(west-virginia-verification-plan-final)West Virginia MAGI-based eligibility verification plan (42 CFR 435.945(j)) as posted by CMS#
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MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: West Virginia Last updated 10/20/2016 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 Both are above, at or below the applicable income standard. Percent Threshold 10% YES YES If the individual attests to income below the applicable standard, and data source indicates income above the applicable income standard, if the difference between the two is 10% or less, the state will consider that reasonably compatible. If the difference is greate than 10%, reasonable explanation, additional verification, and/or paper documentation will be requested. Paper documentation is only required from the client if they are unable to provide a satisfactory reasonable explanation for the compatibility issue. When an individual attests to income above the applicable standard and data source indicates income below the standard, state will take that attestation and make the person ineligible and screen for APTC. Residency YES NO YES N/A N/A YES YES For individuals not known to the system, State will accept self- attestation without additional verification. For individuals already known to the integrated system, (i.e. through SNAP or TANF), State will perform verification using an electronic data source. Paper documentation is only required from the client if they are unable to provide a satisfactory reasonable explanation for the compatibility issue and eligibility is affected. MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION A - Verification Procedures for Factors of Eligibility 1