Update on New Medicaid Requirements to Establish Citizenship and Identity AND Materials to Help You Notify Families of These New Requirements

(8/06) In early July 2006, a "News" article was posted on the HC-NCHC Outreach Web page entitled "New Requirements to Document Citizenship and Identity Become Effective September 1, 2006 for Medicaid." Since then, decisions have been in flux at both the national and state levels as policymakers have sought to simplify the process for Medicaid applicants and for local county department of social services staff.This update will highlight some of the most significant policy shifts.

Based on these updated policies, outreach materials are now available as simple black and white PDF files, in English and Spanish, to help you get the word out to families you serve.

"Medicaid Alert" Notice
(To be hung on a wall)

• English "Medicaid Alert" Notice

• Spanish "Medicaid Alert" Notice

"Medicaid Alert" Handout
(To be distributed to families)

• English "Medicaid Alert" Handout

• Spanish "Medicaid Alert" Handout

On July 12, 2006, the Centers for Medicare and Medicaid Services (CMS) released an interim final rule on the new Medicaid requirements to document citizenship and identity. To review the rules (16 pages), you may go to: http://www.cms.hhs.gov/MedicaidEligibility/05_ProofofCitizenship.asp#TopOfPage

The "Citizenship Documentation Interim Final Rule" is a download at the bottom of that page.

From a federal perspective, these are the changes or clarifications of note since the initial July 2006 Web article:

Automatic Newborn Eligibility:

Infants born to Medicaid-eligible mothers will still qualify for "Automatic Newborn Eligibility" for the first year of life, and will not need to provide documentation until they
re-enroll at age one.

Individuals with Disabilities and Seniors:

Individuals who currently receive Supplemental Security Income (SSI) or Medicare will not have to provide documentation of citizenship and identity to apply for or re-enroll in Medicaid. This documentation is already required to qualify for SSI or Medicare.

Presumptive Eligibility:

For pregnant women applying for Medicaid, rules for determining presumptive eligibility have not changed. Applicants who are presumptively eligible will not be required to provide documentation until they apply for Medicaid through the local department of social services.

"Reasonable Opportunity":

CMS clarified that individuals who are currently Medicaid recipients may be re-enrolled (if they qualify) as long as they make a good faith effort to provide the required documents as soon as they can. However, new applicants for Medicaid must provide required documentation before being made eligible for the program.

From a state perspective, the NC Division of Medical Assistance has made the following State policy decisions:

Children in Foster Care:

Children in foster care may be determined eligible and enrolled in Medicaid prior to obtaining documents to prove citizenship and identity. Those documents may be pursued once the child is enrolled.

Local County DSS Assistance in Documenting Citizenship and Identity:

Families who do not have the required documents to prove citizenship and identity on hand should be encouraged to apply! Local county departments of social services will help families document citizenship and identity.Some electronic look-up options are possible.

Original Versus Copies of Original Documents:

For individuals applying for Medicaid in person at the local department of social services, "original" documents to prove citizenship and identity must be offered (eg. U.S. Passport OR Certified U.S. Birth Certificate AND government-issued identity card).

For individuals applying for Medicaid by mail, copies of the original documents may be mailed in.

Questions?

Call your county department of social services or the toll-free CARELINE Information and Referral Service at
1-800-662-7030.