{"about":"The rules for keeping benefits (notices, deadlines, renewals, reporting, documents) the site's tools use. Built by tools/data/build.py from research/keep-it/rules.json; do not edit by hand.","readOn":"2026-11-01","programs":{"snap":"SNAP (food stamps)","medicaid_chip":"Medicaid and CHIP","medicaid_work_rule":"Medicaid's work rule","marketplace_ptc":"Marketplace health insurance and its tax credit","ssi":"SSI","ssdi":"Social Security disability (SSDI)","tanf":"TANF cash help","wic":"WIC","ccdf":"Child care help","housing":"Housing vouchers and public housing","liheap":"Help with energy bills (LIHEAP)"},"sources":{"ecfr_7_273_13":{"title":"7 CFR 273.13 Notice of adverse action (eCFR, current to 2026-10-29)","by":"USDA Food and Nutrition Service rule, via eCFR / National Archives","url":"https://www.ecfr.gov/current/title-7/section-273.13","checked":"2026-11-01"},"ecfr_7_273_15":{"title":"7 CFR 273.15 Fair hearings (eCFR, current to 2026-10-29)","by":"USDA Food and Nutrition Service rule, via eCFR / National 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Archives (USDA rule)","url":"https://www.ecfr.gov/current/title-7/section-273.8","checked":"2026-10-31"},"snap:plaw_119_21":{"title":"Public Law 119-21 (the \"One Big Beautiful Bill Act\"), 4 July 2025, Title I Subtitle A \"Nutrition\", sections 10101-10108 (139 Stat. 81-85)","by":"U.S. Government Publishing Office (govinfo)","url":"https://www.govinfo.gov/content/pkg/PLAW-119publ21/pdf/PLAW-119publ21.pdf","checked":"2026-10-31"},"mkt:fr_integrity_2025":{"title":"Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability, final rule, 90 FR 27074 (25 June 2025), FR Doc. 2025-11606, effective 25 Aug 2025","by":"US Government Publishing Office (govinfo.gov)","url":"https://www.govinfo.gov/content/pkg/FR-2025-06-25/html/2025-11606.htm","checked":"2026-11-01"},"mkt:ecfr_45_155_410":{"title":"45 CFR 155.410(e)-(f), Initial and annual open enrollment periods (text as of 2026-10-29; last amended 2025-08-25)","by":"eCFR (ecfr.gov)","url":"https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-B/part-155/subpart-E/section-155.410","checked":"2026-11-01"},"opm_holidays":{"title":"Federal Holidays","by":"U.S. Office of Personnel Management","url":"https://www.opm.gov/policy-data-oversight/pay-leave/federal-holidays/","checked":"2026-11-01"}},"rules":{"snap.notice_before_cut_days":{"group":"notices_appeals","value":"Before a state cuts or ends SNAP benefits during a certification period it must mail a notice at least 10 days before the cut takes effect. A weekend or holiday last day is extended if the hearing request arrives the next day.","where":"7 CFR 273.13(a)(1)","checked":"2026-11-01","src":"ecfr_7_273_13","asOf":"2026-10-29"},"snap.notice_must_say":{"group":"notices_appeals","value":"The notice has to say what is proposed and why, the right to a hearing, a phone number, that benefits can continue, and that the household may owe back any extra benefits if it loses; it must also mention free legal help if there is any.","where":"7 CFR 273.13(a)(2)","checked":"2026-11-01","src":"ecfr_7_273_13","asOf":"2026-10-29"},"snap.notice_exceptions":{"group":"notices_appeals","value":"No advance notice is needed in a list of cases, for example a mass change by the state, a death, a move out of the area, a written request to close the case, an IPV disqualification, or a change already agreed at certification.","where":"7 CFR 273.13(b)","checked":"2026-11-01","src":"ecfr_7_273_13","asOf":"2026-10-29"},"snap.hearing_request_deadline":{"group":"notices_appeals","value":"A household may ask for a hearing on any state action or loss of benefits from the last 90 days; a denied request to restore benefits lost 90 days to a year ago is itself an action that can be appealed. Within a certification period a household can always dispute its current level of benefits.","where":"7 CFR 273.15(g)","checked":"2026-11-01","src":"ecfr_7_273_15","asOf":"2026-10-29"},"snap.hearing_request_how":{"group":"notices_appeals","value":"A request is any clear sign, spoken or written, that the household wants to appeal. The state must help and may not interfere.","where":"7 CFR 273.15(h)","checked":"2026-11-01","src":"ecfr_7_273_15","asOf":"2026-10-29"},"snap.keep_benefits_during_appeal":{"group":"notices_appeals","value":"Benefits continue at the old level only if the hearing is requested within the advance-notice period (the 10-day window or the longer period the state set) and the certification period has not ended. The household can waive this. Asking later (up to 90 days) still gets a hearing but does not keep benefits running.","where":"7 CFR 273.15(k)(1)","checked":"2026-11-01","src":"ecfr_7_273_15","asOf":"2026-10-29"},"snap.continued_benefits_stop_when":{"group":"notices_appeals","value":"Continued benefits can still be stopped before the decision when the certification period ends, when the hearing finds the only issue is a federal rule, or when a later change or mass change affects the case and the household does not appeal that too.","where":"7 CFR 273.15(k)(2)","checked":"2026-11-01","src":"ecfr_7_273_15","asOf":"2026-10-29"},"snap.repay_if_lose_appeal":{"group":"notices_appeals","value":"If the state's action is upheld, a claim is set up for all the extra benefits paid during the appeal.","where":"7 CFR 273.15(k)(1), (s)(2)","checked":"2026-11-01","src":"ecfr_7_273_15","asOf":"2026-10-29"},"snap.hearing_decision_clock":{"group":"notices_appeals","value":"A state-level hearing must be held and decided within 60 days of the request; local-level hearings and appeals of them 45 days. A decision that raises benefits must be in the EBT account within 10 days of the decision (or at the next normal issuance if that is within 60 days). A household may postpone up to 30 days, which extends the state's deadline by the same days.","where":"7 CFR 273.15(c)(1)-(4)","checked":"2026-11-01","src":"ecfr_7_273_15","asOf":"2026-10-29"},"snap.expedited_hearing_and_conference":{"group":"notices_appeals","value":"A household denied expedited service is entitled to an agency conference within 2 working days (optional for the household; it never replaces the hearing). Hearing requests from households about to leave the area (such as migrant farmworkers) must be speeded up.","where":"7 CFR 273.15(d)(2), (i)(2)","checked":"2026-11-01","src":"ecfr_7_273_15","asOf":"2026-10-29"},"snap.hearing_notice_and_rights":{"group":"notices_appeals","value":"At least 10 days written notice of the hearing; the household may see its whole case file free, bring a lawyer, relative or friend, bring witnesses, and question the state's evidence.","where":"7 CFR 273.15(l), (p)","checked":"2026-11-01","src":"ecfr_7_273_15","asOf":"2026-10-29"},"snap.missed_hearing":{"group":"notices_appeals","value":"A request can be dismissed if the household does not come without good cause, or withdraws in writing. Oral withdrawals (if the state allows them) must be confirmed in writing within 10 days and the household then has 10 days to reinstate.","where":"7 CFR 273.15(j)","checked":"2026-11-01","src":"ecfr_7_273_15","asOf":"2026-10-29"},"snap.late_request_becomes_restoration":{"group":"notices_appeals","value":"A hearing request that comes too late must be treated as a request to restore lost benefits. If the loss was the state's error, benefits are restored for up to 12 months before the household asked or the state found out, even if the household is not eligible now.","where":"7 CFR 273.17(a), 273.15(j)(1)(i)","checked":"2026-11-01","src":"ecfr_7_273_17","asOf":"2026-10-29"},"snap.claim_hearing_right":{"group":"notices_appeals","value":"A demand letter for an overpayment must give the household 90 days to ask for a hearing on the claim and must set a repayment date no more than 30 days after the letter.","where":"7 CFR 273.18(e)(3)(iv)(I), (v)","checked":"2026-11-01","src":"ecfr_7_273_18","asOf":"2026-10-29"},"snap.decision_clock_standard":{"group":"decision_clocks","value":"A household that completes the application must get an opportunity to participate as soon as possible and within 30 calendar days of the day the office receives a signed application with a name and address.","where":"7 CFR 273.2(g)(1)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.decision_clock_expedited":{"group":"decision_clocks","value":"Expedited households must have benefits on their EBT card and available no later than the 7th calendar day after the application was filed.","where":"7 CFR 273.2(i)(3)(i)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.who_gets_expedited":{"group":"decision_clocks","value":"Three tests: (1) gross income under $150 a month and liquid resources (cash, bank accounts) of $100 or less; (2) a migrant or seasonal farmworker household that is destitute with liquid resources of $100 or less; (3) combined monthly gross income and liquid resources less than the month's rent or mortgage plus utilities.","where":"7 CFR 273.2(i)(1)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.expedited_what_must_be_proved_first":{"group":"decision_clocks","value":"Even in expedited cases, identity must be verified (by a document or a collateral contact). Other proof (residence, income, resources) should be tried within the time, but benefits cannot be held back just because it is not yet in; the rest can be postponed.","where":"7 CFR 273.2(i)(4)(i)(A)-(B)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.expedited_postponed_proof_followup":{"group":"decision_clocks","value":"If proof was postponed, the state may give a short certification (1 month if the household applied on or before the 15th, 2 months if after) or a normal one; the household must finish the postponed proof and be interviewed, or the case ends and benefits for the later month are not issued.","where":"7 CFR 273.2(i)(4)(iii)(A)-(B)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.if_agency_misses_30_days":{"group":"decision_clocks","value":"If the delay is the state's fault the state may not deny; it must send a 'pending' notice by day 30, keep working the case, and if the household is eligible within the second 30 days pay back to the month of application. After 60 days, if the state is at fault and the file is complete it must keep processing until it decides.","where":"7 CFR 273.2(h)(3)-(4)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.household_fault_delay":{"group":"decision_clocks","value":"A delay is the household's fault only after the state has offered help with the form, told it what proof is missing and given at least 10 days from the first request, and told it about a missed interview. After a household-fault delay, benefits start the month after the application month.","where":"7 CFR 273.2(h)(1)(i)(C), (h)(2)(ii)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.denial_notice_timing":{"group":"decision_clocks","value":"An ineligible household gets a notice of denial as soon as possible and no later than 30 days after the application date. If it missed its interview and made no contact, the denial notice goes out on day 30.","where":"7 CFR 273.2(g)(3)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.recert_gap_protection":{"group":"decision_clocks","value":"A household that files for recertification by the 15th day of the last month of its certification period is 'timely'. If the state, through its own fault, cannot finish within 30 days it must pay a full month for the first month of the new period. If the household files within 30 days after the period ends it is still treated as a recertification, with benefits prorated.","where":"7 CFR 273.14(c)(2), (e)","checked":"2026-11-01","src":"ecfr_7_273_14","asOf":"2026-10-29"},"snap.recert_short_certification":{"group":"renewals_reporting","value":"A household certified for one month, or in the second month of a two-month certification period, gets its notice of expiration at certification and has 15 days from the day it receives that notice to file a timely application for recertification (not the 15th of the last month).","where":"7 CFR 273.14(c)(1), (b)(1)(i)","checked":"2026-11-01","src":"ecfr_7_273_14","asOf":"2026-10-29"},"snap.certification_period_length":{"group":"renewals_reporting","value":"A certification period cannot exceed 12 months. Households where every adult is elderly or disabled can get up to 24 months (with at least one contact every 12 months). States should give at least 6 months unless the household is unstable or has an ABAWD (then generally no less than 3).","where":"7 CFR 273.10(f)","checked":"2026-11-01","src":"ecfr_7_273_10","asOf":"2026-10-29"},"snap.recert_notice_of_expiration":{"group":"renewals_reporting","value":"The state must