July 6, 2006 -- Medicaid Recipients Must Show Proof of Citizenship

In a letter to state Medicaid directors, the U.S. Centers for Medicare and Medicaid Services has called attention to a provision of the 2005 Deficit Reduction Act that requires individuals to provide “satisfactory documentary evidence of citizenship or nationality” when initially applying for Medicaid or upon a first Medicaid re-determination. Specific documents that will be recognized as satisfactory documentary evidence of citizenship or nationality include:

• A U.S. passport or a certificate of naturalization;
• A state or local birth certificate;
• Non-governmental documents that show a place of birth, such as medical records or life and health insurance; or
• An affidavit supplied by at least two individuals, one of whom is not related to the applicant or recipient, attesting to personal knowledge of the events establishing the applicant’s or recipient’s claim of citizenship. People signing affidavits must be able to provide proof of their own citizenship and identity and may be asked to explain why the applicant cannot provide documentary evidence of his or her citizenship or nationality.

The new requirements went into effect July 1, but applicants may be given up to 45 days (90 days for persons with disabilities) to come up with the necessary documentation. Medicaid is available only to U.S. citizens and certain “qualified aliens,” but up to now people who declared they were citizens did not have to support the claim. The letter to state Medicaid directors cautions that states may lose their Medicaid funds if they fail to enforce the new rules.

The letter to state Medicaid directors can be downloaded from http://www.cms.hhs.gov/MedicaidEligibility/05_ProofofCitizenship.asp