DAR File No. 32745

Health, Health Care Financing, Coverage and Reimbursement Policy

R414-302-1

Citizenship and Alienage

NOTICE OF PROPOSED RULE

DAR File No.: 32745
Filed: 06/24/2009, 02:00
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this change is to implement the requirements of The Children's Health Insurance Program Reauthorization Act.

Summary of the rule or change:

This change adds provisions to accept tribal records from federally-recognized tribes that verify citizenship of tribal members as required by The Children's Health Insurance Program Reauthorization Act. It also adds a provision to provide a reasonable time for individuals to present citizenship documentation. In addition, this change adds a provision that states that an infant born to a mother who is eligible for Medicaid at the time of birth has provided satisfactory documentation of citizenship.

State statutory or constitutional authorization for this rule:

Section 26-18-3, Sec. 211(b)(1), (b)(2) and (b)(3) of The Children's Health Insurance Program Reauthorization Act, and Pub. L. No. 111-3

This rule or change incorporates by reference the following material:

42 CFR 435.406, 2008 ed.

Anticipated cost or savings to:

the state budget:

There is no impact to the state budget because this change simply modifies the requirements for documenting citizenship.

local governments:

There is no budget impact to local governments because they do not determine eligibility or provide Medicaid services.

small businesses and persons other than businesses:

This change does not impact small businesses because they do not affect which individuals may qualify for Medicaid. This change does not result in any costs or savings to other persons including those who may qualify for Medicaid, as this change does not take away or add any coverage under Medicaid.

Compliance costs for affected persons:

There are no compliance costs to a Medicaid client because this change does not cause a loss in coverage and the Medicaid client does not have to pay more for services.

Comments by the department head on the fiscal impact the rule may have on businesses:

This rule change implements changes in federal law and will not have a fiscal impact on business. David N. Sundwall, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Health Care Financing, Coverage and Reimbursement Policy
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY UT 84116-3231

Direct questions regarding this rule to:

Kimi McNutt at the above address, by phone at 801-538-6381, by FAX at 801-538-6099, or by Internet E-mail at KMCNUTT@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

08/14/2009

This rule may become effective on:

09/01/2009

Authorized by:

David N. Sundwall, Executive Director

R414. Health, Health Care Financing, Coverage and Reimbursement Policy.

R414-302. Eligibility Requirements.

R414-302-1. Citizenship and Alienage.

(1) The [d]Department [adopts]incorporates by reference 42 CFR 435.406[(a)(1), 1997] 2008 ed., which requires applicants and recipients to be U.S. citizens or qualified aliens and to provide verification of their U.S. citizenship or lawful alien status.[is incorporated by reference. The Department adopts Section 1137 and Subsection 1903(v) of the Compilation of the Social Security Laws, in effect January 1, 1998, which is incorporated by reference. The Department adopts Pub. L. 104-193 (401) through (403), (411), (412), (421) through (423), (431), and (435), as amended by Pub. L. 105-33(5302)(b) and (c), (5303), (5305)(b), (5306), (5562), (5563), (5571), and Pub. L. 105-306(2), which are incorporated by reference. The Department adopts Pub. L. 105-33(5307)(a) and (5566) which are incorporated by reference.]

(2) The definitions in R414-1 and R414-301 apply to this rule.

(3) The Department shall decide if a public or private organization no longer exists or is unable to meet an alien's needs. The Department shall base the decision on the evidence submitted to support the claim. The documentation submitted by the alien must be sufficient to prove the claim.

(4) One adult household member must declare the citizenship status of all household members who will receive Medicaid. The client must provide verification of citizenship and identity as described in 42 CFR 435.407.

(5) A qualified alien, as defined in [Pub. L. 104-193 (431) as amended by Pub. L. 105-33(5302)(c)(3), (5562), (5571), and Pub. L. 105-306(2)]8 U.S.C. 1641 who was residing in the United States prior to August 22, 1996, may receive full Medicaid, QMB, SLMB, or Qualifying Individuals (QI) services.

(6) A qualified alien, as defined in [Pub. L. No. 104-193 (431) as amended by Pub. L. 105-33(5302)(c)(3), (5562), and (5571),]8 U.S.C. 1641 newly admitted into the United States on or after August 22, 1996, may receive full Medicaid, QMB, SLMB, or Qualifying Individuals (QI) services after five years have passed from the person's date of entry into the United States.

(7) The Department accepts as verification of citizenship documents from federally recognized Indian tribes evidencing membership or enrollment in such tribe including those with international borders as required under Section 221(b)(1) of The Children's Health Insurance Program Reauthorization Act, Pub. L. No. 111 3, or as prescribed by the Secretary.

(8) The Department provides reasonable opportunity for applicants or clients to present satisfactory documentation of citizenship as required under Section 221(b)(2) of The Children's Health Insurance Program Reauthorization Act, Pub. L. No. 111 3.

(9) The Department considers that an infant born to a mother who is eligible for Medicaid at the time of such infant's birth has provided satisfactory evidence of citizenship. The Department does not require further verification of citizenship for such infant as required under Section 221(b)(3) of The Children's Health Insurance Program Reauthorization Act, Pub. L. No. 111 3.

 

KEY: [benefits, income]public assistance programs, application, eligibility, Medicaid

Date of Enactment or Last Substantive Amendment: [December 16, 2005]2009

Notice of Continuation: January 25, 2008

Authorizing, and Implemented or Interpreted Law: 26-18