Ohio Admin. Code 5160:1-2-11 - Medicaid: United States (U.S.) citizenship documentation
(A) This rule sets forth acceptable
documentary evidence of United States (U.S.) citizenship and the circumstances
under which an individual who declares U.S. citizenship, under penalty of
perjury, may be given a reasonable opportunity to verify U.S.
citizenship.
(B) Any individual
applying for medical assistance and declaring U.S. citizenship or nationality
shall verify citizenship in accordance with
42 C.F.R.
435.407 (as in effect October 1,
2019
2022 ).
(1) After an individual's U.S. citizenship or
nationality is verified by the administrative agency, the administrative agency
shall not require the individual to re-verify citizenship.
(2) The following individuals are not
required to verify their U.S. citizenship:
(a)
An individual applying for medical assistance only for other
individuals.
(b) A child who
received medical assistance as a deemed newborn on or after July 1,
2006.
(c) An individual who is:
(i) Enrolled in medicare; or
(ii) Receiving supplemental security income
(SSI); or
(iii) Receiving social
security disability insurance (SSDI); or
(iv) Receiving adoption or foster care
assistance under Title IV-E of the Social Security Act (as in effect October 1,
2019
2022 );
or
(v) In foster care and receiving
child welfare services under Title IV-B of the Social Security Act (as in
effect October 1, 2019)
2022)
.
; or
(vi)
Receiving federal kinship guardianship assistance
program (KGAP) payments under Title IV-E of the Social Security Act (as in
effect October 1, 2022).
(d) Other individuals on such other basis as
the secretary of the department of health and human services may specify, by
regulation, that satisfactory documentary evidence of citizenship or
nationality was previously presented.
(e) The administrative agency may rely,
without further documentation of citizenship or identity, on a verification of
citizenship made by a federal agency or another state agency, if such
verification was done on or after July 1, 2006.
(C) If the administrative agency is unable to
verify an individual's citizenship through the social security administration
(SSA) or department of homeland security (DHS) electronic data exchange in the
electronic eligibility system, the following documents must be accepted as
satisfactory documentary evidence of citizenship:
(1) A U.S. passport, unless it was issued
with a limitation; limited passports are issued through DHS using form I-131. A
passport does not have to be currently valid unless it was issued to an
individual born in Puerto Rico.
(2)
A certificate of naturalization (DHS form N-550 or N-570).
(3) A certificate of U.S. citizenship (DHS
form N-560 or N-561).
(4) A valid
state-issued driver's license, if the state issuing the license requires proof
of U.S. citizenship before issuance of such license or obtains a social
security number (SSN) from the applicant and verifies before certification that
such number is valid and assigned to the individual, who is a
citizen.
(5) Native American tribal
documents, including, but not limited to:
(a)
A Seneca Indian tribal census record; or
(b) The bureau of Indian affairs tribal
census records of the Navajo Indians; or
(c) A certificate of Indian blood;
or
(d) A U.S. American Indian or
Alaska native tribal document; or
(e) Other native American tribal
documents.
(6) Such
other documents as the secretary of the department of health and human services
may specify, by regulation, provide proof of U.S. citizenship or nationality
and that provide a reliable means of personal identity.
(D) In the case of an individual declaring
citizenship who does not have an SSN at the time of declaration, the county
department of job and family services (CDJFS) may assist the individual with
obtaining an SSN and attempt to verify the individual's citizenship in
accordance with paragraph (B) of this rule.
(E) If none of the documents from paragraph
(C) of this rule are available, the administrative agency shall verify U.S.
citizenship using a combination of one birth or nationality document from
paragraph (E)(1) of this rule and one identity document from paragraph (E)(2)
of this rule. Although some documents may be listed as both birth and
nationality documents and identity documents, a particular document may only be
used to satisfy either birth and nationality or identity, not both. A birth or
nationality document or an identity document alone does not satisfy the
citizenship documentation requirement.
