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MEDICAL SERVICES POLICY MANUAL,SECTION I I-200 Families and Individuals (MAGI) Groups Renewal Process I 220 Regular Renewal

4. If a member in the MAGI household is not found on an open SNAP or TEA case, the system will continue the reasonable compatibility process and check available electronic data sources. 5. If the household attests to income under the MAGI limit (to include zero income) and the electronic data sources return no report of income or income less than the MAGI limit, the system will consider the MAGI household to meet reasonable compatibility and no further income verification is needed. 6. If the electronic data sources return an amount over the MAGI limit, the system will trigger a pending verification notice to the household for income verification. 7. Generate and send a notice to the individual advising of the renewal decision. The notice will include the information used to determine eligibility or ineligibility. The notice will advise the individual to review the information used to determine eligibility and respond to the agency only if any of the information is inaccurate. If the individual is no longer eligible, the notice will also serve as an advance adverse notice of action to terminate the individual’s Medicaid eligibility. 8. Update the individual’s record to reflect continued eligibility or effective date of ineligibility. If ineligible, trigger an Account Transfer to the Federally Facilitated Health Insurance Marketplace (FFM) as appropriate. Caseworker Responsibilities No action is required by the caseworker when an ex parte renewal is completed unless the individual responds to the eligibility decision notice indicating the information upon which the determination was made is inaccurate. When that occurs, the caseworker will review the information provided by the individual, request any necessary verification to validate the information, if validated, enter the new information to the system and trigger a new eligibility determination within the system. The system will then generate appropriate notices to the individual.

I-220 Regular Renewal MS Manual 11/18/15 If the system cannot complete an ex parte renewal because sufficient information to determine eligibility is not available through existing data sources, then the individual will be required to provide the necessary information.