send a Notice of Expiration before the first day of the last month of the certification period but not before the first day of the next-to-last month. It must give the expiry date, the date to apply for uninterrupted benefits, the consequences of being late, the office address, the hearing right, and warn that a missed interview can delay or deny benefits.","where":"7 CFR 273.14(b)(1)","checked":"2026-11-01","src":"ecfr_7_273_14","asOf":"2026-10-29"},"snap.recert_verification_time":{"group":"renewals_reporting","value":"Interviews are scheduled so the household has at least 10 days after the interview to send proof before the period ends. A household whose case is not decided by the end date only because of the time allowed for missing proof gets benefits within 5 working days of sending it (no proration).","where":"7 CFR 273.14(b)(3)(iii), (b)(4)","checked":"2026-11-01","src":"ecfr_7_273_14","asOf":"2026-10-29"},"snap.recert_what_must_be_reproved":{"group":"renewals_reporting","value":"At recertification the state verifies an income change only if the source changed or the amount changed by more than $50; changed medical or utility costs only if they changed by more than $25. Unchanged information is not re-verified unless incomplete, inaccurate, inconsistent or outdated.","where":"7 CFR 273.2(f)(8)(i)(A)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.reporting_simplified_130pct":{"group":"renewals_reporting","value":"In simplified reporting (which a state may use for households certified at least 4 months) the household must report when its monthly gross income goes above the monthly gross income limit for its household size (the 130% of poverty limit), measured against the size at its last certification. It reports by 10 days after the end of that month, or 10 days after the pay if fewer than 10 days remain in the month.","where":"7 CFR 273.12(a)(5)(v), (a)(2)","checked":"2026-11-01","src":"ecfr_7_273_12","asOf":"2026-10-29","stateVaries":"Each state decides which reporting system it uses (change reporting, simplified, quarterly, monthly) and which households are in it."},"snap.reporting_periodic_report":{"group":"renewals_reporting","value":"Households certified for longer than 6 months in simplified reporting file one periodic (interim) report between month 4 and month 6; elderly/disabled households with no earnings certified 13-24 months file one a year. If it is not filed the state sends a reminder giving 10 days; no answer ends the case.","where":"7 CFR 273.12(a)(5)(iii)(B), (E)","checked":"2026-11-01","src":"ecfr_7_273_12","asOf":"2026-10-29"},"snap.reporting_periodic_elderly":{"group":"renewals_reporting","value":"A household in simplified reporting whose adults are all elderly or have a disability, with no earned income, files no periodic report if it is certified for 12 months or less, and one periodic report a year if it is certified for 13 to 24 months.","where":"7 CFR 273.12(a)(5)(iii)(A)-(B)","checked":"2026-11-01","src":"ecfr_7_273_12","asOf":"2026-10-29"},"snap.reporting_change_reporting_households":{"group":"renewals_reporting","value":"In change reporting (the default), report within 10 days of the date the change becomes known: unearned income up by or down by more than $100 (indexed to the nearest $25), starting or stopping a job, a wage or hours change as the state chooses, household members, address and rent, a licensed vehicle, cash or bank savings reaching the resource limit, child support obligation, and for ABAWDs hours below 20 a week.","where":"7 CFR 273.12(a)(1)-(2)","checked":"2026-11-01","src":"ecfr_7_273_12","asOf":"2026-10-29"},"snap.reporting_what_state_does_next":{"group":"renewals_reporting","value":"A change that raises benefits takes effect no later than the first allotment issued 10 days after the report. A change that lowers or ends benefits needs a notice of adverse action within 10 days of the report, and the cut starts after that notice period unless a hearing is requested.","where":"7 CFR 273.12(c)(1)-(2)","checked":"2026-11-01","src":"ecfr_7_273_12","asOf":"2026-10-29"},"snap.reporting_unclear_information":{"group":"renewals_reporting","value":"When the state receives unclear information it must send a written request for contact that gives at least 10 days to respond. No answer leads to a notice of adverse action (termination, or a 1-month suspension first at the state's option); a response in time must be acted on.","where":"7 CFR 273.12(c)(3)","checked":"2026-11-01","src":"ecfr_7_273_12","asOf":"2026-10-29"},"snap.overpayment_recovery_rates":{"group":"renewals_reporting","value":"A state collects by cutting the monthly benefit: for household-error and agency-error claims by the greater of $10 or 10% of the monthly allotment, for intentional-violation claims the greater of $20 or 20%, unless the household agrees to more. A state may drop a claim of $125 or less if the household is no longer on SNAP. Claims go back at least 12 months (IPV to the first violation), never more than 6 years.","where":"7 CFR 273.18(g)(1), (c)(1), (e)(2)","checked":"2026-11-01","src":"ecfr_7_273_18","asOf":"2026-10-29"},"snap.overpayment_who_pays":{"group":"renewals_reporting","value":"Each person who was an adult member of the household when the overpayment happened is responsible for the claim.","where":"7 CFR 273.18(a)(4)","checked":"2026-11-01","src":"ecfr_7_273_18","asOf":"2026-10-29"},"snap.time_limit_abawd":{"group":"renewals_reporting","value":"The law now exempts people 'under 18, or over 65', anyone medically certified unfit for work, a parent or other household member responsible for a dependent child under 14, people exempt under the general work rules, pregnant women, and American Indians/Alaska Natives (including Urban Indians and California Indians). Veterans, homeless people and former foster youth are not on the new exception list. Everyone else of working age must work or train 20 hours a week (80 a month) to keep SNAP beyond the time limit set in the Act (3 countable months in 36; this '3 in 36' figure is from the existing regulation, 7 CFR 273.24(b), not re-read in the law).","where":"Public Law 119-21 sec. 10102(a), amending Food and Nutrition Act sec. 6(o)(3) (7 U.S.C. 2015(o)(3))","checked":"2026-11-01","src":"pl119_21","asOf":"2026-11-01","effective":"on enactment, 4 July 2025 (USDA implementation dates not read)"},"snap.time_to_provide_proof":{"group":"documents_interviews","value":"The state must give at least 10 days to provide required proof.","where":"7 CFR 273.2(f)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.mandatory_proof_list":{"group":"documents_interviews","value":"Must be proved before the first approval: gross income (non-exempt); immigration status of any noncitizen applying (through the immigration database); utility costs if the household claims more than the standard; medical costs for an elderly or disabled member if claimed; Social Security numbers (sent to SSA, benefits not held up for this); residence; identity; disability; child support paid; and for ABAWDs the hours worked.","where":"7 CFR 273.2(f)(1)(i)-(xiv)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.identity_documents_examples":{"group":"documents_interviews","value":"Identity can be shown by a driver's license, work or school ID, ID for health benefits or another program, voter card, wage stubs, and similar; if none is handy, a collateral contact can vouch.","where":"7 CFR 273.2(f)(1)(vii)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.residence_proof":{"group":"documents_interviews","value":"Residence is proved together with rent, mortgage, utilities or identity where possible, otherwise by a collateral contact or other proof. Homeless and new-arrival households may not be able to prove it and the rule excuses 'unusual cases'.","where":"7 CFR 273.2(f)(1)(vi)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.income_proof_examples":{"group":"documents_interviews","value":"Documents named in the rule include wage stubs, rent receipts and utility bills. If an employer will not cooperate and nothing else is available, the worker sets the amount from the best available information.","where":"7 CFR 273.2(f)(4)(i), (f)(1)(i)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.must_accept_reasonable_proof":{"group":"documents_interviews","value":"The state must accept any reasonable documentary evidence and look at how well it proves the statement, not insist on one particular document.","where":"7 CFR 273.2(f)(4)(i)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.collateral_contact_when_no_document":{"group":"documents_interviews","value":"Residence and household size can be proved by documents OR a collateral contact (a landlord, employer, neighbour, social agency). For other items a collateral contact or a home visit may be used when documents are not enough or cannot be got; the household usually names the contact and may ask for help.","where":"7 CFR 273.2(f)(4)(ii), (f)(5)(ii)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.state_must_help_get_proof":{"group":"documents_interviews","value":"The household has the main responsibility for providing proof, but the state must help if the household is cooperating. Proof can be given in person, by mail, fax or other electronic means, or through an authorized representative. The state may not require the household to bring proof in person.","where":"7 CFR 273.2(f)(5)(i)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.cannot_deny_for_failing_to_appear_only":{"group":"documents_interviews","value":"A household can be denied for refusing to cooperate only if it clearly shows it will not do what it can; merely failing to attend an interview is not refusal.","where":"7 CFR 273.2(d)(1)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.discrepancies_must_be_explained_first":{"group":"documents_interviews","value":"When a third-party source contradicts the household, the household must get a reasonable chance to resolve the discrepancy before benefits are decided. Information from an outside data match that is unverified must be checked independently first.","where":"7 CFR 273.2(f)(4)(iv), (f)(9)(iv)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.immigration_status_proof":{"group":"documents_interviews","value":"Noncitizens applying for themselves are checked through the federal immigration database. If someone does not want USCIS contacted the household can withdraw the application or take part without that person. Applicants get at least 10 days to supply acceptable papers and must be certified by day 30 if they were not given that chance.","where":"7 CFR 273.2(f)(1)(ii)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.non_applicant_privacy":{"group":"documents_interviews","value":"On combined forms, SNAP-only households do not have to give information needed only by another program, and non-applicant family members need not give Social Security numbers or immigration information.","where":"7 CFR 273.12(a)(5)(iii)(H)","checked":"2026-11-01","src":"ecfr_7_273_12","asOf":"2026-10-29"},"snap.interview_required":{"group":"documents_interviews","value":"A face-to-face interview with an eligibility worker is required at initial certification and at least once every 12 months. A state cannot require an in-office interview during the certification period. The household may bring anyone it chooses.","where":"7 CFR 273.2(e)(1)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.interview_by_phone":{"group":"documents_interviews","value":"A state may use a telephone interview instead for all applicants, for categories, or case by case for hardship (illness, transport trouble, care of a household member, rural residence, bad weather, work hours). If the state has not already arranged a phone interview and the household meets the hardship test and asks, the state must offer one. The state must grant a face-to-face interview to any household that asks for one.","where":"7 CFR 273.2(e)(2)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.missed_interview_rules":{"group":"documents_interviews","value":"The state must tell the household it missed the interview and that it is responsible for rescheduling. If the household calls within the 30-day processing period the state must schedule a second interview and cannot deny before day 30 for the first miss. If the second interview is granted and the household is eligible, benefits are prorated from the application date. If the household never contacts the office, the denial notice goes on day 30.","where":"7 CFR 273.2(e)(3), (g)(3), (h)(1)(i)(D)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29","stateVaries":"Colorado and other states publish their own missed-interview procedures (the owner's report cites Colorado holding a case 30 days after a missed interview); the federal rule above is the floor."