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

Secondary Sources

a. Birth certificate (Bureau of Vital Statistics); b. Department of Motor Vehicles (DMV); c. Office of Child Support Enforcement (CSE); d. Adoption papers or records; e. Hospital or clinic birth records; f. U.S. Passport; Immigration or Naturalization Papers; or g. Indian census records. Sources of Third Level Documentation a. School records; b. Census records; c. Court support order; d. Juvenile court records; e. Child welfare records; f. Voluntary social service agency records; g. Insurance policy or insurance company records; h. Affidavits; i. Baptismal certificate recorded before age five; j. Church records; k. Military service record; or l. Midwife’s record of birth. B. Relationship 1. Specified Relative Accept attestation. If information is conflicting for any reason, follow up with verifications. Primary Sources State data interfaces available on N-FOCUS (Bureau of Vital Statistics, Child Support Enforcement). Secondary Sources a. Birth certificate; b. Adoption records; c. Court order records; d. Indian census records; e. Marriage licenses; f. Divorce papers; g. Court records of parentage; h. Signed paternity acknowledgement; i. Hospital or clinical records; j. Social service and welfare records; or k. Child support orders.