(1)
Birth or nationality shall be documented using an item from the following
hierarchical list:
(a) A U.S. public birth
record or birth document, showing birth in one of the fifty states, the
District of Columbia, American Samoa, Guam (on or after April 10, 1899), the
Northern Mariana Islands (NMI) (after November 4, 1986 NMI local time), Puerto
Rico (on or after January 13, 1941), Swain's island, or the U.S. Virgin islands
(on or after January 17, 1917) and for individuals whose U.S. citizenship may
be established for collectively naturalized individuals as designated, by
regulation, from the secretary of the department of health and human services.
A birth certificate issued by Puerto Rico is valid only if it was issued on or
after July 1, 2010.
(b) Birth
information obtained through the administrative agency's data exchanges, as
authorized by federal regulation or guidance from the secretary of the
department of health and human services.
(c) A certification of birth abroad issued by
the department of state (DS-1350).
(d) A certification of birth abroad
(FS-545).
(e) A U.S. citizen
identification card (I-197 or I-179).
(f) A report of birth abroad of a citizen of
the U.S. (FS-240).
(g) A northern
Mariana islands identification card (I-873), issued by the United States
citizenship and immigration service (USCIS), to a collectively naturalized
citizen of the United States who was born in the northern Mariana islands
before November 3, 1986.
(h) A
final adoption decree or a statement from a state-approved adoption agency
showing the individual's name and U.S. place of birth. In situations in which
the adoption is not finalized and the state will not release a birth
certificate prior to a final adoption decree, a statement showing the
individual's name and U.S. place of birth, and stating that the source of
information regarding the place of birth is an original birth
certificate.
(i) Evidence of civil
service employment by the U.S. government prior to June 1, 1976.
(j) An official military record of service
showing a U.S. place of birth.
(k)
A data verification with the systematic alien verification for entitlements
(SAVE) program for naturalized citizens, including but not limited to the
provision of the individual's alien registration number.
(l) Evidence showing an individual meets the
requirements of the Child Citizenship Act of 2000, (Pub. L. No.
106-395 ). The administrative agency must obtain
documentary evidence verifying that at any time on or after February 27, 2001,
the following conditions have been met:
(i) At
least one parent of the child is a U.S. citizen by either birth or
naturalization; and
(ii) The child
is under the age of eighteen years; and
(iii) The child is residing in the United
States in legal and physical custody of the U.S. citizen parent; and
(iv) The child was admitted to the U.S. for
lawful permanent residence, as verified under the requirements of
8 U.S.C.
1641 as in effect on July 13, 2007 pertaining
to verification of qualified alien status; and
(v) If adopted, the child satisfies the
requirements of section 101(b)(1) of the Immigration and Nationality Act
(Pub. L. No.
82-414 ) pertaining to international adoptions, as
in effect on July 13, 2007 including:
(a)
Admission for lawful permanent residence as a child adopted outside the U.S.
(IR-3); or
(b) Admission for lawful
permanent residence as a child coming to the U.S. to be adopted, with final
adoption having subsequently occurred (IR-4).
(m) Medical records including, but not
limited to, hospital, clinic, or doctor records or admission papers from a
nursing facility, skilled care facility, or other institution that indicate a
U.S. place of birth.
(n) A life
insurance, health insurance, or other insurance record showing a U.S. place of
birth.
(o) Official religious
record recorded in the U.S. showing that the birth occurred in the
U.S..
(p) School records, including
pre-school, Head Start and daycare, showing the child's name and U.S. place of
birth.
(q) A federal or state
census record showing U.S. citizenship or a U.S. place of birth, including the
individual's age.
(r) Affidavits
made under penalty of perjury. The affidavits do not need to be notarized.
Affidavits may be used only in rare circumstances when the administrative
agency is unable to secure evidence of birth or nationality from another
listing. If the documentation requirement needs to be met through affidavits,
the affidavit must be signed by another individual under penalty of perjury who
can reasonably attest to the applicant's citizenship, and contain the
applicant's name, date of birth, and place of U.S. birth.
(s) Such other documents as the secretary of
the department of health and human services may specify, by regulation, that
provide proof of U.S. citizenship or nationality.
(2) One of the following identity documents
shall be used in combination with a birth or nationality document listed in
paragraph (E)(1) of this rule. A document used to verify birth or nationality
may not also be used to verify identity, even if the document is listed in this
paragraph.
