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State Letter #04-10

Guidelines regarding the use of RMA Health Screening Programs

Published: May 28, 2004
State Letter
guidelines, health screening, rma


FROM: Nguyen Van Hanh, Ph.D.
Office of Refugee Resettlement

SUBJECT: Guidelines regarding the use of RMA Health Screening Programs

In 1995, the Office of Refugee Resettlement provided States with a Screening Protocol for Newly Arriving Refugees (please refer to the attached ORR State Letter 95-37, dated November 21, 1995).  This State Letter is a companion piece to the protocol letter because it identifies the guidelines States should follow regarding the use of Refugee Medical Assistance (RMA) for medical screening.

Any State may apply to use RMA for health screening of refugees, provided that the State has received written approval from the Director, ORR.  (Please refer to 45CFR 400.107(b) of the ORR regulations concerning medical screening).

Health screening and prevention programs are important to insure follow-up, evaluation, treatment and/or referral of Class A and B conditions identified during the overseas medical exam; to identify persons with communicable diseases of potential public health importance; and to identify personal health conditions that adversely impact on effective resettlement.

States may use RMA funds for some or all of the costs of health screening.  Many States cover the costs associated with health screening under Medicaid and/or State/local public health programs.  There are, however, circumstances in which a State may wish to apply for the use of RMA funds for health screening of refugees.  One example would be a situation in which the existing State Medicaid program and other State/local health programs do not cover needed health screening and prevention services that are essential to the health and well being of refugees.

If a State wishes to use RMA funds for the costs associated with health screening and prevention, the following should be clearly identified:

  • A description of existing health screening services that are covered under Medicaid and/or State/local public health programs.
  • The identification of “additional” health screening services that a State wishes to cover but are not currently covered by existing health care programs, such as Medicaid and/or State/local public health programs, and an estimate of the associated costs.
  • A detailed budget breakdown which indicates how the State plans to claim reimbursement of RMA for health screening and prevention.
  • Identification of the mechanism(s) the State intends to use to implement the use of RMA reimbursement, such as Memoranda of Agreement/ Understanding with the State Health Department; contractual agreements /arrangements with State and/or local public health clinics or other health care providers in the community.

Beginning in Fiscal Year 2005, all States will be required to submit an annual plan and budget for the use of RMA funds for medical screening.  States must submit their FY 2005 plans to ORR no later than September 30, 2004.

The Office of Refugee Resettlement is committed to insuring the provision of the best health care screening available to newly arriving refugees.  We encourage States to examine their existing resources and determine whether the use of RMA reimbursement can help provide and enhance the protection and well being of refugees and their communities.

If you have any questions concerning this State letter, please contact Nguyen T. Kimchi, 202-401-4556.

Last Reviewed: May 13, 2019
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