},"snap.recert_missed_interview":{"group":"documents_interviews","value":"At recertification a Notice of Missed Interview is sent (it may be combined with a denial notice) and a household that asks for another interview must get a second one.","where":"7 CFR 273.14(b)(3)(iii)","checked":"2026-11-01","src":"ecfr_7_273_14","asOf":"2026-10-29"},"snap.no_single_document_required":{"group":"documents_interviews","value":"Acceptable proof is not limited to any single type of document, and can be gathered in other ways (collateral contacts, for example).","where":"7 CFR 273.2(f)(4)(i)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.no_in_person_proof":{"group":"documents_interviews","value":"The state must not require a household to present proof in person at the SNAP office; mail, fax, other electronic means and an authorized representative must be accepted.","where":"7 CFR 273.2(f)(5)(i)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.no_selective_verification":{"group":"documents_interviews","value":"A state may require extra proof (beyond the mandatory list and questionable items) only statewide or across a project area, not on selected households one by one, and may not target groups such as migrant farmworkers or American Indians.","where":"7 CFR 273.2(f)(2)(i), (f)(3)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.ssn_does_not_delay":{"group":"documents_interviews","value":"Social Security numbers are sent to SSA for checking, but the state may not delay certification or benefits for an otherwise eligible household solely to verify a household member's number.","where":"7 CFR 273.2(f)(1)(v)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.authorized_representative":{"group":"documents_interviews","value":"A household can name an adult who is not a household member, in writing, to apply, be interviewed, report changes and use the benefits for it; the state must tell people who may have trouble applying about this.","where":"7 CFR 273.2(n)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"snap.apply_same_day_and_minimal_application":{"group":"documents_interviews","value":"Anyone may file an application the same day they contact the office; the application needs only a name, an address and a signature to start the 30-day clock.","where":"7 CFR 273.2(g)(1)","checked":"2026-11-01","src":"ecfr_7_273_2","asOf":"2026-10-29"},"medicaid_chip.notice_before_cut_days":{"group":"notices_appeals","value":"The state must send a notice at least 10 days before the date of action (a cut, suspension or end). The notice can be shortened to 5 days in probable-fraud cases.","where":"42 CFR 431.211; 431.214","checked":"2026-11-01","src":"ecfr_42_431_211","asOf":"2026-10-29"},"medicaid_chip.notice_exceptions":{"group":"notices_appeals","value":"Notice can go out on the day of action when the agency has facts confirming a death, a signed statement from the person, admission to an institution, an unknown address (returned mail), acceptance by another state, or a doctor-prescribed change in care.","where":"42 CFR 431.213","checked":"2026-11-01","src":"ecfr_42_431_213","asOf":"2026-10-29"},"medicaid_chip.notice_must_say":{"group":"notices_appeals","value":"A termination or cut notice must state the action and the date, the specific reasons, the rules or law change behind it, the right to a hearing (or when one is granted for a change of law), and when Medicaid continues if a hearing is requested.","where":"42 CFR 431.210; 435.917(b)(2)","checked":"2026-11-01","src":"ecfr_42_431_210","asOf":"2026-10-29"},"medicaid_chip.plain_language_and_other_bases":{"group":"notices_appeals","value":"Notices must be in plain language and accessible to people with limited English or disabilities. When MAGI income is the reason for denial or termination, the notice must also tell the person about other bases of eligibility (for example disability or age) and how to ask for them to be checked.","where":"42 CFR 435.917(a), (c)","checked":"2026-11-01","src":"ecfr_42_435_917","asOf":"2026-10-29"},"medicaid_chip.hearing_request_deadline":{"group":"notices_appeals","value":"The state must allow a reasonable time, not more than 90 days from the date the notice was mailed, to ask for a hearing. The 90 days is the most a state may set.","where":"42 CFR 431.221(d)","checked":"2026-11-01","src":"ecfr_42_431_221","asOf":"2026-10-29","stateVaries":"Each state sets its own number up to 90 days; the notice itself states it. Marketplace-delegated hearings follow 45 CFR 155.520(b)."},"medicaid_chip.hearing_request_how":{"group":"notices_appeals","value":"A hearing can be requested by any way an application can be submitted (website, telephone, mail, in person, other electronic means), by the person or an authorized representative, and the request can include a request for an expedited hearing.","where":"42 CFR 431.221(a)","checked":"2026-11-01","src":"ecfr_42_431_221","asOf":"2026-10-29"},"medicaid_chip.keep_benefits_during_appeal":{"group":"notices_appeals","value":"If the 10-day (or 5-day) notice was sent and the beneficiary asks for a hearing before the date of action, the agency may not cut or end services until a decision after the hearing (unless the only issue is a federal or state law or policy).","where":"42 CFR 431.230(a)","checked":"2026-11-01","src":"ecfr_42_431_230","asOf":"2026-10-29"},"medicaid_chip.reinstatement_after_late_request":{"group":"notices_appeals","value":"If no advance notice was given, the agency must reinstate and continue services if the hearing is asked for within 10 days of receiving the notice (receipt is presumed 5 days after the notice date) and the action did not come from applying a federal or state policy. If a request comes within 10 days after the date of action the agency may reinstate.","where":"42 CFR 431.231(a)-(c)","checked":"2026-11-01","src":"ecfr_42_431_231","asOf":"2026-10-29"},"medicaid_chip.repay_if_lose_appeal":{"group":"notices_appeals","value":"If the agency's action is upheld, it may recover the cost of services furnished only because services were kept going during the appeal.","where":"42 CFR 431.230(b)","checked":"2026-11-01","src":"ecfr_42_431_230","asOf":"2026-10-29"},"medicaid_chip.hearing_decision_clock":{"group":"notices_appeals","value":"Ordinarily final action within 90 days of the day the agency receives the hearing request (not counting the days the person took). Delays are allowed only for the appellant's own request or an emergency, and the reasons must be written in the record.","where":"42 CFR 431.244(f)(1), (f)(4)","checked":"2026-11-01","src":"ecfr_42_431_244","asOf":"2026-10-29"},"medicaid_chip.expedited_hearing":{"group":"notices_appeals","value":"A person can ask for an expedited hearing if the normal time could jeopardize life, health or ability to attain, maintain or regain maximum function, and the agency must tell the person quickly whether it is granted. For eligibility claims the text sets a decision date of as expeditiously as possible and no later than 7 working days after the request, but that 7-day limit takes effect only on the date in 435.1200(i) (6 months after a Federal Register notice, earliest 30 May 2017), and no such notice was found.","where":"42 CFR 431.224; 431.244(f)(3)","checked":"2026-11-01","src":"ecfr_42_431_244","asOf":"2026-10-29"},"medicaid_chip.hearing_when_agency_is_slow":{"group":"notices_appeals","value":"A hearing must be granted to anyone who believes the agency 'has not acted upon the claim with reasonable promptness', so a late decision is itself appealable.","where":"42 CFR 431.220(a)(1)","checked":"2026-11-01","src":"ecfr_42_431_220","asOf":"2026-10-29"},"medicaid_chip.win_remedy":{"group":"notices_appeals","value":"If the person wins (at the hearing or before it), the agency must promptly make corrective payments retroactive to the date the wrong action was taken.","where":"42 CFR 431.246","checked":"2026-11-01","src":"ecfr_42_431_246","asOf":"2026-10-29"},"medicaid_chip.chip_review_rights":{"group":"notices_appeals","value":"Separate CHIP programs must give a review of a denial of eligibility, a failure to make a timely decision, and a suspension or end of enrollment. The review must be finished within a reasonable time, with expedited review where there is an immediate need for services; the notice must give reasons, review rights, time frames and the circumstances in which enrollment continues during review.","where":"42 CFR 457.1130(a); 457.1160(a); 457.1180","checked":"2026-11-01","src":"ecfr_42_457_1130","asOf":"2026-10-29","stateVaries":"CHIP has no federal day count for asking for a review; the state's notice states it."},"medicaid_chip.chip_continuation_frozen":{"group":"notices_appeals","value":"The federal rule that CHIP enrollment continues during a review (457.1170) and its notice rule (457.1180) may not be implemented, administered or enforced by HHS until 30 September 2034. States may keep their own rules.","where":"Public Law 119-21 sec. 71102 (listing 42 CFR 457.1170, 457.1180)","checked":"2026-11-01","src":"pl119_21","asOf":"2026-11-01"},"medicaid_chip.decision_clock_standard":{"group":"decision_clocks","value":"A decision on an application may not take more than 45 days for most applicants and 90 days for people applying on the basis of disability.","where":"42 CFR 435.912(c)(3)","checked":"2026-11-01","src":"ecfr_42_435_912","asOf":"2026-10-29"},"medicaid_chip.decision_clock_exceptions":{"group":"decision_clocks","value":"The agency may go over only in unusual circumstances (the applicant or a doctor delays, or an emergency beyond its control) and now also when a work-rule notice gives the applicant 30 days; it must write down why in the case record.","where":"42 CFR 435.912(e)-(f)","checked":"2026-11-01","src":"ecfr_42_435_912","asOf":"2026-10-29"},"medicaid_chip.if_agency_misses_clock":{"group":"decision_clocks","value":"The agency may not use its time limits as a waiting period or as a reason to deny coverage. A missed deadline is a ground for a hearing ('not acted upon with reasonable promptness'); for CHIP, a failure to make a timely determination is a reviewable matter.","where":"42 CFR 435.912(g); 431.220(a)(1); 457.1130(a)(2)","checked":"2026-11-01","src":"ecfr_42_435_912","asOf":"2026-10-29"},"medicaid_chip.retroactive_coverage":{"group":"decision_clocks","value":"For applications made on or after the first day of the first quarter beginning after 31 December 2026 (that is, 1 January 2027 on the text), expansion adults can be covered for care in the month before the application month; other applicants for the 2 months before. (Before this the look-back is 3 months.)","where":"Public Law 119-21 sec. 71112(a), (d) amending Social Security Act sec. 1902(a)(34) and 1905(a)","checked":"2026-11-01","src":"pl119_21","asOf":"2026-11-01","effective":"applications on or after the first day of the first quarter that begins after 31 Dec 2026"},"medicaid_chip.renewal_period":{"group":"renewals_reporting","value":"Medicaid based on MAGI income is renewed once every 12 months, and no more often than every 12 months. Other groups (age, blindness, disability) are redetermined at least every 12 months.","where":"42 CFR 435.916(a)(1), (b)","checked":"2026-11-01","src":"ecfr_42_435_916","asOf":"2026-10-29"},"medicaid_chip.renewal_six_month_expansion_adults":{"group":"renewals_reporting","value":"For redeterminations scheduled on or after the first day of the first quarter that begins after 31 December 2026, states must redetermine eligibility every 6 months for adult-expansion enrollees (and the equivalent waiver population), except people who are exempt from the work rule under section 1902(xx)(9)(A)(ii)(II).","where":"Public Law 119-21 sec. 71107(a), adding Social Security Act sec. 1902(e)(14)(L)","checked":"2026-11-01","src":"pl119_21","asOf":"2026-11-01","effective":"renewals scheduled on or after 1 Jan 2027 on the plain text of 'first day of the first quarter that begins after December 31, 2026'"},"medicaid_chip.renewal_how_it_works":{"group":"renewals_reporting","value":"The state must first try to renew using reliable information it already has, without asking the person. If it cannot, it must send a prepopulated renewal form and give at least 30 days from the date of the form to answer. It may not require an in-person interview for the renewal.","where":"42 CFR 435.916(a)(2)-(3)","checked":"2026-11-01","src":"ecfr_42_435_916","asOf":"2026-10-29"},"medicaid_chip.renewal_late_reinstatement":{"group":"renewals_reporting","value":"If MAGI coverage ended for not returning the form or information, the state must reconsider without a new application when the person sends it within 90 days after termination (or longer if the state elects).","where":"42 CFR 435.916(a)(3)(iii)","checked":"2026-11-01","src":"ecfr_42_435_916","asOf":"2026-10-29"},"medicaid_chip.reporting_changes":{"group":"renewals_reporting","value":"States must have a way for beneficiaries to report changes through any of the application channels, and must promptly redetermine eligibility when they learn of a change. The federal rule sets no day count for beneficiaries; the state's notice gives one.","where":"42 CFR 435.916(c)-(d)","checked":"2026-11-01","src":"ecfr_42_435_916","asOf":"2026-10-29","stateVaries":"Reporting deadlines (often 10 or 30 days) are state-set."