Okla. Admin. Code § 317:35-5-25 - Citizenship/noncitizen status and identity verification requirements
(a)
Citizenship/noncitizen status and identity verification
requirements. Verification of citizenship/noncitizen status and identity
is required for all adults and children approved for SoonerCare. An exception
is individuals who are initially eligible for SoonerCare as deemed newborns;
according to Section 1903(x) of the Social Security Act, they will not be
required to further document citizenship or identity at any subsequent
SoonerCare eligibility redetermination. They are considered to have provided
satisfactory documentation of citizenship and identity by virtue of being born
in the United States.
(1) The types of
acceptable evidence that verify identity and citizenship include:
(A) United States (U.S.) passport;
(B) Certificate of Naturalization issued by
U.S. Citizenship & Immigration Services (USCIS)(Form N-550 or
N-570);
(C) Certificate of
Citizenship issued by USCIS (Form N-560 or N-561);
(D) Copy of the Medicare card or printout of
a Beneficiary Earnings and Data Exchange (BENDEX) or State Data Exchange (SDX)
screen showing receipt of Medicare benefits, Supplemental Security Income or
disability benefits from the Social Security Administration; or
(E) Tribal membership card or Certificate of
Degree of Indian Blood (CDIB) card, with a photograph of the
individual.
(2) The types
of acceptable evidence that verify citizenship but require additional steps to
obtain satisfactory evidence of identity are listed in subparagraphs (A) and
(B). Subparagraph (A) lists the most reliable forms of verification and is to
be used before using items listed in (B). Subparagraph (B) lists those
verifications that are less reliable forms of verification and are used only
when the items in (A) are not attainable.
(A)
Most reliable forms of citizenship verification are:
(i) A U.S. public Birth Certificate showing
birth in one (1) of the fifty (50) states, the District of Columbia, Puerto
Rico (on or after 1/13/1941), Guam (on or after 4/10/1899), the U.S. Virgin
Islands (on or after 1/17/1917), American Samoa, Swain's Island, or the
Northern Mariana Islands after 11/4/1986. For Puerto Ricans whose eligibility
is being determined for the first time on or after October 1, 2010 and using a
birth certificate to verify citizenship, the birth certificate must be a
certified birth certificate issued by Puerto Rico on or after July 1,
2010;
(ii) A Consular Report of
Birth Abroad of a U.S. citizen issued by the Department of Homeland Security or
a Certification of Birth issued by the State Department (Form FS-240, FS-545 or
DS-1350);
(iii) A U.S. Citizen
Identification Card (Form I-179 or I-197);
(iv) A Northern Mariana Identification Card
(Form I-873) (Issued by the former INS to a collectively naturalized citizen of
the U.S. who was born in the Northern Mariana Islands before
11/3/1986);
(v) An American Indian
Card issued by the Department of Homeland Security with the classification code
"KIC" (Form I-872);
(vi) A final
adoption decree showing the child's name and U.S. place of birth;
(vii) Evidence of U.S. Civil Service
employment before 6/1/1976;
(viii)
An Official U.S. Military Record of Service showing a U.S. place of birth (for
example a DD-214);
(ix) Tribal
membership card or Certificate of Degree of Indian Blood (CDIB) card, without a
photograph of the individual, for Native Americans;
(x) Oklahoma voter registration
card;
(xi) Other acceptable
documentation as approved by OHCA; or
(xii) Other acceptable documentation to the
same extent as described and communicated by the United States Citizenship and
Immigration Service (USCIS) from time to time.
(B) Other less reliable forms of citizenship
verification are:
(i) An extract of a
hospital record on hospital letterhead established at the time of the person's
birth that was created five (5) years before the initial application date and
that indicates a U.S. place of birth. For children under sixteen (16) the
evidence must have been created near the time of birth or five (5) years before
the date of application;
(ii) Life,
health, or other insurance record showing a U.S. place of birth that was
created at least five (5) years before the initial application date and that
indicates a U.S. place of birth;
(iii) Federal or state census record showing
U.S. citizenship or a U.S. place of birth (generally for persons born 1900
through 1950). The census record must also show the applicant's/member's age;
or
(iv) One (1) of the following
items that show a U.S. place of birth and was created at least five (5) years
before the application for SoonerCare. This evidence must be one (1) of the
following and show a U.S. place of birth:
(I)
Seneca Indian tribal census record;
(II) Bureau of Indian Affairs tribal census
records of the Navajo Indians;
(III) U.S. State Vital Statistics official
notification of birth registration;
(IV) An amended U.S. public birth record that
is amended more than five (5) years after the person's birth; or
(V) Statement signed by the physician or
midwife who was in attendance at the time of
birth.
