23-02 Version of 9.4 Changes

When a change is reported that requires verification, the member must be notified in writing of the specific verification required and allowed a minimum of 20 days to provide it.

9.4.1 Date of Death Matches

BadgerCare Plus uses data exchanges with the Wisconsin Vital Records Office and the Social Security Administration (SSA) to identify when an applicant or member has died and to verify the date of death.

When date of death (DOD) information received from Vital Records exactly matches an applicant or member’s SSN and other demographic information, it is considered verified, and a notice of decision is sent to the household. No refutation period is required.

When DOD information received from Vital Records matches an applicant or member’s SSN but does not exactly match other demographic information, another source, such as a family member or another data exchange, must be used before the DOD can be considered verified.

When SSA data exchange indicates that an applicant or member has died, and the IM agency has not received any other information to confirm the death, the applicant or member, a family member, or the applicant or member’s representative must be allowed 10 days to correct any misinformation prior to benefits being impacted. For ongoing cases, the member for whom a death match was received will still be considered to be alive and benefits for the member or others on the case will not be changed or pended during this time. The case should be pended when verifications, such as earned income, are needed. Benefit changes due to changes in eligibility will still need to be processed. However, for an application, person add, or renewal, it means allowing at least the minimum 10 days for a response before a worker confirms eligibility for the application, person/program add, or renewal.

This 10-day period is known as the “refutation period.” A letter is automatically sent to the primary person requesting a response if the person is not deceased. The response due date will be extended to a longer period to allow for mailing delays due to weekends or holidays (will follow the verification checklist (VCL) due date logic). The refutation period may only be shortened when either:

A member, family member, or their representative, confirms the DOD
A worker verifies a DOD through a third-party source, such as a local newspaper obituary

At the end of the refutation period, if no response is received from the applicant or member or the household, the DOD is considered verified, eligibility for the household must be redetermined, and a notice of decision issued.

This page last updated in Release Number: 23-02
Release Date: 04/17/2023
Section 9.4 Effective Date: 02/25/2023
Section 9.4.1 Effective Date: 04/17/2023