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MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION A - Verification Procedures for Factors of Eligibility 1 MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: District of Columbia Section A. Verification Procedures for Factors of Eligibility Eligibility Factor Self- Attestation Accepted without Additional Verification (Y/N) Self- Attestation Accepted with Post-Eligibility Verification (Y/N) Electronic Data Source Used (Y/N) Reasonable Compatibility Standard Used Specify Reasonable Compatibility Standard for Income Ask for a Reasonable Explanation from the Individual (Y/N) Paper Documentation Required from the Individual (Y/N) Comments Income* NO NO YES Both are above, at or below the applicable income standard. Percent Threshold 10% but see comments NO YES Attestation is considered reasonably compatible unless: 1) the data sources indicate that the applicant’s income is above the applicable Medicaid eligibility threshold; 2) the applicant attests to income that is below the eligibility threshold; and 3) the difference between the income shown by the data sources and the income attested to by the applicant is greater than 10 percent. If individual attests to income above the applicable Medicaid eligibility threshold, attestation is accepted regardless of what electronic data sources show, and individual is screened for eligibility for other insurance affordability programs. Electronic data sources will be used to verity income. Paper documentation will only be requested as a last resort. In cases where the applicant attests to no income and no electronic income information is available, their attestation is accepted without further verification. The requirement for paper documentation may also be waived in exceptional circumstances, as determined on a case-by-case basis. These circumstances include: homelessness; domestic violence; employers closing or moving to another state or country; and employers who refuse to release f Residency YES NO NO N/A NO NO Attestation of residency is accepted without verfication. (DC Comment) DC residency policy change description. See Additional Comments for more details Age (Date of Birth) YES NO NO N/A N/A NO NO Attestation of date of birth is accepted without verification. However, if any inconsistancy is noted between an individual's attestation and available electronic data sources, paper documentation will be required. Social Security Number ** NO NO YES N/A N/A N/A YES Citizenship ** NO NO YES N/A N/A N/A YES Immigration Status ** NO NO YES N/A N/A N/A YES Household Composition YES NO NO An attestation shall be considered reasonably compatible unless two tax filers attest that they will claim the same individual as a tax dependent, or two non-filers in different households claim that the same person is living with them. N/A NO NO Self-attestation will be accepted without electronic verification unless two tax filers attest that they will claim the same person as a tax dependent or two non-filers in different households attest that the same person is living with them on two separate applications. In such cases, we will require physical documentation. Attestation of pregnancy and multiple gestation (e.g., twins or triplets) will be accepted. Pregnancy *** YES NO NO N/A N/A NO NO Caretaker Relative YES NO NO N/A N/A NO NO Medicare YES NO NO N/A N/A NO YES Self- attestation will be accepted without electronic verfication