COVID-19 Pandemic Response - Updated Verification Requirements for Medical Applications and Active Cases

Illinois Department of Human Services Logo
Healthcare and Family Services Logo

Policy Memo

01/13/2021

Summary:

This policy memo updates COVID-19 Pandemic Response Updated Requirements for Acceptance of Self-Attestation.

Due to the COVID-19 Emergency Declaration, effective immediately self-attestation will be accepted for all medical applications and active cases for select eligibility criteria factors. This will ensure applications are quickly approved and most do not pend for verifications. Additionally, there will be no resource test during the COVID-19 emergency.

Effective immediately:

Self-attestation will be accepted for all medical applications and active cases for the following criteria when electronic verification is not available:

  • Income
  • Illinois residency
  • Insured status
  • Incurred medical expenses - self-attestation of incurred medical expenses may by used for active cases to meet spenddown as well as for pending and new applications.
  • Disability


Until system changes can be completed, it is necessary to use existing values in IES that will allow approval of medical. SNAP will not allow the use of self-attestation. Following is guidance regarding use of the verification value to use when accepting self-attestation for each of these criteria. A case comment indicating that self-attestation was accepted and for which criteria should be completed - include in the case comment, "Due to the COVID-19 emergency declaration, self-attestation was accepted for (insert criteria)".


When electronic verification is not available and no verification was provided with the application, use the information provided on the application and select the following verification value.

  • Earned Income - use AWVS as the verification value. This will pend other benefits but will allow medical to be approved.
  • Unearned Income - Select Other Acceptable. IMPORTANT: This verification value is acceptable for all benefits. If self-attestation is being accepted for anyone requesting SNAP or Cash - run eligibility - ONLY certify the medical benefits, then return to Data Collection and update the value to client statement and run eligibility again to pend and send the VCL.
  • Self-Employment - Select Other Acceptable.
  • Incurred medical expenses - Select Medical Only for Program in the TOA dropdown.
  • Illinois Residency - Select Other Acceptable. IMPORTANT: This verification value is acceptable for all benefits. If self-attestation is being accepted for anyone requesting SNAP or Cash - run eligibility - ONLY certify the medical benefits, then return to Data Collection and update the value to client statement and run eligibility again to pend and send the VCL.
  • Insured Status - Select Other acceptable.
  • Disability - Select Other acceptable.


NOTE: Accept the client statement of income if the client statement is lower than the amount from the electronic source, and the income amount is likely reduced due to the national health emergency (for example: restaurants, theaters, travel, hotels, etc.). Enter a case comment in this situation.

Resource Test Temporarily Removed

The Medicaid resource (asset) test is temporarily removed. Assets are disregarded when determining Medicaid eligibility due to the PHE. The resource test has been suspended for BOTH applications and approved cases. At the end of the PHE, additional guidance will be provided about how to review assets. Assets will only be applied going forward, there will not be any retroactive changes in eligibility based on the resource test.

  • Assets are disregarded at this time due to the COVID Emergency Declaration
  • If an individual has resources:
    • Do not enter the record in IES.
    • Enter case comment stating "Assets are disregarded at this time due to the COVID-19 Emergency Declaration".


A VCL is still required when:

  • Income questions are left blank on the application;
  • Income is indicated on the application but no verification is provided, no electronic verification is found and no amount is declared;
  • The difference between the reported income is less than the applicable medical program standard and the electronic verification obtained is more than the applicable medical program standard and the difference is not within the reasonable compatibility limit.

Redeterminations

During the PHE, do not process any REDES whether form A or B. In rare cases when a REDE needs to be processed to benefit the individual, contact your Local Office Administrator for permission. Per Policy Memo COVID-19 Pandemic Response - Delay of Medical Redeterminations, medical cases will no longer be closed for failing to respond to a redetermination or due to certification period ending. To avoid closure of medical, certification dates will be updated systematically.

COVID-19 Telephonic Signature Process

  • Consistent with SNAP flexibilities, permit phone applications without recording of client authorization (telephonic signature).
  • The adjustment to the telephonic signature is limited to SNAP and Medicaid households who submit initial applications without signatures over the phone or by paper application.
  • This adjustment allows customers to call the Family Community Resource Center (FCRC) in the event that there are system issues with the ABE Call Center and a telephonic signature cannot be obtained.
  • In addition, community providers can take applications over the phone from applicants and then submit to the FCRC without having to first send to the applicant for signature.
  • View Policy Memo COVID-19 Adjustment to Audio Recording of a Telephone Signature for SNAP Extended for more detailed information.


[Signed copy on file]

Grace B Hou

Secretary, Illinois Department of Human Services

Theresa Eagleson

Director, Healthcare and Family Services