Page 10

MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: South Dakota Section B2. Use of Electronic Data Sources Non-Financial: Electronic Data Source To Be Used (Y/N) Social Security Number Citizenship Immigration Status Residency Age/DOB Pregnancy Household Composition Caretaker Relative Medicare Application for other Benefits Other Data Source Used at Application (Y/N) Data Source Used at Renewal (Y/N) Data Source Used Post- Enrollment (Y/N) If Used for Post- Enrollment Frequency Used (i.e. monthly, quarterly) Comments 1. Social Security Administration (SSA) YES YES YES NO NO NO NO NO NO YES NO NO YES NO NO State plans on using SSA information provided through the Data Services Hub. The following information is available through the current State SSA agreement: 1) Beneficiary Earnings and Data Exchange (BENDEX) - identifies monthly Medicare premiums Part A/B, age/date of birth, and residency. BENDEX is updated every Monday through Friday and the IEVS targeting match is updated following each BENDX update. 2) State Data Exchange (SDX) identifies age/date of birth. SDX is updated every Monday through Friday and the IEVS target match is updated once a month (usually on the 19th). 3) SVES (State Verification and Exchange System). SVES allows staff to obtain information from SSA regarding Social Security Numbers, Medicare information, citizenship, 40 quarters, residency and age/date of birth. An online verification is received three (3) working days after the SVES request is submitted to SSA. The information received is a "snapshot" of the benefit information as it is the date the information is requires. The data is purged after 45 days of receipt. State accesses these data matches on a case by case basis post-enrollment for Medicare and residency but not a regular frequency 2. Department of Homeland Security (DHS) - SAVE YES NO NO YES NO NO NO NO NO NO NO NO YES NO NO State plans on using DHS information provided through the Data Services Hub. The following information is available through the current State DHS agreement: The Systematic Alien Verification for Entitlements (SAVE) system verifies immigration status of aliens requesting assistance. 3. Vital Statistics YES NO YES NO NO NO NO NO NO NO NO NO YES NO NO Query function in ACCESS to search SD Vital Statistics (Electronic Verification of Vital Events (EVVE) system). 4. Department of The State does not plan on using DMV as the State does not currently have access through DMV for Motor Vehicles NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO verification of applicable eligibility factors (e.g., residency, etc.). (DMV) 5. Temporary Assistance for Needy Families (TANF) YES YES YES YES YES YES NO YES YES NO NO NO YES YES NO Information from the SNAP and TANF programs is located in the same system as Medical. Information from this system will be used at time of application for individuals that are enrolled in these programs and post-eligibility for reported changes. MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION B2 - Use of Electronic Data Sources, Non-Financial 10