(a) A driver's license or similar
document issued for the purpose of identification by a state, if the license or
document contains a photograph of the individual or such other personal
identifying information relating to the individual such as name, date of birth,
gender, height, eye color, and address.
(b) An identification card issued by a
federal, state, or local government agency or entity, provided the card
contains a photograph or other information such as name, date of birth, gender,
height, eye color, and address:
(i) A U.S.
military card or draft record; or
(ii) A military dependent's identification
card; or
(iii) A U.S. coast guard
merchant mariner card; or
(iv) A
school identification card with a photograph.
(c) For children under age nineteen, a
clinic, doctor, hospital, or school record, including preschool or day care
records.
(d) Two documents
containing consistent information that corroborates an applicant's identity.
Such documents include, but are not limited to, employer identification cards,
high school and college diplomas (including high school equivalency diplomas),
marriage certificates, divorce decrees, and property deeds or titles.
(e) If the individual does not have any
document specified in paragraphs (E)(2)(a) to (E)(2)(d) of this rule, the
individual may submit an affidavit signed under penalty of perjury by another
person who can reasonably attest to the individual's identity. Such affidavit
must contain the individual's name and other identifying information
establishing identity, such as date of birth, gender, height, eye color, and
address. The affidavit does not have to be notarized.
(f) Such other documents of personal identity
as the secretary of the department of health and human services finds, by
regulation, provide reliable means of identification.
(F) Reasonable opportunity period.
(1) If the administrative agency is unable to
verify U.S. citizenship through the social security administration (SSA)
electronic state verification and exchange system (SVES), and the individual
has not provided satisfactory documentation as described in paragraphs (C) and
(E) of this rule, the administrative agency is to give the individual a
reasonable opportunity to present satisfactory documentation of U.S.
citizenship.
(2) The administrative
agency shall approve time-limited medical assistance, provided the individual
satisfies all other conditions of eligibility outlined in rule
5160:1-2-10 of the
Administrative Code. The reasonable opportunity period:
(a) Begins on and extends up to ninety days
from the date the notice of reasonable opportunity is received by the
individual.
(i) The date on which the notice
is received is considered to be five days after the date on the notice, unless
the individual shows that he or she did not receive the notice within the
five-day period.
(ii) The
reasonable opportunity period may end before the ninetieth day if the agency
verifies the individual's U.S. citizenship status.
(iii) Medical assistance coverage for an
individual on a reasonable opportunity period is effective the first day of the
calendar month in which the Ohio department of medicaid (ODM) receives the
application as defined in rule
5160:1-2-01 of the
Administrative Code.
(b)
May be extended. The administrative agency is to provide an extension of the
reasonable opportunity period if the individual is making a good faith effort
to resolve any inconsistencies or obtain necessary documentation or if the
administrative agency is unable to complete the verification process within the
ninety-day reasonable opportunity period.
(c) Is granted with each application needing
verification of U.S. citizenship, provided the individual satisfies all other
conditions of eligibility outlined in rule
5160:1-2-10 of the
Administrative Code. If an individual who was previously provided a reasonable
opportunity period was discontinued after ninety days for failing to provide
verification, he or she is to be granted another ninety-day reasonable
opportunity period with each subsequent new application.
(d) Ends on:
(i) The date the administrative agency
verifies the individual's U.S. citizenship; or
(ii) The last date of the month in which the
ninetieth day falls as described in paragraph (F)(2)(a) of this rule;
or
(iii) An administrative agency
approved extension date beyond the ninety-day reasonable opportunity period
when:
(a) The administrative agency has
determined the individual is making a good faith effort to resolve any
inconsistencies or obtain necessary documentation; or
(b) The administrative agency is unable to
complete the verification process within the ninety-day reasonable opportunity
period.
Notes
Promulgated Under: 111.15
Statutory Authority: 111.15
Rule Amplifies: 5162.03, 5163.02, 5164.02
Prior Effective Dates: 10/01/2013, 08/01/2016, 07/08/2020 (Emer.), 12/14/2020
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