EE5
Electronic Verification
CMS-required outcome
The eligibility system uses automated interfaces with electronic data sources to enable real-time or near real-time, no manual touch eligibility determinations. The data sources include (but are not limited to) SSA and the Department of Homeland Security (DHS) (directly or via the Federal Data Services Hub (FDSH)), state quarterly wage data, data from financial institutions for asset verification, Renewal and Redetermination Verification service through the FDSH, Public Assistance Reporting Information System (PARIS) to verify Medicaid coverage in other states.
Default metrics
- Number/percentage of individuals whose determinations were entirely automated
- Percentage of determinations that required a request for additional documentation from the applicant.
Regulatory sources
- For states, District of Columbia, Northern Mariana Islands, and American Samoa:
- - 42 CFR 435.940-965(range cite; opens 435.940)
- - 42 CFR 435.945(d)
- For Guam, Puerto Rico, and the Virgin Islands:
- - 42 CFR 436.901
- For Puerto Rico:
- - Consolidated Appropriations Act of 2023, Section 5101 (requiring an Asset Verification System to be implemented by 2026)