005 Verification of Income

Verification of income is mandatory. Income may be verified either through electronic data matches or paper verification. (A) Electronic Data Matches. (1) Data Matches. The MassHealth agency electronically matches with federal and state data sources described at 130 CMR 502.004: Matching Information to verify attested income. (2) Reasonable Compatibility. The income data received through an electronic data match is compared to the attested income amount to determine if the attested amount and the data source amount are reasonably compatible. If these amounts are reasonably compatible, the attested income is considered verified for purposes of an eligibility determination. To be considered reasonably compatible (a) both the attested income and the income from the data sources must be above the applicable income standard for the individual; or (b) both the attested income and the income from the data sources must be at or below the applicable income standard for the individual; or (c) the attested income is at or below the applicable standard and the income from the data sources is above the applicable standard but their difference is 10% or less; or (d) the attested income is above the applicable standard and the income from the data sources is at or below the applicable standard. (3) Self-attested Income. When self-attested income is reasonably compatible with the electronic data, the income amount used to determine eligibility is the self-attested amount. (B) Paper Verification. If the attested income and the income from the electronic data source are not reasonably compatible, or if the electronic data match is unavailable, paper verification of income is required. (1) Paper verification of monthly earned income includes, but is not limited to (a) recent paystubs; (b) a signed statement from the employer; or (c) the most recent U.S. individual tax return. (2) Verification of monthly unearned income is mandatory and includes, but is not limited to (a) a copy of a recent check or paystub showing gross income from the source; (b) a statement from the income source, where matching is not available; or (c) the most recent U.S. individual tax return. (3) Verification of gross monthly income may also include any other reliable evidence of the applicant's or member's earned or unearned income. (4) For reasonably predictable fluctuating income, as described in 130 CMR 506.003(A)(4), verification may also include documentation of a contract for employment or clear history of predictable fluctuations in income.