See Sec. 703-5 for the application processing time period.
If the due date falls on a non-business day, then the individual has until the close of business on the first business day after the due date to return the requested verifications to the agency.
Verifications turned in at an outreach location at a time the outreach office is open are dated as received on that day. If verifications are turned in at an outreach location at a time when the office is closed, the date received is the last day that a staff person was at that location to receive or collect verifications.
Individuals may ask for more time to return verifications. The agency will give the individual at least 10 more days to provide the verifications if the individual asks for more time by the due date. Workers may provide additional extensions of the due date because of circumstances beyond the individual's control such as individual illness, family emergency or similar causes.
If the agency requests more information, the agency will allow at least 10 days for the individual to return the information. The agency will extend the application processing period as needed to give the individual time to return verifications.
Individuals may ask the eligibility worker for help to obtain verifications.
If verifications are not provided on time, the agency will deny the application or close the eligibility review.
If the agency cannot give 10-day notice for an adverse action, it must continue benefits to the following month. See Section 811 for exceptions to the advance notice requirement.
If the individual provides verifications within 30 days after an application has been denied, or within 3 months after the review is closed for failure to provide verification, the date the verifications are received becomes the new application date. The individual does not have to complete a new application form; however, the new application date changes the date retroactive benefits can start.
If the individual returns verifications more than 30 days after the application has been denied, the individual will have to reapply. If a review is closed for not completing the review or not returning verification, see Sec. 721-1.
Anytime that a due date falls on a Saturday, Sunday or state holiday, the individual has until the close of business on the business day immediately following the due date to turn in verifications or make reported changes.
See Section 721 for more on eligibility reviews. For verifications needed when a change is reported, see Sec. 815