},"medicaid_chip.self_attestation_default":{"group":"documents_interviews","value":"Except where the law requires otherwise (citizenship and immigration status), the agency may accept the person's own statement of the facts it needs without asking for documents.","where":"42 CFR 435.945(a)","checked":"2026-11-01","src":"ecfr_42_435_945","asOf":"2026-10-29"},"medicaid_chip.electronic_data_first":{"group":"documents_interviews","value":"A person must not be asked for extra information or documents unless the electronic data the agency needs cannot be obtained or is not 'reasonably compatible' with what the person said. Income is reasonably compatible if both figures are on the same side of the limit.","where":"42 CFR 435.952(b)-(c)","checked":"2026-11-01","src":"ecfr_42_435_952","asOf":"2026-10-29"},"medicaid_chip.reasonable_period_to_answer":{"group":"documents_interviews","value":"When the agency does ask, it must give a reasonable period to respond and cannot deny, end or reduce coverage on the data alone unless it has asked the person and given notice and hearing rights. Documents can be demanded only where electronic data are not available and a match would not be effective.","where":"42 CFR 435.952(c)(2), (d)","checked":"2026-11-01","src":"ecfr_42_435_952","asOf":"2026-10-29","stateVaries":"'Reasonable period' is not a number in the regulation; states set it (the CMS 10-day-or-more guidance was not read)."},"medicaid_chip.no_documents_exception":{"group":"documents_interviews","value":"If documents do not exist or are not reasonably available (for example the person is homeless or has faced domestic violence or a natural disaster), the agency must allow self-attestation case by case, except for citizenship and immigration status.","where":"42 CFR 435.952(c)(3)","checked":"2026-11-01","src":"ecfr_42_435_952","asOf":"2026-10-29"},"medicaid_chip.interview_rule":{"group":"documents_interviews","value":"A state may not require an in-person interview for MAGI-based Medicaid applications or for MAGI renewals. (The application-interview ban sunsets 1 October 2034 under the June 2026 restatement.)","where":"42 CFR 435.907(d); 435.916(a)(3)(iv)","checked":"2026-11-01","src":"ecfr_42_435_907","asOf":"2026-10-29"},"medicaid_chip.limits_on_what_can_be_asked":{"group":"documents_interviews","value":"The agency may require only the information needed to decide eligibility or run the plan. A non-applicant's Social Security number may be asked for only as a voluntary item with a clear notice saying so.","where":"42 CFR 435.907(e)","checked":"2026-11-01","src":"ecfr_42_435_907","asOf":"2026-10-29"},"medicaid_chip.citizenship_and_immigration_proof":{"group":"documents_interviews","value":"Citizenship and immigration status are checked electronically first (Social Security and DHS data). If that fails the person gets a 'reasonable opportunity period' of 90 days (from receipt of the notice, presumed 5 days after its date), longer for immigrants making a good-faith effort, during which Medicaid cannot be delayed, denied, reduced or ended for an otherwise eligible person. Citizenship is not re-checked at renewal.","where":"42 CFR 435.956(a)-(b)","checked":"2026-11-01","src":"ecfr_42_435_956","asOf":"2026-10-29"},"medicaid_chip.citizenship_documents_accepted":{"group":"documents_interviews","value":"Stand-alone proof of citizenship: a US passport or passport card, certificate of naturalization or citizenship, a qualifying driver's license, a tribal enrollment document, or a Social Security or DHS data match. Otherwise a US birth certificate plus an ID document is accepted. Some groups need no citizenship documents: SSI recipients, Medicare enrollees, people getting Social Security disability, foster-care children, and newborns of Medicaid-covered mothers.","where":"42 CFR 435.407(a)-(b); 435.406(a)(1)(iii)","checked":"2026-11-01","src":"ecfr_42_435_407","asOf":"2026-10-29"},"medicaid_chip.chip_decision_clock":{"group":"decision_clocks","value":"For a separate CHIP program the same timeliness standards as Medicaid apply (except the work-rule exception), with electronic-account transfers to other programs on their own standard.","where":"42 CFR 457.340(d)(1)","checked":"2026-11-01","src":"ecfr_42_457_340","asOf":"2026-10-29"},"medicaid_chip.authorized_representative":{"group":"documents_interviews","value":"The agency must accept an application and the documents needed to establish eligibility from the applicant, an adult in the household, an authorized representative, or someone acting responsibly for a minor or incapacitated person.","where":"42 CFR 435.907(a)","checked":"2026-11-01","src":"ecfr_42_435_907","asOf":"2026-10-29"},"medicaid_chip.renewal_form_accessibility":{"group":"documents_interviews","value":"Any renewal form or notice must be accessible to people with limited English proficiency and people with disabilities.","where":"42 CFR 435.916(g)","checked":"2026-11-01","src":"ecfr_42_435_916","asOf":"2026-10-29"},"medicaid_work_rule.work_rule_basics":{"group":"renewals_reporting","value":"From 1 January 2027 adults 19-64 in the expansion group (and equivalent 1115 coverage), not pregnant, not on Medicare and not otherwise eligible, must show at least 80 hours a month of work, community service, a work program or half-time school (or any combination totalling 80), or monthly income of at least the federal minimum wage times 80 hours ($7.25 x 80 = $580 at today's federal minimum wage).","where":"42 CFR 435.551-435.552; Public Law 119-21 sec. 71119 (SSA sec. 1902(xx))","checked":"2026-11-01","src":"ecfr_42_435_550_563","asOf":"2026-10-29","effective":"coverage furnished on or after 1 Jan 2027 (435.559(a))"},"medicaid_work_rule.work_rule_start_and_delay":{"group":"renewals_reporting","value":"The rule applies to coverage furnished on or after 1 January 2027. A state can start earlier. CMS can give a state a temporary 'good faith' delay of at most 6 months at first, renewable, ending no later than 31 December 2028.","where":"42 CFR 435.559, 435.560(c)","checked":"2026-11-01","src":"ecfr_42_435_550_563","asOf":"2026-10-29"},"medicaid_work_rule.work_rule_lookback":{"group":"renewals_reporting","value":"At application the state looks at 1 to 3 consecutive months (state's choice) before the application month. For people already enrolled it looks at 1 or more months (state's choice, consecutive or not) since the last renewal, verified at the next renewal; a state may choose to check more often. Enrollees on 1 Jan 2027 are checked at their first renewal on or after the start date.","where":"42 CFR 435.556(a); 435.557(d); 435.559(c)","checked":"2026-11-01","src":"ecfr_42_435_550_563","asOf":"2026-10-29"},"medicaid_work_rule.work_rule_exemptions":{"group":"renewals_reporting","value":"Excluded from the rule: former foster youth (under the foster-care group), American Indians/Alaska Natives, parents/guardians/caretaker relatives/family caregivers of a child 13 or under or a disabled person, veterans rated 100% disabled, the medically frail (blind or disabled, substance use disorder, disabling mental disorder, a disability limiting daily activities, serious or complex conditions), people complying with TANF work rules, people in a household on SNAP who are not exempt from SNAP work rules, people in drug or alcohol treatment, inmates, and pregnant or postpartum people. Also deemed compliant for the month: under 19, on Medicare, in mandatory coverage groups, or released from a public institution in the last 3 months.","where":"42 CFR 435.553-435.554","checked":"2026-11-01","src":"ecfr_42_435_550_563","asOf":"2026-10-29"},"medicaid_work_rule.work_rule_hardship_optional":{"group":"renewals_reporting","value":"A state may choose to treat a month as compliant for short-term hardship: inpatient or similar care, a county under a Presidential emergency/disaster declaration (automatic), a county with unemployment at or above the lesser of 8% or 1.5 times the national rate (automatic, if CMS approves), or having to travel for medical care.","where":"42 CFR 435.555","checked":"2026-11-01","src":"ecfr_42_435_550_563","asOf":"2026-10-29"},"medicaid_work_rule.work_rule_noncompliance_notice":{"group":"notices_appeals","value":"If the state cannot verify compliance it must send a notice of noncompliance and give 30 calendar days, counted from when the notice is received, to show compliance or an exemption. The notice is treated as received 5 days after its date. Coverage continues during the 30 days for an enrollee.","where":"42 CFR 435.558(a), (c)(4); Public Law 119-21 sec. 71119 (xx)(6)","checked":"2026-11-01","src":"ecfr_42_435_550_563","asOf":"2026-10-29"},"medicaid_work_rule.work_rule_notice_content":{"group":"notices_appeals","value":"The notice must say which months will be assessed, how to show the hours/income or an exemption, the deadline and how to send it, what happens to Medicaid and to marketplace premium subsidies if there is no answer, and how to reapply.","where":"42 CFR 435.558(c)(1)","checked":"2026-11-01","src":"ecfr_42_435_550_563","asOf":"2026-10-29"},"medicaid_work_rule.work_rule_loss_and_appeal":{"group":"notices_appeals","value":"If no showing is made the state must first check every other basis of eligibility, then deny the application, or end coverage not later than the end of the month after the 30-day period ends, after an advance written notice with fair-hearing rights. A person ended for not responding can be reconsidered without a new application if the form comes in within the 90-day period; a state may not bar reapplication.","where":"42 CFR 435.558(d)-(f)","checked":"2026-11-01","src":"ecfr_42_435_550_563","asOf":"2026-10-29"},"medicaid_work_rule.work_rule_outreach_dates":{"group":"notices_appeals","value":"States must warn affected people by regular mail plus another way (online account, phone, text) starting 3 months plus the application look-back months before 1 January 2027, at enrollment, and again at each application, renewal or change; states often send more.","where":"42 CFR 435.561","checked":"2026-11-01","src":"ecfr_42_435_550_563","asOf":"2026-10-29"},"medicaid_work_rule.work_rule_ex_parte":{"group":"documents_interviews","value":"The state must first use data it already has (payroll data, claims and encounter data, other agencies) to verify compliance or an exclusion before asking the person for anything, and must accept documents sent through any application channel.","where":"42 CFR 435.557(b)-(c); Public Law 119-21 sec. 71119 (xx)(5)","checked":"2026-11-01","src":"ecfr_42_435_550_563","asOf":"2026-10-29"},"marketplace_ptc.notice_of_decision":{"group":"notices_appeals","value":"The marketplace must give timely written notice of any eligibility decision. When a reported or data-matched change would alter eligibility, enrollees get a notice and 30 days from the date of the notice to say the information is wrong.","where":"45 CFR 155.310(g); 155.330(e)(2)(i)(B)","checked":"2026-11-01","src":"ecfr_45_155_330","asOf":"2026-10-29"},"marketplace_ptc.appeal_request_deadline":{"group":"notices_appeals","value":"An applicant or enrollee must be allowed to ask for an appeal within 90 days of the date of the eligibility notice (or a time consistent with the state Medicaid hearing rule, but no less than 30 days).","where":"45 CFR 155.520(b)","checked":"2026-11-01","src":"ecfr_45_155_520","asOf":"2026-10-29"},"marketplace_ptc.appeal_late_request":{"group":"notices_appeals","value":"A late request can still be accepted if the person shows that exceptional circumstances caused the delay; the entity must tell the person what defect to fix and how.","where":"45 CFR 155.520(d)(2)(i)(D)","checked":"2026-11-01","src":"ecfr_45_155_520","asOf":"2026-10-29"},"marketplace_ptc.appeal_how":{"group":"notices_appeals","value":"Appeals can be filed by phone, mail, in person (where