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    State Medicaid and CHIP Eligibility Verification Plans

    *Chart updated May 8, 2014

    Due to the ACA’s new eligibility verification rules, states have developed plans outlining Medicaid and CHIP eligibility verification procedures. This chart highlights key elements from states’ verification plans, such as which eligibility factors are verified through electronic data and the specific data sources states are using, as well as whether self-attestation is accepted for some eligibility factors. The chart also contains information about how states will determine reasonable compatibility, which is how they will resolve issues if there are discrepancies between electronic data sources and information provided by applicants.

    Certain eligibility factors are not included in the chart, such as pregnancy,1 Social Security Numbers,2 citizenship and immigration status3 because the ACA requires states to use the same verification processes for these factors. State CHIP programs also have unique eligibility factors that must be verified in addition to those listed below. Click here for a chart on CHIP-specific eligibility verification plans.

    This chart is based on information contained in publicly available state Medicaid/CHIP eligibility verification plans; each state abbreviation links to each state’s plan. Please note that not all state verification plans have been approved and information from them will be added to this chart as they become available.

    Like all State Refor(u)m research, this chart is a collaborative effort with you, the user. State Refor(u)m captures the health reform comments, documents, and links submitted by health policy thinkers and doers all over the country. And our team periodically supplements, analyzes, and compiles this key content. Do you know of information that should be added to this chart? Your feedback is central to our ongoing, real-time process, so tell us in a comment below.

