Clarification of the Medicaid Program’s New Guidance on Citizenship Documentation for Medicaid Benefits

TO: STATE REFUGEE COORDINATORS
NATIONAL VOLUNTARY AGENCIES
OTHER INTERESTED PARTIES 

FROM: Martha Newton
Director
Office of Refugee Resettlement

SUBJECT: Clarification of the Medicaid Program’s New Guidance on Citizenship Documentation for Medicaid Benefits

On June 9, 2006, the Centers for Medicare and Medicaid Services ( CMS) issued a Medicaid Fact Sheet and a State Medicaid Directors’ Letter providing guidance regarding the implementation of section 6036 of the Deficit Reduction Act of 2005 (Pub. L. No. 109-171).

This Medicaid guidance implements a new requirement effective July 1, 2006 that persons who are applying for Medicaid and claim to be U.S. citizens, provide actual documentary evidence of U.S. citizenship or nationality.

This State Letter is to provide clarification of the impact of this Medicaid guidance on refugees, asylees, Amerasians, Cuban and Haitian entrants, and victims of a severe form of trafficking who receive certification or eligibility letters from ORR, and certain other specified family members. See 45 CFR 400.43 and ORR State Letter #01-13 on the Trafficking Victims Protection Act, dated May 3, 2001 , as modified by ORR State Letter # 02-01, January 4, 2002, and ORR State Letter # 04-12, June 18, 2004.

The Medicaid guidance on implementation of section 6036 of the Deficit Reduction Act of 2005 has no impact on the process for determining Medicaid eligibility of refugees, asylees, Amerasians, Cuban and Haitian entrants, or victims of a severe form of trafficking. The Medicaid eligibility determination process for refugees, asylees, Amerasians, Cuban and Haitian Entrants, and victims of a severe form of trafficking who receive certification or eligibility letters from ORR, and certain other specified family members of trafficking victims, remains the same as it was prior to the enactment of the Deficit Reduction Act of 2005.

Section 1137(d)(2) of the Social Security Act (SSA) describes the procedures to be followed in determining Medicaid eligibility if the individual applying for Medicaid is not a citizen or national of the United States. These procedures have not changed, and are not affected by the implementation of section 6036 of the Deficit Reduction Act of 2005.
http://www.ssa.gov/OP_Home/ssact/title11/1137.htm

Please direct any questions regarding this State letter to Gayle Smith at (202) 205-3590, or by e-mail: gsmith@acf.hhs.gov.