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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 Age (Date of Birth) YES NO NO N/A N/A NO NO For the majority of cases, Louisiana will accept self- attestation. If discrepancy that effects eligibility is discovered as a result of routine system checks for other eligibility factors (i.e. income), then clear issue first with request for a reasonable explanation. Paper documentation would be last resort. Social Security Number ** NO NO YES N/A N/A N/A YES Louisiana uses the SSA connection through the Hub and the state's current electronic data sources are used as back up. Paper documentation is requested to clear discrepancies or when the system provides no definitive data. Citizenship ** NO NO YES N/A N/A N/A YES Louisiana uses the SSA connection through the Hub and the state's current electronic data sources are used as back up. Paper documentation is requested to clear discrepancies or when the system provides no definitive data. Immigration Status ** NO NO YES N/A N/A N/A YES Louisiana uses all three steps the SAVE connection through the Hub. Household Composition YES NO NO N/A N/A NO NO If Louisiana finds an inconsistency, the individual is asked to provide documentation to reconcile the data and the individual's attestation. Pregnancy *** YES NO NO N/A N/A NO NO Caretaker Relative YES NO NO N/A N/A NO NO Medicare NO YES YES N/A N/A YES YES If Louisiana finds an inconsistency, the individual is asked to provide documentation to reconcile the data and the individual's attestation. MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION A - Verification Procedures for Factors of Eligibility 2