    StateSelf-Attestation Accepted without Additional VerificationSelf-Attestation Accepted with Post-Eligibility VerificationElectronic Data Source Used for VerificationReasonable Compatibility Resolution Process (Reasonable explanation required)Reasonable Compatibility Resolution Process (Paper documentation required)Financial Verification Data Sources [4]Non-Financial Verification Data Sources [5]
    ALIncome, Residency, Age, Household, Caretaker Relative, Application for Other BenefitsMedicareIncome, MedicareIncome, MedicareIncome, MedicareIRS, SSA, SNAP, TANF, TALX/Work Number, PARISSSA, DHS, Vital Statistics, TANF, SNAP, TALX, PARIS
    AK Income, Residency, Age, Household, Caretaker RelativeMedicareIncome, Medicare, Application for Other BenefitsIncome, Medicare, Application for Other BenefitsIncome, Medicare, Application for Other BenefitsSSA, SWICA, State Unemployment, State Administered Supplementary Payment Program, State General Assistance Programs, SNAP, TANF, OCSE, The Work Number, PARIS, Department of Revenue Permanent FundSSA, DHS, Vital Statistics, TANF, SNAP, OCSE, PARIS, Department of Revenue, Permanent Fund Dividend, Department of Labor, State Administered Supplementary Payment Program
    AZ Household, Caretaker RelativeN/AIncome, Residency, Age, Household, Caretaker Relative, Medicare, Application for Other BenefitsIncomeIncome, Residency, Age, Household, Caretaker Relative, Medicare, Application for Other BenefitsSSA, SWICA, State Unemployment, SNAP, TANF, Work Number, State New Hire Database, State Eligibility System Database, PARISSSA, DHS, Vital Statistics, DMV, TANF, SNAP, State Eligibility System Database, PARIS
    AR Residency, Household, Caretaker RelativeMedicare, Application for Other BenefitsIncome, Age, Medicare, Application for Other BenefitsIncome, AgeIncome, Age, Medicare, Application for Other BenefitsIRS, SSA, SWICA, State Unemployment, SNAP, Work NumberSSA, DHS, Vital Statistics, DMV, SNAP, PARIS, Corrections
    CA Household, Caretaker Relative, Application for Other Benefits, American Indian/Alaska Native Exemptions,Former Foster Care and Medicaid EnrollmentIncome, Residency, Age, Medicare, Deceased, Former Foster Care and Medicaid EnrollmentDeceasedIncome, Residency, Age, Medicare, Former Foster Care and Medicaid EnrollmentIRS, SSA, SWICA, State Unemployment, State Income Tax, PARISSSA, DHS, DMV, TANF, SNAP, State General Assistance Programs, State Income Tax, PARIS
    COResidency, Age, Household, Caretaker Relative, Medicare, Application for Other BenefitsIncomeIncomeIncomeIncomeSSA, SNAP, TANF, Income Eligibility and Verification System from Colorado Department of Labor and EmploymentSSA, DHS, DMV, TANF, SNAP, PARIS
    CT
    DE Residency, Age, Household, Caretaker Relative, Application for Other BenefitsIncome, MedicareIncome, MedicareIncome, MedicareIncome, MedicareSSA, SWICA, State Unemployment, State General Assistance Programs, SNAP, TANF, TALX/Work Number, Child Care SubsidySSA, DHS, Vital Statistics, DMV, TANF, SNAP, OCSE, State General Assistance Programs, PARIS, Child Care Subsidy
    DC
    FLResidency, Age, Household, Caretaker Relative, Application for Other BenefitsN/AIncome, MedicareIncome, MedicareIncome, MedicareSSA, SWICA, State Unemployment, Work Number, Florida Retirement, Out of State UnemploymentSSA, DHS, Vital Statistics, DMV, PARIS
    GAResidency, Age, Household, Caretaker RelativeMedicare, Application for Other BenefitsIncome, Household, Caretaker Relative, Medicare, Application for Other BenefitsIncome, HouseholdIncome, Household, Caretaker Relative, Medicare, Application for Other BenefitsSSA, SWICA, State Unemployment, SNAP, TANF, OCSE, TALX/Work NumberSSA, DHS, Vital Statistics, TANF, SNAP, OCSE, WIC, PARIS
    HIResidency, Household, Caretaker Relative, Application for Other BenefitsIncomeIncome, Age, Medicare, Incarceration status, Other Insurance CoverageIncome, Age, Household, Caretaker Relative, Medicare, Incarceration status, Other Insurance CoverageIncome, Age, Medicare, Other Insurance CoverageSSA, SWICA, State Unemployment, OCSESSA, DHS, Vital Statistics, OCSE, Third Party Coverage, PARIS, State Workers Compensation, Department of Defense Enrollment Eligibility Reporting, State Dept. of Public Safety, Hawaii Youth Correctional Facility
    IDResidency, Household, Caretaker Relative, Application for Other BenefitsN/AIncome, Age, MedicareIncome, MedicareIncome, MedicareSSA, State Unemployment, SNAP, TANF, OCSE, Work Number, Department of Labor Quarterly Wage, Department of Labor New Hire SSA, DHS, Vital Statistics, PARIS
    IL
    INCaretaker RelativeN/AIncome, Residency, Age, Household, Medicare, Application for Other BenefitsHousehold, Application for Other BenefitsIncome, Residency, Age, Household, Medicare, Application for Other BenefitsSSA, SWICA, State Unemployment, SNAP, TANF, OCSE, Work Number (Equifax)SSA, DHS, Vital Statistics, TANF, SNAP, OCSE, PARIS
    IAResidency, Household, Caretaker Relative, Application for Other BenefitsN/AIncome, Age, MedicareIncome, Age, MedicareIncome, Age, MedicareIRS, SSA, SWICA, State Unemployment, State Administered Supplementary Payment Program, SNAP, TALX/ Work NumberSSA, DHS, PARIS, Death Matches, Prisoner Matches
    KS
    KYAge, Household, Caretaker Relative, Application for Other BenefitsResidencyIncome, Residency, Medicare, IncarcerationIncome, Residency, Medicare, IncarcerationIncome, Residency, Medicare, IncarcerationIRS, SSA, SWICA, State Unemployment, Work NumberSSA, DHS, Vital Statistics, TANF, SNAP, OCSE, PARIS
    LAResidency, Age, Household, Caretaker Relative, Application for Other BenefitsMedicare, Third Party LiabilityIncome, Medicare, Third Party LiabilityMedicare, Third Party LiabilityIncome, Medicare, Third Party LiabilitySSA, SWICA, State Unemployment, SNAP, TANF, TALX/Work Number, PARIS, State Income and Eligibility Verification SystemSSA, DHS, Vital Statistics, TANF, SNAP, OCSE,HMS Coordination of Benefits, PARIS
