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MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) State: Last Updated Section D. Additional Verification Questions Medicaid & CHIP West Virginia 10/20/2016 Question Response 1 If paper documentation is required when a data source is not available or the information obtained from a data source is not reasonably compatible with the information provided by or on behalf of the individual, briefly describe how the state determined that establishing and using an electronic data source was not effective, considering such factors as cost and program integrity in accordance with 42 CFR 435.952(c): The State notes that the demographics in West Virginia are such that many individuals' income will not be reflected in the Hub. Therefore, alternative forms of verification must be accepted so as not to impact the integrity of the determination process. In Section C, numbers one, three, and four, the State will accept paper documentation from individuals when there is a positive data match with the HMS data system indicating that the individual has some other form of insurance. The State feels that the most expeditious way to address a match with HMS will be to allow the client to submit documentation from their previous insurer confirming that their insurance has lapsed. The state accepts self-attestaion without additional verification for some factors of eligiblity and for those that it doesn't, the State plans to use multiple data sources prior to reaching out to the individual for reasonable explanation or paper documentation. 2 Please describe how the state uses PARIS? The State will use PARIS to provide information about health benefits provided by the VA, TriCare, and Department of Defense, benefits from another state health agency, and duplicate benefits. 3 Please indicate (YES) or (NO) if the State intends to request Secretarial approval to solely use alternative data sources for financial verification other than those listed in 42 CFR 435.948 (Numbers 1-8 in Section B-1). NO If (YES), please submit a letter to CMS requesting such approval describing how the state meets the following requirements: 1) Reduces administrative costs and burdens on both individuals and the State, 2) Maximizes accuracy and minimizes delay, 3) Meets the requirements related to confidentiality, disclosure, maintenance and use of information, and 4) Promotes coordination with other insurance affordability programs. N/A MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION D- Additional Verification Questions 15