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July 2012 St@teside

Reasonable Compatibility Straw Models for Income Verification

The Robert Wood Johnson Foundation’s State Network and Maximizing Enrollment programs recently hosted a webinar  examining reasonable compatibility straw models for income verification. Under the Affordable Care Act (ACA), health insurance exchanges will need to make real-time, electronic eligibility determinations and states will have to develop a plan for reconciling information provided by an applicant with what the state is able to gather from external data sources. In the case of a mismatch between the two, the Centers for Medicare and Medicaid Services (CMS) eligibility rules give states the option to determine if the information provided by the different sources is “reasonably compatible.”   Each state will have to determine its own definition of reasonable compatibility based on the comfort level with the information provided by both applicants and external sources.

During the webinar, Deborah Bachrach and Kinda Serafi from Manatt Health Solutions walked through straw models they developed to help states think through how they might want to define reasonable compatibility. Karen Gibson from the Minnesota Department of Human Services shared her preliminary thinking on planning for implementation of reasonable compatibility standards, and Ben Walker from CMS provided his reactions and feedback on the models.

The archived webinar is available for viewing here.