offered) or online; the entity must help on request and may not limit or interfere with the right to appeal.","where":"45 CFR 155.520(a)","checked":"2026-11-01","src":"ecfr_45_155_520","asOf":"2026-10-29"},"marketplace_ptc.keep_coverage_during_appeal":{"group":"notices_appeals","value":"After a valid appeal of a redetermination, the marketplace must keep the appellant eligible while it is pending. If the person accepts, enrollment, advance premium credit and cost-sharing reductions continue at the level before the redetermination. The acknowledgement must warn that advance payments made during the appeal are subject to reconciliation on the tax return.","where":"45 CFR 155.525; 155.520(d)(1)(i)(B)","checked":"2026-11-01","src":"ecfr_45_155_525","asOf":"2026-10-29"},"marketplace_ptc.repay_if_lose_appeal":{"group":"notices_appeals","value":"Credit paid in advance during the appeal is 'subject to reconciliation' on the tax return, so the household may owe part or all of it back if the final result is less.","where":"45 CFR 155.520(d)(1)(i)(B)","checked":"2026-11-01","src":"ecfr_45_155_520","asOf":"2026-10-29"},"marketplace_ptc.appeal_decision_clock":{"group":"notices_appeals","value":"A written appeal decision is due within 90 days of the date the appeal request is received 'as administratively feasible'; expedited appeals as fast as reasonably possible. The decision applies from the first of the next month or, if the appellant chooses, retroactively to the coverage date they would have had.","where":"45 CFR 155.545(b)-(c)","checked":"2026-11-01","src":"ecfr_45_155_545","asOf":"2026-10-29"},"marketplace_ptc.second_level_appeal":{"group":"notices_appeals","value":"If a state-run marketplace's appeal decision goes against the person, a further appeal to the federal (HHS) appeals entity must be filed within 30 days of the state decision notice.","where":"45 CFR 155.520(c)","checked":"2026-11-01","src":"ecfr_45_155_520","asOf":"2026-10-29"},"marketplace_ptc.open_enrollment_2027":{"group":"decision_clocks","value":"For coverage years starting 1 January 2027 or later every marketplace must start open enrollment no later than 1 November and end it no later than 31 December, for no more than 9 weeks; a plan chosen by 31 December starts 1 January. (Through plan year 2026 the federal marketplace ran to 15 January.)","where":"45 CFR 155.410(e)(5), (f)(4)","checked":"2026-11-01","src":"ecfr_45_155_410","asOf":"2026-10-29"},"marketplace_ptc.special_enrollment_60_days":{"group":"decision_clocks","value":"After a qualifying event (for example losing other coverage) a person generally has 60 days from the event to pick a plan outside open enrollment; some events allow picking up to 60 days beforehand.","where":"45 CFR 155.420(c)(1)-(2)","checked":"2026-11-01","src":"ecfr_45_155_420","asOf":"2026-10-29"},"marketplace_ptc.annual_redetermination":{"group":"renewals_reporting","value":"The marketplace must redetermine eligibility every year and send an annual redetermination notice with enough time to review, respond and have changes made before the year starts.","where":"45 CFR 155.335(a)(1), (c)","checked":"2026-11-01","src":"ecfr_45_155_335","asOf":"2026-10-29"},"marketplace_ptc.report_changes_30_days":{"group":"renewals_reporting","value":"An enrollee must report any change that affects eligibility (such as income, household size, address, other coverage) within 30 days of the change. The marketplace may set a reasonable income-change threshold below which no report is needed; changes can be reported through the application channels, by mail only if the marketplace allows.","where":"45 CFR 155.330(b)","checked":"2026-11-01","src":"ecfr_45_155_330","asOf":"2026-10-29"},"marketplace_ptc.file_and_reconcile":{"group":"renewals_reporting","value":"A household that got advance credit must reconcile it on its tax return each year (the 'file and reconcile' step). For plan year 2027 a marketplace must apply one of two 'failure to file and reconcile' policies: it may stop advance credit if the household failed to reconcile for 1 tax year or for 2 consecutive tax years.","where":"45 CFR 155.305(f)(4)","checked":"2026-11-01","src":"ecfr_45_155_305","asOf":"2026-10-29"},"marketplace_ptc.overpayment_full_repayment":{"group":"renewals_reporting","value":"If advance credit paid to a household for a year is more than the credit it turns out to be entitled to, the extra is added to its tax. Until now the extra repaid was capped by income; Public Law 119-21 deletes the cap for tax years beginning after 31 December 2025, so the whole excess is repaid on the 2026 return (filed in 2027).","where":"Public Law 119-21 sec. 71305(a), (c); 26 U.S.C. 36B(f)(2)","checked":"2026-11-01","src":"pl119_21","asOf":"2026-11-01","effective":"taxable years beginning after 31 December 2025"},"marketplace_ptc.overpayment_before_2026_rule":{"group":"renewals_reporting","value":"For tax years through 2025 the amount repaid was limited by income (the 'limitation on increase' in subparagraph (B), amounts in a table by income as a share of the poverty line).","where":"26 U.S.C. 36B(f)(2)(A)-(B) (2024 edition)","checked":"2026-11-01","src":"usc26_36B","asOf":"2026-11-01"},"marketplace_ptc.med_loss_from_work_rule_blocks_credit":{"group":"renewals_reporting","value":"A person who loses (or would be eligible for) Medicaid but is cut off for not meeting the Medicaid work rule is treated as eligible for Medicaid coverage for the premium tax credit test, so cannot claim the credit for those months.","where":"Public Law 119-21 sec. 71119(a), new SSA sec. 1902(xx)(7)(B)","checked":"2026-11-01","src":"pl119_21","asOf":"2026-11-01","effective":"same start as the work rule, 1 Jan 2027"},"marketplace_ptc.inconsistency_90_days":{"group":"documents_interviews","value":"If the marketplace cannot verify something (for example income, immigration status, other coverage), it must try to fix it with the person, then send a notice giving 90 days from the date the notice is sent to send documents or otherwise resolve it. It may extend the 90 days for a good-faith effort. During the 90 days it must proceed with eligibility using the person's own statement, including advance credit if the tax filer understands it is subject to reconciliation.","where":"45 CFR 155.315(f)(2)-(4)","checked":"2026-11-01","src":"ecfr_45_155_315","asOf":"2026-10-29"},"marketplace_ptc.attest_if_no_documents":{"group":"documents_interviews","value":"If a person has no documents and the issue cannot be settled otherwise, the marketplace must on a case-by-case basis accept the person's own statement with an explanation (not for citizenship or immigration status).","where":"45 CFR 155.315(g)","checked":"2026-11-01","src":"ecfr_45_155_315","asOf":"2026-10-29"},"marketplace_ptc.minimum_information":{"group":"documents_interviews","value":"The marketplace must not ask for more information than the minimum necessary for the marketplace, Medicaid, CHIP and any Basic Health Program.","where":"45 CFR 155.315(i)","checked":"2026-11-01","src":"ecfr_45_155_315","asOf":"2026-10-29"},"marketplace_ptc.income_proof_rule":{"group":"documents_interviews","value":"Projected yearly income is checked against IRS tax data and other electronic data. For a household that qualifies for the 'alternate verification process' (for example it says its income or family size has changed, or someone has applied for unemployment), a stated income no more than 10 percent below what the data show is accepted without more proof. A statement lower than the marketplace's 'reasonable threshold' (not less than 10 percent), or missing tax data, leads to attempts to verify and then, if unresolved, the 90-day document process.","where":"45 CFR 155.320(c)(3)(ii)-(vi)","checked":"2026-11-01","src":"ecfr_45_155_320","asOf":"2026-10-29"},"ssi.notice_before_cut_days":{"group":"notices_appeals","value":"SSA must give advance written notice before it suspends, reduces or ends payments (except on confirmed death). The notice must allow 60 days from receipt for an appeal.","where":"20 CFR 416.1336(a)-(b)","checked":"2026-11-01","src":"ecfr_20_416_1336","asOf":"2026-10-29"},"ssi.receipt_presumption_5_days":{"group":"notices_appeals","value":"'Date you receive notice' means 5 days after the date on the notice unless you show it came later. That is why the deadline is often written '60 days plus 5 mailing days'.","where":"20 CFR 416.1401","checked":"2026-11-01","src":"ecfr_20_416_1401","asOf":"2026-10-29"},"ssi.reconsideration_deadline":{"group":"notices_appeals","value":"Ask for reconsideration in writing within 60 days after the date you receive notice of the decision (i.e. 60 days after 5 days from the notice date).","where":"20 CFR 416.1409(a)","checked":"2026-11-01","src":"ecfr_20_416_1409","asOf":"2026-10-29"},"ssi.late_filing_good_cause":{"group":"notices_appeals","value":"If the deadline is missed you can ask in writing for more time and give the reason; SSA extends it if you show good cause (illness, a death in the family, lost records, misleading SSA action, limited English, and similar).","where":"20 CFR 416.1409(b); 416.1411","checked":"2026-11-01","src":"ecfr_20_416_1409","asOf":"2026-10-29"},"ssi.hearing_and_appeals_council_deadlines":{"group":"notices_appeals","value":"After reconsideration: a hearing before an administrative law judge must be asked for in writing within 60 days after you receive notice of the previous decision; Appeals Council review within 60 days after you receive the hearing decision.","where":"20 CFR 416.1433(b); 416.1468(a)","checked":"2026-11-01","src":"ecfr_20_416_1433","asOf":"2026-10-29"},"ssi.keep_payments_during_appeal":{"group":"notices_appeals","value":"If you appeal within 10 days after receiving the notice, payment is continued or reinstated at the old level until the first appeal decision is issued, unless you waive in writing. If you appeal after day 10 but within 60 days there is no right to continued payment.","where":"20 CFR 416.1336(b)","checked":"2026-11-01","src":"ecfr_20_416_1336","asOf":"2026-10-29"},"ssi.keep_payments_medical_cessation":{"group":"notices_appeals","value":"If SSA decides you are no longer disabled or blind, you can choose to keep benefits during reconsideration and during an ALJ hearing, but you must ask for reconsideration and continued benefits no later than 10 days after you receive the notice (and the same 10 days after a reconsideration notice to keep them through the ALJ hearing). Late requests need good cause.","where":"20 CFR 416.996(e)-(f)","checked":"2026-11-01","src":"ecfr_20_416_996","asOf":"2026-10-29"},"ssi.repay_if_lose_appeal":{"group":"notices_appeals","value":"If the final decision goes against you, continued benefits are treated as an overpayment you are asked to pay back, but you can ask for waiver; waiver is considered if the appeal was in good faith (assumed unless you failed to cooperate).","where":"20 CFR 416.996(g)","checked":"2026-11-01","src":"ecfr_20_416_996","asOf":"2026-10-29"},"ssi.redetermination_timing":{"group":"renewals_reporting","value":"SSA reviews SSI eligibility (a 'redetermination') on a schedule whose length varies with how likely the situation is to change, and also when you report a change. A separate continuing disability review covers whether you are still disabled.","where":"20 CFR 416.204(b)","checked":"2026-11-01","src":"ecfr_20_416_204","asOf":"2026-10-29","stateVaries":"Interval is not printed in the regulation; SSA's POMS gives it by case type (not read)."