All Medicaid Programs |
Obsolete Policy |
Verification
We are required to verify items of eligibility through electronic interfaces before requesting that a client provide documentation. Use a client’s SSN, or other identifying information if an SSN is not available, for the electronic match. Do not require a client to provide verification when the information is available through electronic interfaces.
We may accept client statement for most items of eligibility except citizenship and immigration status.
Only ask a client to provide documentation:
If verification is not available electronically, or
If the client statement is not reasonably compatible with electronic matches.
If the client statement is not compatible with the case history.
Income information from electronic matches is reasonably compatible with client statement if both are either above or at or below the income limit or threshold. If income information is not compatible you must request information from the client, including:
A statement that explains the discrepancy
Other information from the client that is not available electronically
If information is not compatible, do not deny or close a program or reduce benefits until you have given the client an opportunity to give you verification.
Applicants and recipients are required to cooperate with and provide requested verifications to the Department and the eligibility agency to assist in quality control and payment accuracy reviews. See 107-7.
How to verify information
There are several ways to verify items of eligibility, and in some cases, the information available in the record of a client participating in one program can be used to verify their eligibility for another program. Explore all possible avenues of eligibility and rely on information that is reasonably available.
Use computer matches and collateral contacts whenever possible to verify items of eligibility.
Client statement can serve as verification for most eligibility factors.
Provide a written request for verifications that are needed to make an eligibility decision. Do not request verification of items available to the eligibility agency through electronic interfaces that do not require independent verification. Do not request verification of items that are not subject to change and which have been verified before. (See 115-1 for computer match information that must be independently verified.)
Give clients at least 10 days from the date you mail the written request to provide verifications. If the 10th day is a non-business day, give the client until the business day following the 10th day to provide verifications. Section 107-2 defines when verification are due.
Help clients get verifications when requested by making collateral contacts or sending signed release of information forms to entities that have the needed verifications.
Clients may request more time to provide verifications. The eligibility agency can also extend the time when extenuating circumstances have made it difficult for the client to respond timely or if the worker knows more time will be needed.
The client must request more time by the date that the verifications were due.
Applicants must request more time by the end of the application period.
If the post office returns the request for verification notice with no forwarding address, see Sec. 811-4.