    MEResidency, Household, Caretaker Relative, IncarcerationAge, Medicare, Application for Other BenefitsIncome, Age, Medicare, Application for Other BenefitsIncome, Age, Medicare, Application for Other BenefitsIncome, Age, Medicare, Application for Other BenefitsSSA, State Unemployment, State Administered Supplementary Payment Program, SNAP, TANF, OCSE, Work Number, Verify DirectSSA, DHS, Vital Statistics, DMV, TANF, SNAP, PARIS, Maine Department of Corrections
    MDResidency, Household, Caretaker Relative, American Indian/Alaska NativeMedicare, Application for other Benefits, Public Institution StatusIncome, Age, Medicare, Application for other Benefits, Public Institution StatusIncome, Application for other Benefits, Public Institution StatusIncome, Age, Application for Other BenefitsIRS, SSA, SWICA, State Unemployment, SNAP, TANF, OCSE, Equifax Work NumberSSA, DHS, Vital Statistics, TANF, SNAP, OCSE, Jail Match, PARIS
    MAHousehold, Caretaker Relative, Application for Other Benefits, Access to ESIIncome, Residency, Age, Identity, Access to ESI, Third Party RecoveryIncome, Residency, Age, Medicare, Identity, Access to ESI, Incarceration, Third party RecoveryAge, IncarcerationIncome, Residency, Age, Medicare, Identity, Third Party RecoveryIRS, SSI, SWICA, State Unemployment Compensation, SNAPSSA, DHS, Vital Statistics, DMV, TANF, SNAP, State General Assistance Programs, Third Party Liability Data Matching, PARIS, Experian/LexisNexis
    MI
    MNResidency, Age, Household, Caretaker Relative, Application for Other BenefitsN/AIncome, MedicareIncomeIncomeIRS, SSA, SWICA, State Unemployment, OCSE, TALX/ Work NumberSSA, DHS, PARIS
    MSResidency, Household, Application for Other Benefits, Third Party LiabilityIV-D Child Support AgencyIncome, Age, Caretaker Relative, Medicare, IV-D Child Support Agency, Title II 40 Work QuartersIncome, AgeIncome, Age, Caretaker Relative, Medicare, Title II 40 Work QuartersIRS, SSA, SWICA, State Unemployment, Work Number EquifaxSSA, DHS, Vital Statistics, OCSE, PARIS
    MOResidency, Age, Household, Caretaker RelativeApplication for Other BenefitsIncome, Medicare, Application for Other BenefitsIncome, Medicare, Application for Other BenefitsIncome, Medicare, Application for Other BenefitsIRS, SSA, SWICA, State Unemployment, State Administered Supplementary Payment Program, SNAP, TANF, OCSE, PARIS, TALX/ Work Number, Quarterly Wage Match, Directory of New Hire MatchesSSA, DHS, Vital Statistics, DMV, TANF, SNAP, PARIS, MMIS
    MTResidency, Household, Caretaker Relative, Application for Other Benefits, Third Party Liability, Child Support Enforcement Division, Premium cost-effectiveness for the Health Insurance Premium Payment ProgramIncome, Household, Caretaker RelativeIncome, Age, Household, Caretaker Relative, MedicareIncome, Age, Household, Caretaker RelativeIncome, Age, Household, Caretaker RelativeSSA, SWICA, State Unemployment, SNAP, TANF, Work Number, National Directory of New HiresSSA, DHS, Vital Statistics, TANF, SNAP, OCSE, PARIS
    NEResidency, HouseholdN/AIncome, Age, Caretaker Relative, Medicare, Application for other BenefitsIncomeIncome, Age, Cartaker Relative, Medicare, Application for Other BenefitsIRS, SSA, SWICA, State Unemployment Compensation, State Administered Supplementary Payment Program, SNAP, TANF, OCSE, TALX/The Work Number, Provider Alerts, National Directory of New Hires, IRS 1099 information,SSA, DHS, Vital Statistics, DMV, TANF, SNAP, Office of Child Support Enforcement, PARIS, CMS: Medicare Part D Interface,
    NVResidency, Household, Caretaker RelativeHousehold, Caretaker Relative, Medicare, Application for Other BenefitsIncome, Residency, Age, Household, Caretaker Relative, Medicare, Application for Other BenefitsIncome, Residency, Age, Household, Caretaker Relative, Medicare, Application for Other BenefitsIncome, Residency, Age, Household, Caretaker Relative, Medicare, Application for Other BenefitsSSA, SWICA, State Unemployment, SNAP, TANF, Work Number, State New HireSSA, DHS, Vital Statistics, TANF, SNAP, OCSE, PARIS, Third Party Liability vendor Emdeon
    NHResidency, Household, Caretaker Relative, Application for Other BenefitsIncome, Age, MedicareIncome, Age, MedicareIncome, AgeIncome, AgeSSA, SWICA, State Unemployment, State Administered Supplementary Payment Program, SNAP, TANF, Work Number, Verify Direct, PARISSSA, DHS, Vital Statistics, TANF, SNAP, PARIS
    NJResidency, Age, Household, Caretaker Relative, Application for Other BenefitsN/AIncome, MedicareIncomeIncome, MedicareSSA, SWICA, State Unemployment, State Income TaxSSA, DHS, Vital Statistics, OCSE, State Income Tax, Health Management Systems, PARIS
    NM Residency, Household Composition, Caretaker Relative, Application for Other BenefitsN/AIncome, Age, Household Composition, MedicareIncome, Age, MedicareIncome, Age, MedicareIRS, SSA, SWICA, State Unemployment Compensation, State Administered Supplementary Payment Program, State General Assistance Programs, SNAP, TANF, OCSE, TALX, PARISSSA, DHS, DMV, TANF, SNAP, OCSE, State General Assistance Programs, PARIS
    NYResidency, Household, Caretaker RelativeApplication for Other BenefitsIncome, Age, Medicare, Application for Other Benefits, Federal public MEC beyond Medicare (e.g. Peace Corps) ESI known to MedicaidIncome, MedicareIncome, Age, Medicare, Application for Other BenefitsIRS, SSA, SWICA, State UnemploymentSSA, DHS, Experian, PARIS, Medicaid/CHIP active coverage
    NC Age, Household Composition, Caretaker RelativeMedicareIncome, Residency, Medicare, Application for Other BenefitsIncomeIncome, Residency, Medicare, Application to Other BenefitsSSA, SWICA, State Unemployment Compensation, SNAP, TANF, OCSE, State Income Tax, The Work Number, Address Verification System, PARISSSA, DHS, DMV, TANF, SNAP, OCSE, The Work Number, PARIS, North Carolina Department of Corrections, MMIS
