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REV. MAY 3, 2018 NEBRASKA DEPARTMENT OF MEDICAID ELIGIBILITY HEALTH AND HUMAN SERVICES 477-000-004 MANUAL LETTER #43-2018 Nebraska MAGI-Based Eligibility Verification Plan for Medicaid & CHIP (MAGI) Eligibility Factor Verification Source Reasonable Compatibility/ Reasonable Explanation Electronic Sources to be Utilized Comments Income Electronic data sources shall be utilized to verify income if available.

If the electronic data sources are not available, reasonably compatible or a reasonable explanation does not apply, paper documentation will be required. If an applicant/beneficiary attests to income below the applicable standard and the electronic data source indicates income above the applicable standard, a 10% threshold shall be applied. If the attested income and the electronic data source is within 10% or less, the income is reasonably compatible and no further action is required.

A reasonable explanation shall be used if for example, the individual ended employment the month (March) before the application was made (April). Internal Revenue Service (IRS), TALX, SEW, SSA, or unemployment. New hire matches (NHM) and Provider payments are a lead only (not to be used to verify income). Applicable information gathered from TANF and SNAP (I.e. current paystubs) If the self- attested income and electronic data source is both below the applicable standard, the income is verified. If the self- attested income and electronic data source is both above the applicable income standard, the individual is ineligible for Medicaid. If the self- attested income is above and the electronic data source is below the applicable standard, the individual is ineligible for Medicaid.