About

Changes related to electronic verifications utilized in determining eligibility for MA cases were incorporated in VaCMS with the October 2019 deployment to improve the success rate of the self-direct process.

Changes made to VaCMS included:

1.    Utilizing “Attested Income”, this is the income stated on the application; received or expected to be received by the client/those requesting assistance as listed on the application.

2.    Comparing “Attested Income” and “Electronic Verified Income” to the appropriate “Medicaid Eligibility Threshold” (MET).

3.    Applying the reasonable compatibility standard during intake actions when one of two income outcomes exist in VaCMS:

a.    Attested income is below the “MET” and electronic verifications is above the “MET” but the electronic income is within 10% of the attested income

b.    Attested income is and the electronic verification(s) is below the “MET”.

VaCMS will now only determine “reasonable compatibility” when one of the two instances above exist – at non Intake case actions, only scenario 3.b will result in a pass for income verification.

VaCMS Electronic Sources

VaCMS will continue to utilize the following electronic sources:

·         TALX – earned income verification as provided by employers

·         VEC – both earned income and unearned (unemployment benefits) income

·         SOLQ – unearned income (SSA, Title II, and SSI)

·         IRS -  all income types

Special Electronic Verification Process Flows

Specific QRGs have been developed for:

·         Electronic Verification Sources (responses)

·         SNAP Flow

·         IRS Flow

11/30/19