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Title 8: Medicaid Page 6 Iowa Department of Health and Human Services Employees’ Manual Chapter A: Administration Overview Revised January 13, 2023 Definitions “Reasonable Compatibility” means the standard by which the total attested countable income for each person’s household size is compared with the total amount from available Electronic Data Sources used by DHS. In order for attested income to meet the standards for ‘reasonable compatibility’ it must meet one of three criteria: ▪ Both the total attested income and the total income from the Electronic Data Sources are above, at, or below the applicable income limit for Medicaid or HAWK-I, or ▪ The total attested income is within 10% of the total income from Electronic Data Sources, or ▪ The total attested income exceeds the total income from electronic data sources. If the attested income meets any of the reasonable compatibility criteria, the income is considered to be verified. “Reasonably compatible” is another term used in place of “reasonable compatibility” and carries the same meaning as “reasonable compatibility”. “RCF” means a residential care facility licensed by the Iowa Department of Inspections and Appeals. “Recipient” means a person who is receiving assistance, including receiving assistance for another person (also referred to as a “member”). “Recovery” is the process by which an overpayment is collected from the client. Department staff are responsible for establishing the amount of the overpayment and making the referral to the Department of Inspections and Appeals. DIA is responsible for collection actions. “Retroactive period” means the three calendar months immediately preceding the month in which a Medicaid application is filed for: ▪ A pregnant woman ▪ An infant (under one year of age) ▪ A child under 19 years of age ▪ A resident of a nursing facility licensed under Iowa Code chapter 135C “Retroactive certification period” is one, two, or three calendar months before the month in which application for Medicaid is filed. Under Medically Needy, the retroactive certification period begins with the first month Medicaid-covered services were received and continues to the end of the month immediately before the month of application. “SLMB” means the NonMAGI-related specified low-income Medicare beneficiary coverage group. “SNF” means a nursing facility certified to provide skilled care under the Medicare program. “Spouse” is a legally married person under state law. This includes common-law and separated spouses. “State Data Exchange” or “SDX” means the system by which the Social Security Administration transmits information related to SSI or federally administered State Supplementary Assistance beneficiary eligibility and benefit amounts to the beneficiary’s state of residence. The SDX file is designed to disperse SSI eligibility data from the Department central office to the local office.