Page 14

Louisiana Medicaid Eligibility Manual Application Processing

Issued January 7, 2026 Replaced July 16, 2024 Page 14 of G-0000 Revised/added text indicated by underscore Deleted text indicated by “**”

 The rights and responsibilities of applicants and beneficiaries.

G-1000 SECURING INFORMATION TO DETERMINE ELIGIBILITY Secure essential information for determining eligibility. Only require the applicant to provide information that cannot be obtained from other data sources, or the information obtained electronically is not reasonably compatible, and is necessary to make an eligibility determination or for purposes directly connected to the administration of the Medicaid State Plan.

The agency shall not request verification for information sent to the agency by the FFM that has been verified.

Consider the applicant as the primary source of information. The act of designating an authorized representative does not change or diminish the applicant/beneficiary’s responsibility to provide complete and correct information on the application form.

The applicant/beneficiary/responsible person or authorized representative is required to:  Make an effort to obtain all information needed to determine eligibility;  Authorize the obtaining of documents from third parties;  Answer all eligibility related questions to the best of their knowledge; and  Report any changes that may affect eligibility. If the applicant cannot furnish all of the required verifications at the time of application:  Send a request for information (RI) that contains a list of the items or actions needed with the deadline for submission specified. Allow at least ten (10) calendar days for an applicant/beneficiary to provide the requested verifications.

Exception: Allow at least thirty (30) calendar days for a beneficiary to provide the requested verifications for a renewal. If the applicant is unable to obtain the needed information, provide assistance by: