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Administrative Manual Section: General Administrative Procedures and Compliance Policy Manual Number: 200.035 Chapter: Verification Legal Authority: 42 CFR 435.945; 42 CFR 435.948; 42 CFR 435.949; 42 CFR 435.952; 42 CFR 435.956; 42 CFR 457.380; 42 CFR 435.1101; 42 CFR 435.1102; 42 CFR 435.1103 1. Overview The Affordable Care Act (ACA) of 2010 reformed the verification processes used to determine eligibility for TennCare Medicaid and CoverKids. To support a streamlined application process, state Medicaid agencies must use electronic data sources, if available, to verify information provided by an individual. If an electronic data source is not available, or there are discrepancies between the information provided by the individual and the information obtained via an electronic data source, the state may request additional verification if the information is necessary to make the eligibility determination. 2. Policy Statement Verification is the process of confirming or substantiating information provided by an individual. Non-financial and financial information must be verified and documented for all TennCare Medicaid and CoverKids individuals.

It is the responsibility of the applying individual to provide additional information that is requested. TennCare is required to verify information provided by the individual using electronic data sources, whenever possible. If information is available through an electronic data source, TennCare must use the information available prior to requesting additional information or documentation from the individual.

TennCare follows the verification procedures for TennCare Medicaid and CoverKids as established in TennCare’s Verification Plan, or as otherwise agreed to by the Single State Agency and the Centers for Medicare and Medicaid (CMS).

NOTE: Self-attestation is accepted for certain non-financial eligibility criteria for TennCare Medicaid and CoverKids, unless other procedures are required by law (such as for citizenship and immigration status and enumeration). Self-attestation is accepted for all eligibility criteria for presumptive categories. 3. The Federal Data Services Hub The Federal Data Services Hub (the Hub) is an electronic service established by the U.S. Department of Health and Human Services (HHS) to facilitate sharing of data and other information between