GIS 17 MA/007: Income Attestation at Renewal - Reminder

The purpose of this General Information System (GIS) message is to remind local departments of social services of the renewal simplification policy that allows certain Medicaid recipients to attest to income at renewal.

Section 366-a(5)(d) and (e) of the Social Services Law (SSL), as enacted by Chapter 58 of the laws of 2007, allows attestation of income at renewal unless the recipient has a resource test and seeks Medicaid coverage for community-based long-term care or institutional long-term care services. With the enactment of the Affordable Care Act (ACA), effective January 1, 2014, most recipients who are not aged or disabled, transitioned to a Modified Adjusted Gross Income (MAGI) category, with no resource test. In re-determining eligibility for MAGI individuals at renewal, such individuals can attest to income.

As stated in 08 OHIP/ADM-4, “Renewal Simplification for Medicaid and Family Health Plus Recipients,” districts are required to verify the accuracy of income information provided by the recipient by comparing it to information that is available such as the Resource File Integration (RFI), or through current stored budget or income information from an active Temporary Assistance (TA), Supplemental Nutrition Assistance Program (SNAP) or Home Energy Assistance Program (HEAP) case. It should be noted that due to the elimination of the Family Health Plus program on December 13, 2013, there is no longer the option to upgrade or downgrade coverage based on the income information shown by data sources and documentation provided by the recipient. Therefore, when a Medicaid recipient, including those who are self-employed, attests to income that remains within the applicable Medicaid income limit and the RFI information is also within the Medicaid level or there is no RFI hit, there is no need to require documentation. The attached “Income Attestation at Renewal” desk aid, which was revised and reissued in GIS 12 MA/015 “Income Attestation at Renewal” has been updated to reflect these current requirements.

For further details regarding the renewal simplification policy, refer to 08 OHIP/ADM-4 and 11 OHIP/ADM-1 “Expansion of Attestation of Income, Resources and Residence at Renewal, and Attestation of Interest Income at Application for Family Health Plus and Certain Medicaid Applicants.”

Please direct any questions to your local district liaison.