Kansas Department of Health & Environment

Kansas Family Medical Assistance

Manual (KFMAM)

Eligibility Policy - 10/16/2021

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1333 Mandatory Verification - Eligibility staff shall verify the following information prior to approval for initial applicants, when processing a review, or a reported change.

1333.01 SSN - An applicant is required to supply their Social Security Number or verification of application for the required SSN prior to approval of coverage unless the individual claims good cause. See 2033. The reported SSN is then verified using either the Federal HUB or SVES in Tier One, or through EATSS-SSA in Tier Two. Verification of the SSN does not include a copy of the paper SSN card. Verification of the SSN is a once-in-a-lifetime requirement. For persons without an SSN, they must apply for an SSN and provide proof of application. The requirement to supply and verify an SSN does not apply to non-citizens.
When an applicant fails to provide an SSN, he or she may qualify for a Reasonable Opportunity Period. See 2045.07

1333.02 Citizenship and Identity - Persons applying for medical assistance attesting to be a citizen must have citizenship and identity verified as described in 2045. Unless otherwise exempt, this applies to all applicants. This is a once-in-a-lifetime requirement. Information is not requested from the client once citizenship is verified.

This requirement does not apply to the following individuals:

- Current or former SSI recipients

- Current or former Medicare beneficiaries

- Current or former recipients of Social Security Disability benefits

- Children in foster care or recipients of foster care maintenance

- Children who are recipients of adoption support payments

- Children born on or after July 1, 2006 to a Medicaid recipient as outlined in 2320.

Tier One verification includes the Federal HUB.

Tier Two verification includes Web-IZ. When the Web-IZ is from Vital Statistics, it can be used as proof of both Citizenship and Identity. Otherwise, it is only proof of Identity.

Note: For verification of citizenship and identity, it is acceptable to access the file in Tier 3 to determine if documentation has previously been provided before accessing the Tier 2 sources. Both Tier 2 and Tier 3 must be followed before proceeding to Tier 4.

Tier Three and Four verification can include birth certificates and other paper documents. See KDHE Eligibility Policy-Appendix Item A-12 and 2045.

1333.03 Non-Citizenship Status - Qualified non-citizenship status must be verified for persons applying for coverage. Verification is not required for SOBRA but may be necessary to establish the individual is not a qualified non-citizen. Verification is accomplished through the Department of Homeland Security and additional verification steps may be necessary. The SAVE process is used to obtain the information. Verification is not requested for non-applicants.

Tier One verification includes the Non-Citizen VLP through the Federal HUB, including subsequent SAVE processes.

Tier Two includes the manual SAVE process.

Tier Three includes information available in the case file.

A Reasonable Opportunity period may be granted for persons who fall to Tier Four. The Reasonable Opportunity period is granted only if the individual reports a non-citizenship status that would qualify him/her for medical assistance. See 2047.01.

1333.05 Medical Expenses - The amount of any medical expenses used to meet a spenddown must be verified in order to allow it against the spenddown. Failure to verify expenses doesn't disqualify the individual, as eligibility is determined without allowing the expense. Medical expenses for Spenddown submitted through Provider Billing protocols in the MMIS are considered verified if proper procedures are followed.

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