Page 10

Official source

REV. MAY 3, 2018 NEBRASKA DEPARTMENT OF MEDICAID ELIGIBILITY MANUAL LETTER #43-2018 HEALTH AND HUMAN SERVICES 477-000-004

F. Household Composition

Accept attestation. If information is conflicting for any reason, follow up with verifications. Primary Sources 1. Rent or mortgage receipt, lease, agreement, etc.; 2. School records; or 3. A signed statement from a landlord; Secondary Sources 1. A current driver’s license; 2. Utility bills or company records; 3. Verification of vehicle registration from the Department of Motor Vehicles; 4. County assessor records; 5. Post Office records; 6. Church or synagogue records; or 7. A signed statement from an individual(s) who has knowledge of the situation. G. Pregnancy Accept attestation. If information is conflicting for any reason, follow up with verifications. Verification may be provided by a physician or another licensed medical professional who verifies pregnancy for programs such as Maternal Health, WIC, Family Planning, or presumptive eligibility. Licensed medical professionals may include but are not limited to – 1. Physicians; 2. Nurse practitioners; 3. Physician assistants; 4. Nurse midwives; 5. Qualified providers (for presumptive eligibility determinations); or 6. Other, with approval of the DHHS Central Office. The verification statement must include the licensed medical professional's name, title, date completed, and expected due date. H. Social Security Number Primary Source Federal Data Hub (Social Security data match)

loading…

Page 10

Official source

REV. MAY 3, 2018 NEBRASKA DEPARTMENT OF MEDICAID ELIGIBILITY MANUAL LETTER #43-2018 HEALTH AND HUMAN SERVICES 477-000-004

F. Household Composition

Accept attestation. If information is conflicting for any reason, follow up with verifications. Primary Sources 1. Rent or mortgage receipt, lease, agreement, etc.; 2. School records; or 3. A signed statement from a landlord; Secondary Sources 1. A current driver’s license; 2. Utility bills or company records; 3. Verification of vehicle registration from the Department of Motor Vehicles; 4. County assessor records; 5. Post Office records; 6. Church or synagogue records; or 7. A signed statement from an individual(s) who has knowledge of the situation. G. Pregnancy Accept attestation. If information is conflicting for any reason, follow up with verifications. Verification may be provided by a physician or another licensed medical professional who verifies pregnancy for programs such as Maternal Health, WIC, Family Planning, or presumptive eligibility. Licensed medical professionals may include but are not limited to – 1. Physicians; 2. Nurse practitioners; 3. Physician assistants; 4. Nurse midwives; 5. Qualified providers (for presumptive eligibility determinations); or 6. Other, with approval of the DHHS Central Office. The verification statement must include the licensed medical professional's name, title, date completed, and expected due date. H. Social Security Number Primary Source Federal Data Hub (Social Security data match)