MR #15.13: Reasonable Opportunity Period to Verify Citizen and Immigration Status for Medical Programs

Helping Families. Supporting Communities. Empowering Individuals.

Illinois Department of Healthcare and Family Services

Illinois Department of Human Services

05/12/15

Summary:

  • Approve medical benefits for an applicant who reports that they have a Medicaid qualifying immigration status when verification of immigration status is pending, and they meet all other eligibility criteria.
  • This release also clarifies that medical benefits may be approved for applicants who report to be U.S. citizens when their citizenship was not confirmed by the Federal Data Hub social security number (SSN) match, and the applicant meets all other eligibility criteria.
  • In the above situations, allow a 90 day 'Reasonable Opportunity' period for the client to provide documentation of U.S. citizenship or qualifying noncitizen status.
  • Noncitizens who have been approved for temporary relief from removal under the Deferred Action for Childhood Arrivals (DACA) process are considered to be undocumented for purposes of receipt of medical benefits.
  • Removes outdated language in PM 03-01-00 about certain categories of noncitizens who do not qualify for medical benefits.

  1. Reasonable Opportunity to Verify Qualifying Noncitizen Status
    1. Verification Process
    2. IES Changes
  2. Reasonable Opportunity to Verify U.S. Citizen Status
  3. Deferred Action for Childhood Arrivals (DACA)
  4. Noncitizens Who Do Not Qualify for Medical Benefits
  5. MANUAL REVISIONS

Reasonable Opportunity to Verify Qualifying Noncitizen Status

Effective immediately, medical benefits may be approved pending verification of immigration status for an applicant who reports that they have a Medicaid qualifying status when the applicant meets all other eligibility criteria. Medicaid qualifying immigration status are listed in PM 03-01-02 sections b through i. Federal regulations (42 U.S.C. 1320b-7) require that we allow a 90 day Reasonable Opportunity period for the client to provide documentation of qualifying noncitizen status.  

This policy applies to medical programs and does not change existing policy for the cash and SNAP programs.

Verification Process

When verification of eligibility criteria is needed at initial application, or when adding a person (other than a deemed newborn) to medical benefits, send a request for information to the applicant as described in PM 02-07-02 and pend the application.  

If the required immigration documentation is not provided after the initial request for information, or additional proof is needed to verify the status through the federal data Hub or SAVE for a person reporting to be a qualified noncitizen, approve medical benefits if the person meets all other eligibility criteria. Allow 90 days for the person to provide the proof or resolve the issue with the U.S. Citizenship and Immigration Services (USCIS). 

IES Changes

The following IES changes were implemented in late April 2015. On the Alien-Details screen, a new drop down "Qualified Immigration Status Pending (90 days)" will appear below the "Alien Admission Status" drop down. The new drop down has the following values:

  1. (Blank) - default value
  2. Yes
  3. No

When Alien Admission Status 'Documented' is selected, and 'Qualified Immigration Status Pending (90 days)' = Yes, the 'Alien Type/ Document' and 'Alien Type Verification' drop downs are mandatory.

  • Example 1: In June 2015, Mr. D applies for medical benefits and reports to have obtained legal permanent resident status in January 2010 and provides an alien ID number. The HUB verify lawful presence (VLP) clearance is unable to confirm the applicant's immigration status. Additional documentation is required. If all other proofs are provided, and the applicant is otherwise eligible, select Alien Admission Status = Documented, and Qualified Immigration Status Pending (90 days).

When the Alien Admission Status 'Unknown' is selected, and 'Qualified Immigration Status Pending (90 days)' = Yes, the 'Alien Type/ Document' and 'Alien Type Verification' drop downs will be enabled and made mandatory. Other fields on the screen are disabled.

  • Example 2: In June 2015, Ms. G applies for medical benefits and reports to have obtained legal permanent resident status in January 2014, after having entered the U.S. in 2012 as a refugee. She recently had a house fire and does not have any immigration documentation, and she does not know her alien ID number. We are unable to run a VLP clearance at this time. If all other proofs are provided, and the applicant is otherwise eligible, select Alien Admission Status = Unknown, and Qualified Immigration Status Pending (90 days).

When the 'Qualified Immigration Status Pending (90 days)' is selected the following things will happen:

  • Eligibility for medical benefits will not be denied for lack of noncitizen status verification if all other criteria are satisfied.
  • When the medical EDG is certified, a Verification Check List (VCL) is created with a due date that is 90 days out for this individual.
  • After the 90 day reasonable opportunity period, when the worker runs eligibility the medical benefits will be denied if the VCL record is not cleared.

Reasonable Opportunity to Verify U.S. Citizen Status

Continue to provide a Reasonable Opportunity period to applicants who report to be U.S. citizens when we are unable to verify U.S. citizenship via the Federal Data Hub SSN citizenship clearance in IES. Federal regulations (42 U.S.C. 1396a) require us to approve medical benefits for applicants who report to be U.S. citizens and are otherwise eligible. This release updates the policy to clarify that we allow citizens up to 90 days, rather than 3 months, to provide documentation of their status when their citizenship was not confirmed by the SSN citizenship clearance.

IES is programmed to approve medical benefits when the HUB clearance does not verify U.S. citizenship for a person reporting to be a U.S. citizen and the individual meets all other factors of eligibility. When Phase 2 of IES is implemented, the system will automatically set a worker alert for 90 days after the mail date of the request for verification. Until then the worker must continue to set a manual control.

Deferred Action for Childhood Arrivals (DACA)

This release clarifies that for purposes of eligibility for assistance benefits, persons who have been approved for temporary relief from removal under Deferred Action for Childhood Arrivals (DACA) status are considered to be undocumented.

In August 2012, the U. S. Department of Homeland Security began accepting requests for consideration of deferred action from removal for undocumented persons who meet certain guidelines. The guidelines include that the person came to the U.S. as a child, is now under age 31 and does not pose a national security or public safety risk. Persons approved in this status receive a U.S. Citizenship and Immigration Services (USCIS) Form 797 DACA Approval Notice or other document indicating that they are approved under DACA.

Noncitizens Who Do Not Qualify for Medical Benefits

Language in PM 03-01-00 is updated to remove the statement that certain persons who are temporarily in the U.S. do not qualify for medical benefits. This statement applies to cash and SNAP only. This is because children in certain non-immigrant statuses who are lawfully residing in the U.S. do qualify for medical benefits as long as they meet all other criteria, including being an Illinois resident. See PM 03-01-02-k for a list of ineligible Visa types.

MANUAL REVISIONS

[signed copy on file]

Gregory M. Bassi

Acting Secretary, Illinois Department of Human Services 

Felicia F. Norwood

Director, Illinois Department of Healthcare and Family Services