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MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: Nevada Section A. Verification Procedures for Factors of Eligibility Eligibility Factor Self- Attestation Accepted without Additional Verification (Y/N) Self- Attestatio n Accepted with Post- Eligibility Verificatio n (Y/N) Electron ic Data Source Used (Y/N) Reasonable Compatibility Standard Used Specify Reasonable Compatibili ty Standard for Income Ask for a Reasonabl e Explanatio n from the Individual (Y/N) Paper Documentati on Required from the Individual (Y/N) Comments Income* NO NO YES Both are above, at or below the applicable income standard. Dollar Threshold $225 YES YES Electronic data sources will be used to verify income for initial enrollment, if the individual attests to income below the applicable standard and the data source indicates income above the standard and the discrepancy between the two is greater than $225 a reasonable explanation or paper documentation will be requested. The $225 reasonable compatibility threshold was determined because it is the income limit at the high-end (i.e. 10% of 138% of income threshold for a household of 3). This figure will be adjusted annual with the update to FPL. If the individual attests to income above the applicable standard but electronic sources show b l h d d h ll k h l bl d f Residency YES NO YES N/A N/A YES YES If individual is known to current data sources (i.e. if a member of SNAP and TANF) we utilize those data sources. If there is an inconsistency with the attested information and the information from the data sources, state will use other data sources to try and resolve the inconsistency and then ask for a reasonable explanation and/or paper documentation if necessary. If individual is not known to their current data sources, then State will accept Self-Attestation without additional verification. Age (Date of Birth) NO NO YES N/A N/A YES YES If there is an inconsistency with the attested information and the information from the data sources, State will ask for a reasonable explanation and/or paper documentation if necessary. MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION A - Verification Procedures for Factors of Eligibility 1