409 VERIFICATION (MAM)

SR 17-03 Dated 09/17

Previous Policy

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Use third-party (collateral) information or Asset Verification System (AVS) responses to establish the accuracy of statements made by the individual requesting assistance.Document the countable or excluded status of all the assistance group's resources. Document and list the value of countable resources. Show computations for determining equity or values for those resources with allowable deductions. Total the value of countable resources to prove the individual is within the appropriate resource limit.

 

Verify all countable and excluded resources at,

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initial eligibility determination,

 

subsequent redeterminations,

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whenever a change is reported or discovered, or

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whenever conflicting information is discovered.

 

Deny or terminate assistance for the entire assistance group if the individual refuses or fails to verify resources.

 

Asset Verification System (AVS) Requests

 

The AVS is used to verify resources that an applicant or recipient discloses and to conduct a random search for undisclosed resources owned by the applicant or recipient of OAA/ANB/APTD/MEAD/QMB/SLMB/SLMB135/NF/HCBC categories of medical assistance. AVS will detect and verify most common resources such as checking and savings accounts.

 

AVS requests will be automatically sent out to at:

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initial eligibility determination; and

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subsequent redeterminations.

 

Manually request AVS verification of an individual’s resources:

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whenever a change is reported or discovered, or

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whenever conflicting information is discovered.

 

The AVS responses of electronic information verifying an individuals resources will be available within 16 days of the AVS request.

 

If the AVS responses indicate the individual

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is within the appropriate resource limit; and

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disclosed all the resources indicated in the resource

 

The AVS responses are adequate verification of the individual’s resources and no paper verification is needed.

 

If the AVS responses indicate the individual:

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did not disclose all the resources AVS response contained; or

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has more resources than the appropriate resource limit;

 

Ask the individual to provide paper verification of all resources.

 

Transfer of Assets for Less Than Fair Market Value

 

LTC Workers will use AVS responses to examine whether an applicant for NH or HCBC transferred assets for less than Fair Market Value. For Long Term Care – AVS will provide the worker with monthly balances on all accounts as of the 3rd of each month for the 60 months prior to the application. The workers will review the account balances and determine if there are any questionable transfers based on the balances each month. If there appears to be a questionable transfer the worker would generate a letter requesting paper verification for the 60 month period.

 

Note: AVS will not do a lookback for trusts if the trust has a separate Employer Identification Number (EIN).