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MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION A - Verification Procedures for Factors of Eligibility 1 MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: Texas Date Submitted: (mm/dd/yyyy) 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 Documentatio n Required from the Individual (Y/N) Comments Residency YES NO YES N/A N/A NO YES *Self attestation of residency is allowed for all children's Medicaid and CHIP. *Verification of residency is required for adult groups. For these groups, electronic sources will be used. If the client statement is not compatible with the information from the data sources and affects eligibility, the client will be required to provide paper documentation of residency. Age (Date of Birth) YES NO YES N/A N/A NO YES *Self attestation of date of birth is allowed for children's Medicaid, CHIP, and the age of adults applying for Medicaid. *Verification of a child's date of birth is required for the purpose of verifying the adult's "caretaker relative" status. For these groups, electronic sources will be used. If the client statement is not compatible with the information from the data sources and affects eligibility, the client will be required to provide paper documentation of the child's date of birth. Social Security Number ** NO NO YES N/A N/A N/A YES State plans to use current real time SOLQi data feed for verification. In the case that an SSN is not verified with SOLQi, the SSN will be verified post-enrollment, if otherwise eligible, through a monthly batch process with the SSA using the Enumeration Verification System. Citizenship ** NO NO YES N/A N/A N/A YES State plans to use current SOLQi data feed for verification. In the event that SOLQi cannot verify citizenship, HHSC will attempt to verify citizenship with vital statistics. In the event that vital statistics information cannot verify citizenship, HHSC will provide applicants who are otherwise eligible with a 90-day period of reasonable opportunity to provide verification of citizenship.

Updates to the SOLQi services to receive citizenship data in "realtime" are scheduled for implementation Jan. 1, 2014. Immigration Status ** NO NO YES N/A N/A N/A YES State plans to use current DHS SAVE data feed for verification. In the event that DHS SAVE cannot verify immigration status, HHSC will provide applicants who are otherwise eligible with a 90-day period of reasonable opportunity to provide verification of immigration status. Household Composition YES NO NO N/A N/A NO NO Pregnancy *** YES NO NO N/A N/A NO NO Caretaker Relative NO NO YES N/A N/A NO YES *Age of the child and relationship to the child will be verified using SSA, the Texas Birth Verification Systems, and TANF or SNAP if data is available. *The domicile requirement cannot be verified electronically. Therefore, the client will be required to provide paper documentation of the child living in their home. When the individual attests to income below the applicable standard, and the data source indicates income above the applicable standard, the individual will be required to provide paper documentation of income. No percentage or dollar threshold will be used. When the individual attests to income above the applicable standard and data source indicates income below the standard. HHSC will take that attestation and make the person ineligible and screen for APTC. 07/22/2019 YES Income* NO NO YES N/A NO Both are above, at or below the applicable income standard.