loading…
loading…
loading…
MAGI-BASED ELIGIBILITY VERIFICATION PLANSECTION A - Verification Procedures for Factors of Eligibility 1 MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: Tennessee Section A. Verification Procedures for Factors of Eligibility Eligibility Factor Self- Attestation Accepted without Additional Verification (Y/N) Self- Attestation Accepted with Post-Eligibility Verification (Y/N) Electronic Data Source Used (Y/N) Reasonable Compatibility Standard Used Specify Reasonable Compatibility Standard for Income Ask for a Reasonable Explanation from the Individual (Y/N) Paper Documentation Required from the Individual (Y/N) Comments Income* NO NO YES If attestation is below and the data source is above the applicable income standard. Percent Threshold 10% NO YES The State applies the reasonable compatibility standard to attested data and information obtained via VAHI(IRS), VCI(Equifax), DOL, and TALX. If an individual attests to income below the applicable standard and data sources indicate income above the applicable standard, and the difference between the two is 10% or less, we accept attestation. If difference is more than 10%, the State will request paper documentation. If an applicant attests to income above the applicable standard, even if data sources indicate income is below the standard, the state will take the attestation, deny eligibility, and screen for APTC. The State will attempt to verify SSA income with SSA using the compressed verification process. If SSA returns income over the income limit, the applicant will be denied. Residency NO YES YES N/A N/A NO YES State conducts post-eligibility verification using PARIS data. Adjudication of paper documentation, as necessary. Age (Date of Birth) The State uses SSA and SVES data to verify whether the attested DOB and DOB in data match. Adjudication of paper documentation, as necessary. source YES NO YES N/A N/A NO YES Social Security Number ** NO NO YES N/A N/A N/A YES The State uses SSA data at application and when individuals have reported incorrect or changed data on a case by case basis. Paper documentation is required if there is no match with electronic data source, and is not subject to exception, including copy of SS5 application if applicable. Adjudication of paper documentation, as necessary. Citizenship ** NO NO YES N/A N/A N/A YES The State uses SSA data at application and when individuals have reported incorrect or changed data on a case by case basis. Paper documentation required if there is no match with an electronic data source.