56.01 Data

Tax data42 For all individuals whose income is counted in making a health-benefits eligibility determination, and for whom Social Security numbers are available, AHS will request tax return data regarding income and family size from the Secretary of the Treasury and data regarding Social Security benefits from the Commissioner of Social Security by transmitting identifying information specified by HHS to HHS. If the identifying information for one or more individuals does not match a tax record on file with the Secretary of the Treasury that may be disclosed, AHS will proceed in accordance with the provisions in § 57.00(c)(1). (b) Non-tax data. For all individuals whose income is counted in making a health-benefits eligibility determination, AHS will request non-tax data from other agencies in the state and other state and federal programs, as follows: To the extent that AHS determines such information is useful to verifying the financial eligibility of an individual, the following will be requested: (i) Information related to wages, net earnings from self-employment, and unearned income and resources from: The State Wage Information Collection Agency (SWICA); 41 Generally, the ACA’s provisions regarding modernization of Medicaid eligibility procedures (e.g., application, renewal, attestation, electronic verification, submission modes, etc.) apply to determination of MAGI- and non-MAGI based eligibility decisions. See, CMS response to comments on proposed rule, 77 FR 17,143 (March 23, 2012). Accordingly, the provisions in this section apply in determining MABD income. However, as the concept of “family size” does not apply in the context of MABD (that program utilizes the concepts of “financial responsibility group” and “Medicaid group” in determining the countable non-MAGI-based income), provisions in this section that refer to “family size” apply only to MAGI-related Medicaid eligibility. 42 42 CFR § 435.948; 45 CFR § 155.320(c). Eligibility-and-Enrollment Procedures Part 7 – Page 19 (Sec.56.00, Sub.56.02) The IRS; The SSA; The State of Vermont’s new-hire database; The agency or agencies administering the state unemployment compensation laws; The state-administered supplementary payment program under § 1616(a) of the Act (AABD, See AABD Rule 2700); and Any state program administered under a plan approved under Titles I, X, XIV, or XVI of the Act; (ii) Information related to eligibility or enrollment from the 3SquaresVt Program, the Reach Up Program, other health-benefits programs, and other public-assistance programs that are administered by the State of Vermont; and (iii) Any other information source bearing upon the individual’s financial eligibility. To the extent that the information identified in this subsection is available through the federal electronic verification service (§ 53.00(d)), the information will be obtained through such service. The information will be requested by Social Security number, or if a Social Security number is not available, using other personally-identifying information in the individual’s account, if possible.