    NDResidency, Household, Caretaker Relative, Application for Other BenefitsN/AIncome, Age, MedicareIncome, Age, MedicareIncome, Age, Household, MedicareIRS, SSA, SWICA, State Unemployment, SNAP, TANF, OCSE, PARIS, TALX/Work NumberSSA, DHS, Vital Statistics, DMV, OCSE, PARIS
    OHResidency, Age, Household, Caretaker Relative, Application for Other BenefitsN/AIncome, Medicare, Application for Other Benefits, Former foster care statusHousehold, Caretaker RelativeIncome, Household, Caretaker Relative, Medicare, Application for Other Benefits, Former foster care statusIRS, SSA, SWICA, State Unemployment, OCSE, TALX/Work Number, PARIS,SSA, DHS, PARIS, Incarceration
    OKAge, Household, Caretaker Relative, Application for Other BenefitsIncome, Residency, Medicare Income, Residency, Household, Caretaker Relative, MedicareIncome, Residency, Household, MedicareIncome, Residency, Household, MedicareSSA, SWICA, State Unemployment SSA, DHS, Vital Statistics, OCSE, PARIS
    ORResidency, Household, Caretaker RelativeIncome, Age, Household, Caretaker Relative, Medicare, Application for Other BenefitsIncome, Age, Household, Caretaker Relative, Medicare, Application for Other Benefits, Oregon Medicaid/CHIP beneficiaryIncome, Age, Household, Caretaker Relative, Medicare, Application for Other BenefitsIncome, Age, Household, Caretaker Relative, Application for Other BenefitsIRS, SSA, SWICA, State Unemployment, State Administered Supplementary Payment Program, SNAP, TANF, OCSE, Work NumberSSA, DHS, Vital Statistics, DMV, OCSE, APPRISS Incarceration Match, PARIS, Department of Corrections, State of Oregon Medicaid/CHIP eligibility data
    PAResidency, Household, Caretaker RelativeMedicare, Application for Other BenefitsIncome, Age, Medicare, Application for Other BenefitsIncome, Age, Medicare, Application for Other BenefitsIncome, Age, Medicare, Application for Other BenefitsIRS, SSA, SWICA, State Unemployment, State Administered Supplementary Payment Program, State General Assistance Programs, SNAP, TANF, OCSE, Work Number, OnBaseSSA, DHS, Vital Statistics, DMV, TANF, SNAP, OCSE, State General Assistance Programs, Health Management Systems, PARIS
    RIResidency, Household, Caretaker RelativeAge, Application for Other BenefitsIncome, Age, Medicare, Application for Other BenefitsIncomeIncome, Age, Application for Other BenefitsIRS, SSA, SWICA, State UnemploymentSSA, DHS, Vital Statistics, OCSE, PARIS
    SCIncome, Residency, Household, Caretaker Relative,N/AIncome, Age, Medicare, Application for Other BenefitsIncome, MedicareIncome, Age, Medicare, Application for Other BenefitsSSA, SWICA, State Unemployment, SNAP, TANF, Work Number and Verify DirectSSA, DHS, Vital Statistics, TANF, SNAP, PARIS, State Wage Collection Agency/Unemployment
    SDResidency, Age, Household, Caretaker Relative, Application for Other BenefitsMedicareIncome, Residency, Age, Household, Caretaker Relative, MedicareIncome, Residency, Age, Household, Caretaker Relative, MedicareIncome, Residency, Age, Household, Caretaker Relative, MedicareIRS, SSA, SWICA, State Unemployment, SNAP, TANF, TALX/Work NumberSSA, DHS, Vital Statistics, TANF, SNAP, PARIS, HMS (ORFI)
    TNCaretaker Relative, Application for Other BenefitsHousehold, IncarcerationIncome, Residency, Age, Household, Medicare, IncarcerationN/AIncome, Residency, Age, Household, IncarcerationIRS, SSA, SWICA, State Unemployment, Work Number, Defense Enrollment Eligibility Reporting System, IRS Computer Matching ProgramSSA, DHS, Vital Statistics, PARIS, TN Department of Corrections, Unemployment Data, Quarterly Wage Data
    TXResidency, Age, Household Composition, Application for Other BenefitsIncome, Residency, Age, Caretaker Relative, Medicare, Application for Other BenefitsN/AIncome, Residency, Age, Caretaker Relative, Medicare, Application for Other Benefits SSA, SWICA, State Unemployment Compensation, SNAP, TANF, The Work Number System, Office of Attorney General Employee New Hire Data, Choices Information Transmittal, State Employee Benefits Data from the Employees Retirement System and Teacher Retirement SystemSSA, DHS, Vital Statistics, DMV, TANF, SNAP, PARIS
    UT
    VTResidency, Household, Caretaker Relative, Application for Other BenefitsN/AIncome, Age, MedicareIncome, Age, MedicareIncome, Age, MedicareSSA, SNAP, TANFSSA, DHS, Vital Statistics, TANF, SNAP, PARIS
    VAResidency, Age, Household, Caretaker RelativeN/AIncome, Medicare, Application for Other BenefitsIncomeIncome, Medicare, Application for Other BenefitsIRS, SSA, SWICA, State Unemployment, SNAP, TANF, Work Number, PARISSSA, DHS, Vital Statistics, DMV, PARIS
    WA
    WVResidency, Household, Caretaker Relative, Application for Other BenefitsOther insurance coverageIncome, Residency, Age, Household, Caretaker Relative, Medicare, Other insurance coverageIncome, Residency, Age, Household, Caretaker Relative, Medicare, Other insurance coverageIncome, Residency, Age, Household, Caretaker Relative, Medicare, Other insurance coverageIRS, SSA, SWICA, State Unemployment, SNAP, TANF, OCSE, Work Number, Work Force West Virginia, Families and Children Tracking SystemSSA, DHS, Vital Statistics, DMV, TANF, SNAP, Health Management System, PARIS, Third Party Administrator, Public Employees Insurance Agency, Families and Children Tracking System
    WI
    WYHousehold, Caretaker RelativeResidency,Application for Other BenefitsIncome, Residency, Age, Household, Caretaker Relative, Medicare, Application for Other BenefitsHousehold, Caretaker RelativeIncome, Residency, Age, Household, Caretaker Relative, Medicare, Application for Other BenefitsIRS, SSA, State Unemployment, TALX/Work Number, PARISSSA, DHS, Vital Statistics, DMV, OCSE, PARIS, Electronic Verification of Vital Events, WYCAPS, SWICA, IRS

