7 AAC 100.016 - Verification and documentation
Current through December 2, 2021
(a) The department
will verify whether an applicant or recipient meets eligibility
requirements.
(b) The department
will request in writing that an applicant or recipient provide documentation
that the applicant or recipient meets eligibility requirements if the required
documentation is not readily available to the department from any alternative
source or the information needed cannot be verified from an alternative source
readily available to the department. Except as provided in
7
AAC 100.030, an applicant or a recipient who refuses
to provide the department with documentation under this section will be
determined ineligible for Medicaid by the department.
(c) The department will determine whether the
verification and documentation supports a finding of eligibility by evaluating
whether
(1) it reasonably proves the fact in
question;
(2) it is consistent with
all other information contained in the application and record; and
(3) alternative types of verification or
documentation, if necessary, are obtainable.
(d) If an applicant who is eligible to
receive Medicaid benefits based on the application and all other documents and
verification available has not provided all of the documentary evidence needed
to verify all eligibility requirements, the department will authorize issuance
of benefits only for the month in which the application was received and the
following month, and only if the
(1) applicant
shows that the applicant
(A) does not possess
the necessary documents;
(B) cannot
readily obtain the documents;
(C)
has requested any custodian of the documents to provide them; and
(D) cannot reasonably be expected to receive
the documents within 30 days after requesting them from any
custodian;
(2)
department has made at least one other contact that supports the applicant's
claim that an unverified eligibility requirement is met; and
(3) department does not have evidence that
the eligibility requirement is not met.
Notes
Authority:AS 47.05.010
AS 47.07.040
The following state regulations pages link to this page.
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.