North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-02.1 - Eligibility for Medicaid › Section 75-02-02.1-34.3 - Reasonable compatibility of income for individuals subject to a MAGI-based methodology

Current through Supplement No. 393, July, 2024
1. For purposes of
				this section, "reasonable compatibility" refers to an allowable difference or
				discrepancy between the income reported by an applicant or recipient and the
				income reported by an electronic data source.
2. The department may request additional
				information or documentation from an applicant or recipient only if
				verification cannot be obtained from an electronic data source or information
				obtained from the electronic data source is not reasonably compatible with
				information provided by the applicant or recipient.
3. The most recent verification of income
				from an electronic data source is reasonably compatible if it results in the
				same eligibility outcome as information reported by the applicant or
				recipient.
4. Any income
				verification information requested and received by the department as a result
				of the application or review of other economic assistance programs must be used
				to determine eligibility for medicaid and children's health insurance program
				and reasonable compatibility does not need to be determined.
5. If an applicant or recipient has multiple
				types of income and income from different sources, each type of income and each
				source of income must be compared for reasonable compatibility, and the highest
				amount from each type and source must be used to determine
				eligibility.
6. When income
				verification is received quarterly, the income must be converted to a monthly
				amount to determine reasonable compatibility.
7. For purposes of determining reasonable
				compatibility for earned income, other than self-employment, and unearned
				income:
a. When both the electronic data
				source and the applicant or recipient report total countable income that is
				below the budget unit income level, the two data sources are considered to be
				reasonably compatible and further verification may not be requested. The higher
				of the two amounts will be used to determine eligibility.
b. When both the electronic data source and
				the applicant or recipient report total countable income that is above the
				budget unit income level, the two data sources are considered to be reasonably
				compatible and further verification may not be requested.
c. When verification from the electronic data
				source is above the budget unit income level, but the information reported by
				the applicant or recipient is less than the budget unit income level, or when
				verification from the electronic data source is below the budget unit income
				level but the information reported by the applicant or recipient is higher than
				the budget unit income level, the two data sources are not reasonably
				compatible and further verification is required to determine
				eligibility.
d. When the electronic
				data source does not provide verification of income from the same source and
				type as the applicant or recipient reported, the two data sources are not
				reasonably compatible and further verification is required in order to
				determine eligibility.