Rhode Island Code of Regulations › Title 210 - Executive Office of Health and Human Services › Chapter 10 - EOHHS General Provisions › Subchapter 00 - General Provisions › Part 3 - Medicaid and Children's Health Insurance Program (CHIP) Non-Financial General Eligibility Requirements › Section 210-RICR-10-00-3.6 - Non-financial Eligibility Factors

Current through June 14, 2024
A.
				  Self-attestations and attestations at the time of initial application are
				  accepted for certain non-financial eligibility requirements. Verification of
				  this information is required in some by Federal or State law or Regulation, as
				  indicated in §
										3.6(B)   of
				  this Part below. Rhode Island has opted to utilize approved Federal and State
				  electronic interfaces with the IES for verification purposes when available, as
				  authorized in  42 C.F.R. §§
											435.948 through  435.956. Paper documentation is
				  therefore utilized only in instances when there is no information available
				  through an electronic data source or there is a discrepancy between a
				  self-attestation or an attestation and the electronic data source.
B. All persons seeking Medicaid eligibility
				  must provide a date of birth (age) and an SSN. Rhode Island resident children
				  under the age of nineteen (19) are not subject to the eligibility requirements
				  related to citizenship and immigration status and are not required to provide
				  proof of legal immigration status or to have an SSN. Attestations and
				  self-attestations about Rhode Island residency are accepted and require no
				  verification, However, attestations and self-attestations about age and SSN are
				  verified through electronic data sources. All applicants must provide an SSN,
				  show proof that one has been requested, or seek the assistance of an agency
				  representative to apply for an SSN before a determination of eligibility can be
				  made.
1. Information and verification by
				  coverage category - The respective responsibilities of applicants and the State
				  associated with non-financial eligibility factors such as SSN and residency may
				  vary by category of coverage. Accordingly, the applicable provisions are set
				  forth in the Chapters of this Title related to each category of coverage, as
				  indicated below:
a. Medicaid Affordable Care
				  Coverage (MACC) Groups and Non-MAGI eligible children and youth. Required
				  information and verification for families, children, ACA expansion adults and
				  pregnant women whose eligibility is determined using the MAGI standard is
				  located at Part
				  30-00-1 of this Title; For members
				  of these populations deemed eligible due to a characteristic (newborns) or by
				  current or past participation in a Federal or State program (SSI or Rhode
				  Island Department of Children, Youth and Families (DCYF)) are set forth in Part
				  30-00-1 of this Title.
b. Integrate Health Care Coverage (IHCC)
				  Groups and Non-MAGI eligible adults and elders - Information related to
				  non-financial eligibility requirements for all coverage groups subject to
				  determinations using the SSI methodology, including the SSI and Community
				  Medicaid eligibility pathway and Medicare Premium Payment Program (MPPP) are
				  set forth in the application provisions in Part
				  40-00-1 of this Title and general
				  eligibility section of Part
				  40-05-1 of this Title.
c. LTSS - All new applicants for LTSS must
				  meet the general eligibility requirements related to age, SSN and residency.
				  Existing Medicaid beneficiaries who are seeking LTSS do not have to provide
				  additional information about these non-financial factors if already known to
				  the State and, therefore, are not subject to verification. For applicants
				  pursing the ACA adult MAGI pathway, the non-financial eligibility requirements
				  are set forth in Part
				  30-00-1 of this Title. For all
				  other LTSS applicants, the provisions related to the SSI methodology for
				  Community Medicaid located in Part
				  40-05-1 of this Title
				  apply.