Page 25

28 Effective Date: July 1, 2001

Approval Date: The application asks the citizenship status and Social Security Number (SSN) of only those children for whom the family is seeking benefits. Since disclosure of the Social Security Number is optional, children are enrolled into CHIP without having a Social Security Number. Adults, and other children listed on the application for whom the family is not applying, are not required to declare their citizenship status or provide an SSN.

When the application is screened into the ACES system, data such as the SSN is transmitted to other available state and federal data exchanges. The information from these exchanges may then be used as electronic proof of eligibility requirements. One such system is the SVES data match with the Social Security Administration (SSA). SSN information is entered into the ACES system during the screening process, and transmitted to SSA in an overnight batch. Verification of citizenship and enumeration is federally verified and transmitted back to the ACES system where the clients’ record is automatically updated even before the application has completed the application process. Wherever possible, department staff utilize electronically available information rather than delaying the application approval process by requesting paper documents from the applicant.

For continuing enrollment, an eligibility review form is generated and mailed to the head of household approximately six weeks prior to the end of the client’s 12 month certification period. The eligibility review form must be completed and returned with current information such as household members, income, and health insurance status. The eligibility review form is reviewed first for Medicaid, and then reviewed for CHIP eligibility if the recipient is not Medicaid eligible. As an alternative to completing the eligibility review form, the client may call into a statewide 800# and complete the review over the phone with an eligibility specialist .

CHIP applicants have the same appeal rights as Medicaid applicants. Applicants who are denied eligibility are sent a letter with information on their rights for an Administrative Hearing. Clients may call the Office of Administrative Hearings (OAH)