Medicaid Policy                                                                 

731-1 Electronic Match

Effective Date: December 1, 2024

Previous Policy

 

Using Electronic Data Sources

Verify items of eligibility by electronic match before asking an individual to provide verification.  If data is not available through any electronic data system, or the electronic data received is not reasonably compatible with what the individual has told you, ask the individual for an explanation. If needed, ask for hard copy documentation. 

Here are some examples of items that may be verified electronically:

1. Citizenship/identification
2. Immigration/non-citizen status
3. Social Security Number
4. Assets: Determine if the declared assets match, or are reasonably compatible with the findings on the electronic match.  See 731-3 on when to accept client statement as verification of assets, and when hard copy verification of assets is required.
   1. Electronic asset match information is reasonably compatible with client statement if both are either above, at, or below the asset limit. If asset information is not compatible, or electronic information is not available, you must ask the individual to verify assets. Such information may be an explanation of the discrepancy from the individual, or hard copy verification of current assets. (731-3)
5. Income:  Determine if the declared income matches, or is reasonably compatible with the findings on the electronic match (751).
   1. Electronic income match information is reasonably compatible with client statement if both are either above, or at or below the income limit. If income information is not compatible, or electronic information is not available, you must ask the individual to verify income. Such information may be an explanation of the discrepancy from the individual, or hard copy verification of current income.

•  If individual explanation is accepted to resolve the discrepancy, document the conversation and the result.
  2. Use electronic data sources to verify Social Security and SSI income. Request verification from the individual only if the information is not available electronically.
     1. The interface with the Social Security system can verify the amount and source of any RSDI (Title II Social Security Benefit) or SSI (Title XVI Supplemental Security Income Benefits). It may also be used to establish eligibility for Medicare benefits.
     2.  If an individual receives SSA benefits under someone else's Social Security number, and this information does not appear on the SSA electronic data source, get the claim number from the individual to enter into eREP.