    Notes: 

    [1] Self-attestation of pregnancy is a requirement for states regardless of the benefit package provided by the State; however under § 435.956(e) if a state has information that is not reasonably compatible with the attestation, the State may verify pregnancy in a manner consistent with § 435.952.

    [2] Per §435.956(d)(1), the agency must verify Social Security numbers (SSNs) in accordance with §435.910.

    [3] States will be required to verify citizenship and immigration status through the federal data services hub if available (§435.956(a)(1)).

    [4] Financial Verification Data Source acronym definitions: SSA = Social Security Administration; SWICA= State Wage Information Collection Agency; SNAP = Supplemental Nutrition Assistance Program; TANF = Temporary Assistance for Needy Families; OCSE = Office of Child Support Enforcement; PARIS = Public Assistance Reporting Information System; IRS= Internal Revenue Service.

    [5] Non-Financial Verification Data Source acronym definitions: SSA = Social Security Administration; DHS = Department of Homeland Security; TANF = Temporary Assistance for Needy Families; SNAP = Supplemental Nutrition Assistance Program; OCSE = Office of Child Support Enforcement; PARIS = Public Assistance Reporting Information System; DMV = Department of Motor Vehicles; MMIS = Medicaid Management Information Systems; HMS ORFI = HMS is used to identify enrollment in private health insurance for Targeted Low Income Children; WYCAPS = Wyoming Child Assistance and Protection System.

    Produced by Anita Cardwell and Kaitlin Sheedy.

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