Page 15

Section A. Additional Comments Exception for Special Circumstances as required under 435.952: The State will permit on a case by case basis, self-attestation of individuals for all eligibility criteria when documentation does not exist at the time of application or is not reasonably available, such as for individuals who are homeless, have experienced domestic violence, or have experienced a natural disaster. Section B1. Additional Comments Section B2. Additional Comments Immigration Status: Eligibility worker enters information into the ASSIST Worker Web eligibility system. VLP (Step 1) is requested by the worker via AWW. An immediate response is returned from the FDSH. The response received is translated into system codes which are used in our eligibility determination. The applicant is given a 90-day reasonable opportunity period at this time if verification is not sucessful at Step 1. Regardless of what the response is from FDSH VLP Step 1, the request is closed via the FDSH ‘VLP Close Case’ service. If VLP status cannot be confirmed via FDSH VLP Step 1 the eligibility worker completes a SAVE form and sends it to a designated person with DHSS/DSS. The designated person accesses the SAVE portal and enters the information off of the SAVE form (Step 1 and Step 2 are completed at this point via SAVE portal). An immediate response is received for both. The response from SAVE is returned to the eligibility worker – either confirming the VLP immigration status OR requesting documents to be sent to USCIS. Eligibility worker would then either change the ‘verified by’ response in AWW to SAVE or send immigration documents to the designated person so they can be sent to USCIS to initiate Step 3. Section C. Additional Comments Monthly data exchange with insurance carriers and monthly data exchange with CMS for Medicare enrollment. MAGI-BASED ELIGIBILITY VERIFICATION PLAN Additional Comments 15