},"ssi.report_changes_by_the_10th":{"group":"renewals_reporting","value":"A change in address, living arrangement, income (including a spouse's or parent's), resources, work, marital status and similar must be reported. A report is late if it is not made within 10 days after the close of the month in which the event happened (so by the 10th of the next month); SSA may take a penalty deduction from benefits for a late report.","where":"20 CFR 416.714(a); 416.708","checked":"2026-11-01","src":"ecfr_20_416_714","asOf":"2026-10-29"},"ssi.report_when_asked_30_days":{"group":"renewals_reporting","value":"If SSA asks in writing for a report and you do not answer within 30 days, it may decide you are ineligible and suspend benefits starting the month after.","where":"20 CFR 416.714(b)","checked":"2026-11-01","src":"ecfr_20_416_714","asOf":"2026-10-29"},"ssi.overpayment_recovery_rate":{"group":"renewals_reporting","value":"Taking money back from a current SSI payment is limited each month to the lesser of the month's benefit or 10 percent of the person's total income (countable income plus SSI and state supplement). SSA's system starts the 10 percent adjustment 60 days after the overpayment notice.","where":"20 CFR 416.571; POMS SI 02220.001","checked":"2026-11-01","src":"ecfr_20_416_571","asOf":"2026-10-29"},"ssi.overpayment_waiver":{"group":"renewals_reporting","value":"Waiver of repayment may be granted if you were without fault and repayment would defeat the purpose of SSI, be against equity and good conscience, or impede efficient administration because the amount is small. SSA must send written notice of the overpayment and of its waiver decision; the waiver-request steps (file review, personal conference) are set out in the SSDI notice rule and in POMS, which were not read for SSI.","where":"20 CFR 416.550","checked":"2026-11-01","src":"ecfr_20_416_550","asOf":"2026-10-29"},"ssi.documents_to_prove_eligibility":{"group":"documents_interviews","value":"SSA can ask for any information and documents it needs to prove age, citizenship or lawful status, residence, income, resources and living arrangement; and an applicant must apply for any other benefits they may be entitled to (pension, VA, Social Security) after SSA's written notice.","where":"20 CFR 416.200; 416.210","checked":"2026-11-01","src":"ecfr_20_416_200","asOf":"2026-10-29"},"ssdi.receipt_presumption_5_days":{"group":"notices_appeals","value":"'Date you receive notice' means 5 days after the date on the notice unless you show otherwise.","where":"20 CFR 404.901","checked":"2026-11-01","src":"ecfr_20_404_901","asOf":"2026-10-29"},"ssdi.reconsideration_deadline":{"group":"notices_appeals","value":"Ask for reconsideration in writing within 60 days after the date you receive notice of the initial decision (60 days plus the 5 mailing days).","where":"20 CFR 404.909(a)","checked":"2026-11-01","src":"ecfr_20_404_909","asOf":"2026-10-29"},"ssdi.late_filing_good_cause":{"group":"notices_appeals","value":"If you miss it, ask in writing for more time and say why; SSA extends the time if you show good cause (standards in 404.911: serious illness, family death, records destroyed, trying hard to find evidence, limited education or English).","where":"20 CFR 404.909(b); 404.911","checked":"2026-11-01","src":"ecfr_20_404_909","asOf":"2026-10-29"},"ssdi.keep_benefits_during_appeal":{"group":"notices_appeals","value":"If SSA finds you are no longer disabled, you can keep benefits (and Medicare) while you appeal, but you must ask for reconsideration and continued benefits no later than 10 days after you receive the notice, and the same 10 days after a reconsideration notice to keep them through the ALJ hearing. Late requests are paid only if there is good cause.","where":"20 CFR 404.1597a(f)-(g)","checked":"2026-11-01","src":"ecfr_20_404_1597a","asOf":"2026-10-29"},"ssdi.repay_if_lose_appeal":{"group":"notices_appeals","value":"If the cessation is upheld you will be asked to pay back continued disability payments (Medicare costs are not asked back), but you may ask for waiver, which is considered if the appeal was in good faith.","where":"20 CFR 404.1597a(j)","checked":"2026-11-01","src":"ecfr_20_404_1597a","asOf":"2026-10-29"},"ssdi.hearing_and_appeals_council_deadlines":{"group":"notices_appeals","value":"Hearing before an administrative law judge, then Appeals Council review: each must be requested in writing within 60 days after you receive notice of the previous decision.","where":"20 CFR 404.933(b); 404.968(a)","checked":"2026-11-01","src":"ecfr_20_404_933","asOf":"2026-10-29"},"ssdi.report_changes":{"group":"renewals_reporting","value":"A person getting disability benefits should promptly tell SSA if their condition improves, they return to work, they have a new employer, they increase the amount of work, or their earnings increase. The rule gives no day count for SSDI. If SSA has authority to get pay data from the employer through a participating payroll provider, some of these reports are reduced.","where":"20 CFR 404.1588(a)-(b)","checked":"2026-11-01","src":"ecfr_20_404_1588","asOf":"2026-10-29"},"ssdi.continuing_disability_review_timing":{"group":"renewals_reporting","value":"If your condition is expected to improve SSA generally reviews at 6 to 18 months after its last decision; if not permanent but improvement cannot be predicted, at least once every 3 years (subject to a waiver); a case won on appeal is not reviewed for 3 years unless a specific review is scheduled.","where":"20 CFR 404.1590(d), (f), (g)","checked":"2026-11-01","src":"ecfr_20_404_1590","asOf":"2026-10-29"},"ssdi.overpayment_notice_and_30_days":{"group":"renewals_reporting","value":"An overpayment notice asks for full immediate refund (or withholding from the next month's benefit), proposes adjustment if no refund within 30 days of the notice, and says that if no waiver or reconsideration is asked for within 30 days of the notice adjustment begins. SSA staff are told to leave about 90 days (at least 60) before withholding starts, so the person can appeal.","where":"20 CFR 404.502a(c), (h); EM-25029 REV sec. C","checked":"2026-11-01","src":"ecfr_20_404_502a","asOf":"2026-10-29"},"ssdi.overpayment_default_withholding_50":{"group":"renewals_reporting","value":"Since overpayment notices sent on or after 25 April 2025, SSA withholds by default 50 percent of the monthly Title II benefit (it was 10 percent before). A person can ask for a lower rate, installments, reconsideration or waiver. The default does not apply to fraud or similar fault cases, and the SSI rate stays at 10 percent. The 50 percent applies to matured overpayments from 'COM 08/2025'.","where":"SSA EM-25029 REV (28 Aug 2025), sections B-C; EM 25029 (25 Apr 2025)","checked":"2026-11-01","src":"ssa_em25029rev","asOf":"2026-11-01","effective":"25 April 2025"},"ssdi.overpayment_waiver":{"group":"renewals_reporting","value":"Waiver of repayment if you were not at fault and repayment would defeat the purpose of the Act or be against equity and good conscience; the overpayment notice must explain the right to waiver, reconsideration and a personal conference.","where":"20 CFR 404.502a(e); 404.506","checked":"2026-11-01","src":"ecfr_20_404_502a","asOf":"2026-10-29"},"tanf.appeal_rights_federal_requirement":{"group":"notices_appeals","value":"Each state's TANF plan must set out objective criteria for eligibility and benefits and 'how the State will provide opportunities for recipients who have been adversely affected to be heard in a State administrative or appeal process'. Federal law gives no day counts.","where":"42 U.S.C. 602(a)(1)(B)(iii)","checked":"2026-11-01","src":"usc42_602","asOf":"2026-11-01"},"tanf.notice_before_cut_days":{"group":"notices_appeals","value":"No federal rule on how many days before a TANF cut a notice must be sent. States use their own rules (many follow the SNAP/Medicaid 10-day pattern, but that is not a federal TANF rule).","where":"42 U.S.C. 601-619 and 45 CFR parts 260-265 (no notice rule found)","checked":"2026-11-01","stateSet":true},"tanf.hearing_request_deadline":{"group":"notices_appeals","value":"State-set. Example from a web-search summary only: California CDSS hearing-rights notices give 90 days from the notice date (not opened or verified).","where":"State TANF manuals","checked":"2026-11-01","stateSet":true,"stateVaries":"Look up the state's TANF hearing rule; the notice itself states the deadline."},"tanf.keep_benefits_during_appeal":{"group":"notices_appeals","value":"State-set. Many states pay 'aid pending' if the hearing is requested before the cut takes effect, but no federal TANF rule requires it.","where":"State TANF manuals","checked":"2026-11-01","stateSet":true},"tanf.child_support_cooperation_sanction":{"group":"renewals_reporting","value":"A state must reduce a family's assistance by at least 25 percent (or end it) when the child-support agency finds that an adult is not cooperating in establishing paternity or enforcing support, unless the person has good cause or another state exception.","where":"42 U.S.C. 608(a)(2)","checked":"2026-11-01","src":"usc42_608","asOf":"2026-11-01"},"tanf.time_limit_60_months":{"group":"renewals_reporting","value":"No state may use federal TANF funds for assistance to a family with an adult head of household or spouse who has received federal assistance for 60 cumulative months, whether or not consecutive. A state may exempt up to 20 percent of its caseload for hardship or for families that include a battered or abused person. Months in Indian country with 50 percent adult non-employment and some other months do not count.","where":"42 U.S.C. 608(a)(7); 45 CFR 264.1(a)-(b)","checked":"2026-11-01","src":"ecfr_45_264_1","asOf":"2026-10-29","stateVaries":"A state may set a shorter time limit or pay beyond 60 months with its own money."},"tanf.work_hours_federal_measure":{"group":"renewals_reporting","value":"The federal work participation rate counts a family as engaged if the work-eligible adult averages at least 30 hours a week of countable activities (with at least 20 from the core list). This is a state-level target, not a rule that a particular recipient is cut off for fewer hours; individual work requirements and sanctions are set by states.","where":"45 CFR 261.31(a)","checked":"2026-11-01","src":"ecfr_45_261_31","asOf":"2026-10-29","stateVaries":"Sanction size and timing, cure periods and exemptions are state-set."},"tanf.decision_clock_standard":{"group":"decision_clocks","value":"No federal TANF application deadline. States set one (no current federal TANF standard was found).","where":"none found in 42 U.S.C. 601-619 or 45 CFR 260-265","checked":"2026-11-01","stateSet":true},"tanf.renewals_and_reporting":{"group":"renewals_reporting","value":"State-set: redetermination interval, change-reporting deadlines (commonly 10 days), and overpayment recovery are all state rules.","where":"State TANF manuals","checked":"2026-11-01","stateSet":true},"tanf.documents_and_interview":{"group":"documents_interviews","value":"State-set. Federal law requires states to check applicants against federal and state data (income and eligibility verification, 45 CFR 264.10) but lists no documents or interview rule.","where":"45 CFR 264.10 (IEVS matching, not quoted); state manuals","checked":"2026-11-01","stateSet":true},"wic.notice_before_cut_days":{"group":"notices_appeals","value":"A participant about to be suspended or disqualified mid-certification must be told in writing at least 15 days before, with the reasons and the right to a fair hearing. Each participant must also be told at least 15 days before the certification period expires.","where":"7 CFR 246.7(j)(6), (j)(8)","checked":"2026-11-01","src":"ecfr_7_246_7","asOf":"2026-10-29"},"wic.hearing_request_deadline":{"group":"notices_appeals","value":"The state must give a reasonable time to ask for a fair hearing, no less than 60 days from the date the agency mails or gives the notice of adverse action. A hearing is available on a claim for improperly issued benefits, a denial of participation, or a disqualification.","where":"7 CFR 246.9(a), (e)","checked":"2026-11-01","src":"ecfr_7_246_9","asOf":"2026-10-29","stateVaries":"A state may allow more than 60 days; the notice states its number."