Arkansas Code § 20-77-2103 - Medicaid Eligibility Verification System -- Requirements

(a) Beginning concurrently with the establishment of live, full-time operation of the Federal Data Services Hub and the Arkansas Data Services Hub, the Department of Human Services shall deploy an automated eligibility verification system that electronically queries the Federal Data Services Hub and the Arkansas Data Services Hub under this subchapter.

(b) The department shall electronically query the Federal Data Services Hub upon receiving a Medicaid application and to the extent permitted by the Federal Data Services Hub for purposes of Medicaid eligibility renewal.

(c) If the Medicaid eligibility or continued Medicaid eligibility of an individual can be determined based on information received via the Federal Data Services Hub, the department shall determine eligibility and notify the applicant or recipient.

(d) If the Medicaid eligibility or continued eligibility of an individual cannot be determined based on information received via the Federal Data Services Hub, the department shall electronically query the Arkansas Data Services Hub and determine whether the information received from each data services hub is:

(1) Reasonably compatible and establishes that the individual is Medicaid-eligible;

(2) Reasonably compatible and establishes that the individual is not Medicaid-eligible; or

(3) Not reasonably compatible.

(e) If the information received from the Federal Data Services Hub and the Arkansas Data Services Hub is reasonably compatible, the department shall enter an eligibility determination and inform the applicant or recipient of the decision.

(f) (1) If the information received from the Federal Data Services Hub and Arkansas Data Services Hub is not reasonably compatible, the department shall conduct a supplemental manual verification investigation.

(2) At the conclusion of the supplemental manual verification investigation, the department shall enter an eligibility determination and inform the applicant or recipient of the decision.

(g) The department may adopt rules to implement this subchapter.

Section: Previous  20-77-2102  20-77-2103  

Last modified: November 15, 2016