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North Carolina Department of Health and Human Services North Carolina Medicaid Division of Health Benefits AGED, BLIND AND DISABLED MEDICAID MANUAL MA-2251

REASONABLE COMPATIBILITY

REVISION 01/12/23– CHANGE NO. 01-23

DHB Administrative Letter NO: 03-23, Medicaid Procedures for Asset Verification System (AVS) During the Continuous Coverage Unwinding (CCU) Period

I. REASONABLE COMPATIBILITY

Reasonable Compatibility refers to the standard used to compare the self-attested income/resources and income/resources as reported by an electronic data source. Reasonable Compatibility applies to all categorically needy programs and must be applied anytime there is a self-attestation and an electronic source for income/resources.

A. Reasonable Compatibility

Reasonable Compatibility is determined for each applicant/beneficiary (a/b) based on the total countable income/resources for their household. For income/resources to be considered reasonable compatible, all countable income/resources for the applicable household must meet the reasonable compatibility standard. Refer to MA-2250, Income to determine total countable income. B. Requirements for Reasonable Compatibility

Reasonable compatibility cannot be used without self-attestation and an electronic source of all countable income/resources for each financially responsible household member. Self-attestation may be the a/b’s statement or information they provide.

C. Aged, Blind, and Disabled (ABD) Programs

Reasonable Compatibility does apply in Private Living Arrangement (PLA) budgeting for both resources and income except RSDI, see D.1 below.

D. Exceptions to Reasonable Compatibility

1. Reasonable Compatibility does not apply to Retirement, Survivors, Disability Insurance (RSDI) income.

a. Always use the gross income provided by SOLQIS.

b. Caseworkers must review RSDI evidence in NC FAST for all MAGI and non-MAGI cases.

c. Caseworkers must manually update the a/b’s attestation evidence to reflect the gross RSDI income verified by SOLQIS.