},"wic.keep_benefits_during_appeal":{"group":"notices_appeals","value":"Participants who appeal a termination within the 15-day advance-notice period must keep getting WIC until the hearing decision or until the certification period expires, whichever comes first. This does not apply to applicants denied at initial certification, participants whose certification period has expired, or people who become categorically ineligible; they may appeal but do not get benefits while waiting.","where":"7 CFR 246.9(g)","checked":"2026-11-01","src":"ecfr_7_246_9","asOf":"2026-10-29"},"wic.repay_if_lose_appeal":{"group":"notices_appeals","value":"If the agency's disqualification is upheld, continued benefits stop as soon as administratively feasible, as the hearing decides. The text read does not say the participant must repay benefits that were continued during the appeal.","where":"7 CFR 246.9(k)(3)","checked":"2026-11-01","src":"ecfr_7_246_9","asOf":"2026-10-29"},"wic.hearing_clock":{"group":"notices_appeals","value":"The hearing must be accessible and held within three weeks of the date the request was received, with at least 10 days' written notice of the time and place. The written decision is due within 45 days of the request; if the decision is for the participant and benefits were denied or ended, they begin immediately.","where":"7 CFR 246.9(j), (k)(3)","checked":"2026-11-01","src":"ecfr_7_246_9","asOf":"2026-10-29"},"wic.decision_clock_standard":{"group":"decision_clocks","value":"When a clinic is not at its maximum caseload it must notify an applicant of eligibility or ineligibility within 20 days of the first request for benefits; within 10 days (a state may extend to 15 on request) for 'special nutritional risk' applicants. Those categories must at least include pregnant women who are Priority I and migrant farmworker families about to leave the area.","where":"7 CFR 246.7(f)(2)(iii)","checked":"2026-11-01","src":"ecfr_7_246_7","asOf":"2026-10-29"},"wic.waiting_list":{"group":"decision_clocks","value":"A clinic serving its maximum caseload must keep a waiting list and cannot refuse anyone who asks to be put on it; people must be told within 20 days after their visit that they are on the list.","where":"7 CFR 246.7(f)(1)","checked":"2026-11-01","src":"ecfr_7_246_7","asOf":"2026-10-29"},"wic.if_agency_misses_clock":{"group":"decision_clocks","value":"The WIC regulation read states the processing deadlines but no automatic remedy for a missed deadline. The fair-hearing article lists only denials, disqualifications and claims, so a plain delay is not listed there.","where":"7 CFR 246.9(a); 246.7(f)","checked":"2026-11-01","src":"ecfr_7_246_9","asOf":"2026-10-29"},"wic.certification_periods":{"group":"renewals_reporting","value":"Pregnant women: through the pregnancy and up to the end of the month the baby turns six weeks old. Postpartum: up to the end of the sixth month after birth. Breastfeeding women and infants: about every six months (a state may allow up to the baby's first birthday month). Children: about every six months to the end of the month of their 5th birthday (a state may allow up to one year with required health checks). Local scheduling trouble may stretch or shorten a period by up to 30 days.","where":"7 CFR 246.7(g)","checked":"2026-11-01","src":"ecfr_7_246_7","asOf":"2026-10-29"},"wic.mid_certification_changes":{"group":"renewals_reporting","value":"If the clinic learns that a participant's household income has changed it must re-check income eligibility during the certification period (not needed if 90 days or less remain). A participant found ineligible is disqualified. Someone who qualified automatically through Medicaid, SNAP or TANF cannot be dropped just because they stopped getting that program until their income has been re-checked in the usual way. A state may also allow disqualification for failing to collect food benefits for several consecutive months.","where":"7 CFR 246.7(h)(1)-(3)","checked":"2026-11-01","src":"ecfr_7_246_7","asOf":"2026-10-29"},"wic.overpayment_recovery_rate":{"group":"renewals_reporting","value":"Claims for improperly issued benefits exist (246.9(a)) but no recovery rate was found in the sections read (246.12 claims rules not read).","where":"7 CFR 246.9(a)","checked":"2026-11-01","stateSet":true},"wic.proof_of_identity_residence":{"group":"documents_interviews","value":"At certification the applicant must show proof of residency and proof of identity (for an infant or child, the parent's or guardian's identity). A state may certify people with no proof (theft, loss, disaster, homeless, migrant farmworker) if they confirm residence or identity in writing. The certification procedure must be free.","where":"7 CFR 246.7(c)(2), (c)(4)","checked":"2026-11-01","src":"ecfr_7_246_7","asOf":"2026-10-29"},"wic.proof_of_income":{"group":"documents_interviews","value":"Applicants who qualify automatically through another program (Medicaid, SNAP, TANF) must document that enrollment; the income documentation rule does not apply to people for whom the necessary documentation is not available, or for whom it would be an unreasonable barrier (such as a homeless woman or child).","where":"7 CFR 246.7(d)(2)(v)","checked":"2026-11-01","src":"ecfr_7_246_7","asOf":"2026-10-29"},"wic.proof_of_pregnancy":{"group":"documents_interviews","value":"A state that asks for proof of pregnancy may start benefits on the applicant's word if the pregnancy is not visible, then allow a reasonable time, not more than 60 days, to bring documents; failing that, benefits can end mid-certification.","where":"7 CFR 246.7(c)(2)(ii)","checked":"2026-11-01","src":"ecfr_7_246_7","asOf":"2026-10-29"},"wic.presence_at_appointment":{"group":"documents_interviews","value":"Applicants must be physically present at each certification, except people with disabilities who cannot attend, and (at state option) children already certified who are receiving ongoing health care or whose parents work. Remote-certification waivers that USDA granted separately were not read.","where":"7 CFR 246.7(o)","checked":"2026-11-01","src":"ecfr_7_246_7","asOf":"2026-10-29"},"wic.citizenship_option":{"group":"documents_interviews","value":"A state may limit WIC to citizens, nationals and qualified aliens if it tells FNS; most do not. A reader should not assume either way without the state's WIC page.","where":"7 CFR 246.7(c)(3)","checked":"2026-11-01","src":"ecfr_7_246_7","asOf":"2026-10-29"},"ccdf.hearing_request_deadline":{"group":"notices_appeals","value":"No federal individual appeal deadline in the sections read. Part 98 requires a plan to describe the public hearing process for the state plan (98.16(f)), which is not an individual appeal.","where":"45 CFR 98.16(f)","checked":"2026-11-01","src":"ecfr_45_98_16","stateSet":true},"ccdf.decision_clock_standard":{"group":"decision_clocks","value":"No federal application deadline. A state may let a child be 'presumptively eligible' for up to 3 months and start paying a provider before full documents are in, using a lighter minimum proof; if the child proves ineligible the provider must still be paid (except for fraud).","where":"45 CFR 98.21(e)","checked":"2026-11-01","src":"ecfr_45_98_21","asOf":"2026-10-29","stateVaries":"Presumptive eligibility is a state option."},"ccdf.eligibility_period_12_months":{"group":"renewals_reporting","value":"A state must redetermine a child's eligibility no sooner than 12 months after the first determination or latest redetermination. In between, the child stays eligible at the same service level regardless of a change in family income if income stays at or below 85 percent of state median income, or a temporary change in work/school status (a short absence, seasonal gap, school break, reduced hours, a cessation of up to three months, turning 13, a move within the state).","where":"45 CFR 98.21(a)(1)","checked":"2026-11-01","src":"ecfr_45_98_21","asOf":"2026-10-29"},"ccdf.job_loss_three_months":{"group":"renewals_reporting","value":"A state may end help after a parent loses work or school only if it continues help at the same level for at least three months for job search or to return; after that, if the parent is in a qualifying activity with income below 85 percent of SMI, assistance continues to the next redetermination.","where":"45 CFR 98.21(a)(2)","checked":"2026-11-01","src":"ecfr_45_98_21","asOf":"2026-10-29"},"ccdf.reporting_rule":{"group":"renewals_reporting","value":"A state must require a family to report during the 12 months only if income goes above 85 percent of SMI (taking irregular income into account) and, at the state's option, a non-temporary stop in work/school. Families may report other changes voluntarily; the state must act on information that lowers the co-pay or raises the subsidy, and may not act on information that would cut the subsidy unless it shows income over 85 percent of SMI (or, at option, a non-temporary stop in work).","where":"45 CFR 98.21(h)(1), (h)(4)","checked":"2026-11-01","src":"ecfr_45_98_21","asOf":"2026-10-29","stateVaries":"Extra reporting duties states impose must not be an undue burden and cannot require an office visit."},"ccdf.copay_changes":{"group":"renewals_reporting","value":"A state cannot raise a family's co-payment within the 12-month period, except during a graduated phase-out when income has passed the initial limit.","where":"45 CFR 98.21(a)(3), (b)(3)","checked":"2026-11-01","src":"ecfr_45_98_21","asOf":"2026-10-29"},"ccdf.can_end_early_when":{"group":"renewals_reporting","value":"A state may end help before the next redetermination only for: excessive unexplained absences after multiple contact attempts and prior warning; a move out of the state/territory/tribal area; or substantiated fraud or intentional program violation.","where":"45 CFR 98.21(a)(5)","checked":"2026-11-01","src":"ecfr_45_98_21","asOf":"2026-10-29"},"ccdf.overpayment_recovery":{"group":"renewals_reporting","value":"A payment for a child who met the rules at the last determination is not an error just because the family's circumstances changed (98.21(a)(4)); recovery rules for families are state-set and were not read.","where":"45 CFR 98.21(a)(4)","checked":"2026-11-01","src":"ecfr_45_98_21","stateSet":true},"ccdf.documents_other_programs":{"group":"documents_interviews","value":"At the state's option, enrollment in, or documents used for, other benefit programs (for example SNAP or Medicaid) can verify income and work or school. A state must not make parents disrupt their work or school to complete an eligibility determination and should offer online applications.","where":"45 CFR 98.21(f)-(g)","checked":"2026-11-01","src":"ecfr_45_98_21","asOf":"2026-10-29","stateVaries":"Which documents each state asks for is in its CCDF plan and manual (not read)."},"ccdf.irregular_income":{"group":"documents_interviews","value":"Processes for initial determination and redetermination must account for irregular earnings so that temporary increases (including a month over 85 percent of SMI) do not affect eligibility or co-payments.","where":"45 CFR 98.21(c)","checked":"2026-11-01","src":"ecfr_45_98_21","asOf":"2026-10-29"},"housing.voucher_notice_and_hearing_right":{"group":"notices_appeals","value":"Before ending a voucher family's assistance for something the family did or failed to do, or for being away from the unit too long, the PHA must give prompt written notice with brief reasons, tell the family it may ask for an informal hearing, and state the deadline for asking. The hearing must be offered before the PHA ends payments under the HAP contract.","where":"24 CFR 982.555(a)(2), (c)(2)","checked":"2026-11-01","src":"ecfr_24_982_555","asOf":"2026-10-29","stateVaries":"HUD sets no number of days. Search-result summaries (not opened) show 10 business days at some PHAs (Placer County CA, Columbia SC, Georgia DCA) and 15 business days at another (Anchorage); the family's own notice and the PHA's Administrative Plan state the real deadline."},"housing.voucher_hearing_other_decisions":{"group":"notices_appeals","value":"An informal hearing also covers the family's income and the rent calculated from it, the utility allowance, and the unit size. For those the PHA must tell the family it may ask for an explanation and then a hearing. No hearing is required for discretionary decisions, extending a voucher term, approving a unit or tenancy, or inspection findings (except termination for a family-caused breach).","where":"24 CFR 982.555(a)(1), (b), (c)(1)","checked":"2026-11-01","src":"ecfr_24_982_555","asOf":"2026-10-29"},"housing.voucher_keep_assistance_during_hearing":{"group":"notices_appeals","value":"For terminations the PHA must give the opportunity for an informal hearing before it ends housing assistance payments. The regulation does not give a separate number of days for the PHA to hold the hearing: it must proceed 'in a reasonably expeditious manner'. A PHA need not follow a hearing decision that is contrary to law or HUD rules.","where":"24 CFR 982.555(a)(2), (d), (f)","checked":"2026-11-01","src":"ecfr_24_982_555","asOf":"2026-10-29"},"housing.voucher_applicant_denial":{"group":"notices_appeals","value":"An applicant denied assistance gets prompt notice with brief reasons and the right to an informal review described in the PHA's Administrative Plan; the reviewer cannot be the person who made the decision.","where":"24 CFR 982.554(a)-(b)","checked":"2026-11-01","src":"ecfr_24_982_554","asOf":"2026-10-29"},"housing.public_housing_eviction_notice":{"group":"notices_appeals","value":"In public housing a lease termination notice must be at least 30 days for nonpayment of rent, a reasonable period (not more than 30 days) for health and safety threats, and 30 days in any other case unless state or local law gives a shorter period. The lease must also promise at least 30 days' notice before an eviction for nonpayment is filed.","where":"24 CFR 966.4(l)(3), (q)","checked":"2026-11-01","src":"ecfr_24_966_4","asOf":"2026-10-29"},"housing.public_housing_grievance":{"group":"notices_appeals","value":"A public housing tenant with a complaint about the PHA's action presents it first for an informal settlement; the PHA gives a written summary within a reasonable time, which