Wisconsin Administrative Code › Department of Health Services › DHS 101-109 - Medical Assistance › Chapter DHS 102 - Application › Section DHS 102.03 - Verification of information

Current through June 24, 2024
(1) An agency that
				has complied with subs. (1g) and (1r) shall deny an application for MA when the
				applicant or recipient is able to produce required verifications but refuses or
				fails to do so, except that a refusal or failure by an applicant for MA to
				verify assets does not affect eligibility for BadgerCare Plus under s.
				49.471, Stats. If the applicant
				or recipient is not able to produce verifications, or requires assistance to do
				so, the agency may not deny assistance but shall proceed immediately to verify
				the data elements.
(1g) An
				individual shall not be required to provide additional information or
				documentation if it is not required to determine eligibility for the type of
				Medicaid or BadgerCare Plus, under subch. IV of ch. 49, Stats., that the member
				is requesting.
(1r) An individual
				shall not be required to provide additional information of documentation unless
				information needed by the agency cannot be obtained electronically or the
				information obtained electronically is not reasonably compatible with
				information by or on behalf of the individual. Income information obtained
				through an electronic data match shall be considered reasonably compatible with
				income information provided by or on behalf of an individual if both are at or
				below the applicable standard for MA.
(2) The agency shall verify those data
				elements deemed appropriate under the circumstances of the case history for an
				applicant who has been convicted of public assistance-related fraud, is
				repaying aid pursuant to an agreement with the district attorney's office, or
				is known to have provided erroneous information on a previous application which
				resulted in an incorrect issuance of assistance.
(3) Each of the following items shall be
				verified when applicable:
(a)
				Income.
(b) Pregnancy, when the
				agency has information that contradicts the member's self-attestation. If there
				is no contradictory information, the agency shall accept the member's
				self-attestation of pregnancy.
(d)
				Social security number, subject to all of the following requirements:
1. Services must not be denied or delayed to
				an otherwise eligible individual pending issuance or verification of the
				individual's social security number by the Social Security
				Administration.
2. Any of the
				following individuals are not required to provide a social security number:
a. Individuals who are deemed eligible for
				MA, based on being born to a pregnant woman eligible for MA in Wisconsin, until
				they turn 1 year of age.
b.
				Individuals who are not eligible to receive a social security number.
c. Individuals who do not have a social
				security number and may only be issued a social security number for a valid
				non-work reason in accordance with
				20 CFR
				422.104.
d. Individuals who refuse to obtain a social
				security number because of well-established religious objections, as provided
				in s. 49.82 (2) (b)
				3, Stats.
(e) Age.
(f) Citizenship subject to s.
				DHS
				102.035.
(g) Disability, blindness, or both.
(h) Assets.
(i) Residence.
(j) Immigration status, subject to s.
				DHS
				102.036.