Page 68

Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M01 October 2024 Subchapter Subject Page ending with Page M0130 APPLICATION PROCESSING M0130.200 6

The eligibility worker must allow at least 10 calendar days for receipt of the necessary verifications, but additional time may be allowed depending on the type of information requested. The specific information requested and the deadline for receipt of the verifications must be documented in the case record. If the applicant reports to the EW that he needs help to obtain certain verifications, the EW must attempt to assist the applicant. If the verification cannot be obtained, the application must be denied.

3. Copy or Scan Verification Documents Legal documents and documents that may be needed for future eligibility determinations or audits must be copied or scanned into VaCMS using the Document Management Imaging System (DMIS) and preserved for the record. These include citizenship and identity documents, alien status documentation, verification of legal presence, trusts, annuities, contracts, wills, life insurance policies, the current value of all other countable resources, and verifications of earned and unearned income. Notes by the eligibility worker that the verifications were viewed are not sufficient. 4. Non-custodial Parent Applying for Child Eligibility for a child is based on the income of the parent with whom the child lives. If a non-custodial parent applies for his child, he must give written permission for the eligibility worker to contact the custodial parent. The eligibility worker must obtain the custodial parent’s income information, written permission to verify income using available online data sources, and other information necessary to verify and calculate countable income, including Social Security Number and residence address. If the either the non-custodial parent or the custodial parent fails to give the necessary permission, the child’s eligibility cannot be determined using the application filed by the non-custodial parent.

5. Information Not Provided If information necessary to make an eligibility determination is requested but not provided by the applicant and cannot be obtained from any other source, the application must be denied (or the coverage cancelled) due to the inability to determine eligibility. Individuals whose applications are denied due to the inability to determine eligibility are not referred to the VIM. See M0130.300 D.2. If the Verification Checklist or other mail is returned to the agency, follow the steps in M0130.500 Returned Mail prior to taking negative action. When the deadline date falls on a weekend or holiday, LDSS may choose to deny the application (or cancel coverage) before the deadline date. However, if the early denial or cancel action is taken, LDSS must re-open the application if the individual provides the necessary information on or before the original deadline date. If the individual’s application is re-opened and he/she is determined eligible, the LDSS must send a notice to the individual notifying them of the changed action.