Massachusetts State Seal
|
The Official Website of the Massachusetts Health Care Training Forum
Health Care Training Forum

Reasonable Compatibility Update

March 1, 2022
 
On Friday evening 2/25, a technical update was made to the online application at MAhealthconnector.org. This update impacts Reasonable Compatibility rules. “Reasonable Compatibility” is a term for a set of rules to determine when the self-attested income (the amount the applicant reports on the application) and the electronic data match amounts are ‘close enough’ (within a specific range) to be considered verified.
 
Currently, for MassHealth’s purposes, an individual’s income is considered to be reasonably compatible when: 
  • both the attested income and the income from the data sources are above the applicable income standard for the individual;
  • both the attested income and the income from the data sources is at or below the applicable income standard for the individual;
  • the attested income is at or below the applicable standard and income from the data sources is above the applicable standard, but their difference is 10% or less; or
  • the attested income is above the applicable standard and the income from the data sources is at or below the applicable standard.
 
For Health Connector purposes, currently, an applicant’s income is considered verified if it is no more than 10% lower than data sources, or if the attested income is higher than the data sources.
 
Beginning on March 1, 2022, for the unwinding of the Public Health Emergency, MassHealth and the Health Connector will apply an increased threshold when checking if an applicant’s self-attests income is verified by data sources. The reasonable compatibility rules will increase to 20%, and if the consumers income is within that threshold, the Health Connector and MassHealth will accept the applicant’s self-attested income and consider it verified. This means that applicants are less likely to be sent an RFI asking for proof of income, to receive a pre-populated MassHealth renewal, or to experience eligibility changes as part of Health Connector.