42 CFR § 423.904 - Eligibility determinations for low-income subsidies.
(c) Screening for eligibility for Medicare cost-sharing and enrollment under the State plan. States must -
(2) Offer enrollment for the programs under the State plan (or under a waiver of the plan) for those meeting the eligibility requirements.
(d) Application form and process -
(1) Assistance with application. No later than July 1, 2005, States must make available -
(i) Low-income subsidy application forms;
(ii) Information on the nature of, and eligibility requirements for, the subsidies under this section; and
(iii) Assistance with completion of low-income subsidy application forms.
(2) Completion of application. The State must require an individual or personal representative applying for the low-income subsidy to -
(i) Complete all required elements of the application and provide documents, as necessary, consistent with paragraph (d)(3) of this section; and
(ii) Certify, under penalty of perjury or similar sanction for false statements, as to the accuracy of the information provided on the application form.
(3) The application process and States.
(i) States may require submission of statements from financial institutions for an application for low-income subsidies to be considered complete; and
(ii) May require that information submitted on the application be subject to verification in a manner the State determines to be most cost-effective and efficient.