PM 02-07-03-c.
See policy memorandum dated 10/03/13 Verifications for Medical Programs.
For sources and forms to verify citizen/INS status, see WAG 03-01-00.
IES and 90-day Reasonable Opportunity Period for Citizens
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 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.
IES and 90-day Reasonable Opportunity Period for Noncitizens
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 after the initial request for information the required documentation is not provided, or additional proof is needed to verify the status through the federal data Hub 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 USCIS.
IES Screens
On the Alien-Details screen, a new drop down "Qualified Immigration Status Pending (90 days)" appears below the "Alien Admission Status" drop down. The new drop down has the following values:
- (Blank) - default value
- Yes
- 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.