states how to get a hearing if still unsatisfied. The deadline to ask for the hearing is the PHA's, in its grievance procedure.","where":"24 CFR 966.54","checked":"2026-11-01","src":"ecfr_24_966_54","asOf":"2026-10-29"},"housing.decision_clock_standard":{"group":"decision_clocks","value":"HUD sets no federal deadline for deciding a voucher or public housing application and waiting lists are local; the PHA's Administrative Plan or ACOP and its notice to the applicant govern. The only numbers found are: a 'reasonable' period for an interim reexamination, 'generally' not more than 30 days after an income change is reported.","where":"24 CFR 982.516(c)(1)","checked":"2026-11-01","src":"ecfr_24_982_516","stateSet":true},"housing.annual_reexamination":{"group":"renewals_reporting","value":"A PHA must reexamine family income and composition at least annually (public housing families on flat rent: composition annually and income at least every three years). Third-party verification is required, or a note in the file of why it was not available; where net family assets are $50,000 or less (adjusted yearly) a PHA may accept the family's declaration, with third-party verification of assets every 3 years.","where":"24 CFR 982.516(a); 960.257(a)","checked":"2026-11-01","src":"ecfr_24_982_516","asOf":"2026-10-29"},"housing.interim_ten_percent_rule":{"group":"renewals_reporting","value":"A family can ask for an interim reexamination at any time when income or composition changes; the PHA may decline if it estimates adjusted income will drop by less than 10 percent. The PHA must do an interim reexamination when adjusted income rises by 10 percent or more, but may not count an increase in earned income unless the family earlier got an interim reduction in the same certification period. The PHA may skip it in the last three months of the period.","where":"24 CFR 982.516(c)(2)-(3); 960.257(b)","checked":"2026-11-01","src":"ecfr_24_982_516","asOf":"2026-10-29"},"housing.rent_change_notice_and_effective_date":{"group":"renewals_reporting","value":"If the family reported a change on time, an increase in the family's share takes effect after 30 days' advance notice, from the first of the month after those 30 days; decreases take effect the first of the month after the reported change. If the family failed to report on time, increases are applied retroactively to the first of the month after the change.","where":"24 CFR 982.516(c)(4); 960.257(b)(6)","checked":"2026-11-01","src":"ecfr_24_982_516","asOf":"2026-10-29"},"housing.family_must_report":{"group":"renewals_reporting","value":"The PHA must adopt its own written policy on when and what the family must report; HUD sets no national day count for voucher families in the sections read.","where":"24 CFR 982.516(d)","checked":"2026-11-01","src":"ecfr_24_982_516","asOf":"2026-10-29","stateVaries":"Look up the PHA's Administrative Plan; many require reporting within 10-30 days."},"housing.pha_error_in_family_favor":{"group":"renewals_reporting","value":"If a PHA overcharged a family by an income error it must credit or repay the family; if it undercharged, the family is not required to repay. Errors up to $30 a month in adjusted income ($360 a year) are 'de minimis' and need not be treated as non-compliance.","where":"24 CFR 982.516(f)(1)","checked":"2026-11-01","src":"ecfr_24_982_516","asOf":"2026-10-29"},"housing.documents_third_party_verification":{"group":"documents_interviews","value":"The PHA must get third-party verification of reported income, asset values, deductions and other factors, or write in the file why it could not. The family must sign HUD's release and consent form that lets the PHA check with banks, employers and agencies.","where":"24 CFR 982.516(a)(2), (g)","checked":"2026-11-01","src":"ecfr_24_982_516","asOf":"2026-10-29"},"housing.streamlined_fixed_income":{"group":"documents_interviews","value":"A PHA may use a streamlined income determination for families on fixed income (Social Security, SSI, pensions): when 90 percent or more of income is fixed, the PHA applies the cost-of-living increase if the family certifies nothing changed, with third-party verification every three years.","where":"24 CFR 982.516(b)","checked":"2026-11-01","src":"ecfr_24_982_516","asOf":"2026-10-29","stateVaries":"Optional for the PHA."},"liheap.hearing_right":{"group":"notices_appeals","value":"Each state must provide an opportunity for a fair administrative hearing to people whose claims for assistance are denied or are not acted on with reasonable promptness. No number of days is in the federal law.","where":"42 U.S.C. 8624(b)(13)","checked":"2026-11-01","src":"usc42_8624","asOf":"2026-11-01","stateVaries":"Deadline to request a hearing and any notice period are state-set; a web-search summary of West Virginia hearing decisions shows the program can close 'without prior notice when funds are deemed exhausted' (not opened)."},"liheap.notice_before_cut_days":{"group":"notices_appeals","value":"LIHEAP is mostly a one-time seasonal payment, so there is usually no 'cut'. The federal law gives no notice period; states set denial and appeal notices.","where":"42 U.S.C. 8621-8630 (no notice period found)","checked":"2026-11-01","stateSet":true},"liheap.crisis_clock":{"group":"decision_clocks","value":"Each state reserves money for energy crisis intervention (until 15 March of the program year) and must provide some form of assistance that resolves the crisis not later than 48 hours after a household applies, or 18 hours if the household is in a life-threatening situation, provided the household is eligible.","where":"42 U.S.C. 8623(c)(1)-(2)","checked":"2026-11-01","src":"usc42_8623","asOf":"2026-11-01"},"liheap.decision_clock_standard":{"group":"decision_clocks","value":"No federal deadline for ordinary (non-crisis) LIHEAP applications. The statute requires only that the state provide, in a timely manner, that the highest level of assistance goes to households with the lowest incomes and highest energy costs.","where":"42 U.S.C. 8624(b)(5)","checked":"2026-11-01","src":"usc42_8624","stateSet":true},"liheap.who_is_eligible_federal":{"group":"renewals_reporting","value":"A state may pay only for households where someone receives TANF, SSI, SNAP or certain VA pensions (categorical), or households with income not above the greater of 150 percent of the federal poverty level or 60 percent of state median income. A state may not exclude a household solely because income is under 110 percent of poverty.","where":"42 U.S.C. 8624(b)(2)","checked":"2026-11-01","src":"usc42_8624","asOf":"2026-11-01","stateVaries":"Most states set a lower income cap than the federal maximum."},"liheap.renewals_and_reporting":{"group":"renewals_reporting","value":"State-set: LIHEAP is applied for each heating (or cooling) season; reporting duties and overpayment recovery are in each state's manual.","where":"State LIHEAP plans and manuals","checked":"2026-11-01","stateSet":true},"liheap.funding_status_2026_27":{"group":"decision_clocks","value":"ACF's funding-release page lists a first block grant funding release for FFY 2027 on 9 October 2026 (and for FFY 2026 on 28 Nov 2025, 17 Apr 2026 and a reallotment on 13 Aug 2026). The report's claim that heating money was 'frozen until 30 November 2026' (from a SAN article) was not confirmed from an source; the ACF listing does not show a freeze either way.","where":"acf.gov LIHEAP Funding Releases page","checked":"2026-11-01","src":"acf_liheap_releases","asOf":"2026-11-01","effective":"2026-10-09"},"liheap.scam_warning_official":{"group":"documents_interviews","value":"ACF says LIHEAP does not give grants directly to individuals and charges no fee; a message offering a LIHEAP grant or asking for a fee should be reported to the HHS Fraud Hotline (1-800-447-8477). To find where to apply: Energyhelp.us or the National Energy Assistance Referral line 1-866-674-6327.","where":"acf.gov LIHEAP page (Browser pane, 1 Nov 2026)","checked":"2026-11-01","src":"acf_liheap_releases","asOf":"2026-11-01"},"liheap.documents_and_interview":{"group":"documents_interviews","value":"State-set. The statute lets a state use the verification procedures of TANF, SNAP and similar programs for income eligibility (8624(b)(2)); typical documents (ID, proof of income, recent energy bill) come from state manuals, which were not read.","where":"42 U.S.C. 8624(b)(2)","checked":"2026-11-01","stateSet":true}},"n":{"snap.noticeDays":{"n":10,"unit":"days","rule":"snap.notice_before_cut_days"},"snap.hearingDays":{"n":90,"unit":"days","rule":"snap.hearing_request_deadline"},"snap.hearingDecisionDays":{"n":60,"unit":"days","rule":"snap.hearing_decision_clock"},"snap.hearingDecisionLocalDays":{"n":45,"unit":"days","rule":"snap.hearing_decision_clock"},"snap.winToCardDays":{"n":10,"unit":"days","rule":"snap.hearing_decision_clock"},"snap.conferenceWorkingDays":{"n":2,"unit":"working days","rule":"snap.expedited_hearing_and_conference"},"snap.recertShortDays":{"n":15,"unit":"days","rule":"snap.recert_short_certification"},"snap.claimHearingDays":{"n":90,"unit":"days","rule":"snap.claim_hearing_right"},"snap.proofDays":{"n":10,"unit":"days","rule":"snap.time_to_provide_proof"},"snap.unclearDays":{"n":10,"unit":"days","rule":"snap.reporting_unclear_information"},"snap.decisionDays":{"n":30,"unit":"days","rule":"snap.decision_clock_standard"},"snap.expeditedDays":{"n":7,"unit":"days","rule":"snap.decision_clock_expedited"},"snap.recertFileByDay":{"n":15,"unit":"day of the month","rule":"snap.recert_gap_protection"},"snap.recertLateDays":{"n":30,"unit":"days","rule":"snap.recert_gap_protection"},"snap.recertProofDays":{"n":10,"unit":"days","rule":"snap.recert_verification_time"},"snap.reportAfterMonthDays":{"n":10,"unit":"days","rule":"snap.reporting_simplified_130pct"},"snap.changeReportDays":{"n":10,"unit":"days","rule":"snap.reporting_change_reporting_households"},"snap.cutNoticeAfterReportDays":{"n":10,"unit":"days","rule":"snap.reporting_what_state_does_next"},"snap.periodicFromMonth":{"n":4,"unit":"month","rule":"snap.reporting_periodic_report"},"snap.periodicToMonth":{"n":6,"unit":"month","rule":"snap.reporting_periodic_report"},"snap.periodicReminderDays":{"n":10,"unit":"days","rule":"snap.reporting_periodic_report"},"snap.maxCertMonths":{"n":12,"unit":"months","rule":"snap.certification_period_length"},"snap.maxCertMonthsElderly":{"n":24,"unit":"months","rule":"snap.certification_period_length"},"snap.recoverErrorDollars":{"n":10,"unit":"dollars","rule":"snap.overpayment_recovery_rates"},"snap.recoverErrorPct":{"n":10,"unit":"percent","rule":"snap.overpayment_recovery_rates"},"snap.recoverIpvDollars":{"n":20,"unit":"dollars","rule":"snap.overpayment_recovery_rates"},"snap.recoverIpvPct":{"n":20,"unit":"percent","rule":"snap.overpayment_recovery_rates"},"snap.claimYears":{"n":6,"unit":"years","rule":"snap.overpayment_recovery_rates"},"snap.restoreMonths":{"n":12,"unit":"months","rule":"snap.late_request_becomes_restoration"},"medicaid.noticeDays":{"n":10,"unit":"days","rule":"medicaid_chip.notice_before_cut_days"},"medicaid.fraudNoticeDays":{"n":5,"unit":"days","rule":"medicaid_chip.notice_before_cut_days"},"medicaid.hearingMaxDays":{"n":90,"unit":"days","rule":"medicaid_chip.hearing_request_deadline"},"medicaid.receiptDays":{"n":5,"unit":"days","rule":"medicaid_chip.reinstatement_after_late_request"},"medicaid.reinstateDays":{"n":10,"unit":"days","rule":"medicaid_chip.reinstatement_after_late_request"},"medicaid.hearingDecisionDays":{"n":90,"unit":"days","rule":"medicaid_chip.hearing_decision_clock"},"medicaid.decisionDays":{"n":45,"unit":"days","rule":"medicaid_chip.decision_clock_standard"},"medicaid.decisionDisabilityDays":{"n":90,"unit":"days","rule":"medicaid_chip.decision_clock_standard"},"medicaid.renewalFormDays":{"n":30,"unit":"days","rule":"medicaid_chip.renewal_how_it_works"},"medicaid.reconsiderDays":{"n":90,"unit":"days","rule":"medicaid_chip.renewal_late_reinstatement"},"medicaid.renewalMonths":{"n":12,"unit":"months","rule":"medicaid_chip.renewal_period"},"medicaid.renewalMonthsExpansion":{"n":6,"unit":"months","rule":"medicaid_chip.renewal_six_month_expansion_adults"},"medicaid.citizenshipDays":{"n":90,"unit":"days","rule":"medicaid_chip.citizenship_and_immigration_proof"},"medicaid.citizenshipReceiptDays":{"n":5,"unit":"days","rule":"medicaid_chip.citizenship_and_immigration_proof"},"work.receiptDays":{"n":5,"unit":"days","rule":"medicaid_work_rule.work_rule_noncompliance_notice"},"work.answerDays":{"n":30,"unit":"days","rule":"medicaid_work_rule.work_rule_noncompliance_notice"},"work.hours":{"n":80,"unit":"hours a 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