(3) Acceptable evidence of identity that must
accompany citizenship evidence listed in (A) and (B) of paragraph (2) of this
subsection includes:
(A) A driver's license
issued by a U.S. state or territory with either a photograph of the individual
or other identifying information such as name, age, sex, race, height, weight,
or eye color;
(B) A school
identification card with a photograph of the individual;
(C) An identification card issued by federal,
state, or local government with the same information included on driver's
licenses;
(D) A U.S. military card
or draft record;
(E) A U.S.
military dependent's identification card;
(F) A Native American Tribal document
including Certificate of Degree of Indian Blood, or other U.S. American
Indian/Alaska Native Tribal document with a photograph of the individual or
other personal identifying information;
(G) A U.S. Coast Guard Merchant Mariner
card;
(H) A state court order
placing a child in custody as reported by the OKDHS;
(I) For children under sixteen (16), school
records may include nursery or daycare records;
(J) If none of the verification items on the
list are available, an affidavit may be used for children under sixteen (16).
An affidavit is only acceptable if it is signed under penalty of perjury by a
parent or guardian stating the date and place of the birth of the child and
cannot be used if an affidavit for citizenship was
provided.
(b)
Reasonable opportunity to obtain verification.
(1) The state provides Medicaid to citizens
and nationals of the United States and certain noncitizens, including during a
reasonable opportunity period pending verification of citizenship, national
status, or immigrations status. The reasonable opportunity period begins on the
date the notice of reasonable opportunity is received by the individual and
extends at minimum ninety (90) days. Receipt by the individual is deemed to
occur five (5) days after the date on the notice, unless the individual shows
that the notice was not received in the five-day period. The state provides an
extension of the reasonable opportunity period if the individual subject to
verification is making a good faith effort to resolve any inconsistencies or
obtain any necessary documentation, or the state needs more time to complete
the verification process. The state begins to furnish benefits to otherwise
eligible individuals on the date of application containing the declaration of
citizenship or immigration status and throughout the reasonable opportunity
period.
(2) The following methods
of verification are the least reliable forms of verification and should only be
used as a last resort:
(A) Institutional
admission papers from a nursing facility, skilled care facility or other
institution. Admission papers generally show biographical information for the
person including place of birth; the record can be used to establish U.S.
citizenship when it shows a U.S. place of birth;
(B) Medical (clinic, doctor, or hospital)
record created at least five (5) years before the initial application date that
indicates a U.S. place of birth. For children under the age of sixteen (16),
the document must have been created near the time of birth. Medical records
generally show biographical information for the person including place of
birth; the record can be used to establish U.S. citizenship when it shows a
U.S. place of birth. An immunization record is not considered a medical record
for purposes of establishing U.S. citizenship;
(C) Written affidavit. Affidavits are only
used in rare circumstances. If the verification requirements need to be met
through affidavits, the following rules apply:
(i) There must be at least two (2) affidavits
by two (2) individuals who have personal knowledge of the event(s) establishing
the applicant's/member's claim of citizenship;
(ii) At least one (1) of the individuals
making the affidavit cannot be related to the applicant/member;
(iii) In order for the affidavit to be
acceptable, the persons making them must be able to provide proof of their own
citizenship and identity;
(iv) If
the individual(s) making the affidavit has information which explains why
evidence establishing the applicant's/member's claim of citizenship does not
exist or cannot be readily obtained, the affidavit must contain this
information as well;
(v) The State
must obtain a separate affidavit from the applicant/member or other
knowledgeable individual (guardian or representative) explaining why the
evidence does not exist or cannot be obtained; and
(vi) The affidavits must be signed under
penalty of perjury.
(c)
Noncitizen eligibility.
SoonerCare services are provided as described to the defined groups as
indicated in this subsection if they meet all other factors of eligibility,
including but not limited to residency requirements, and if the relevant
noncitizen status is verifiable by federally approved means.
(1)
Unauthorized resident
noncitizen. An unauthorized resident noncitizen is a foreign-born
individual who is not lawfully present in the United States, regardless of
having had authorization during a prior period. Unauthorized resident
noncitizens have formerly been known as "illegal" or "undocumented" immigrants
or "aliens". Per 8 U.S.C.
1611(a) and (b)(1)(A) an
unauthorized resident noncitizen is ineligible for Title XIX Medicaid benefits
except for emergency Medicaid as defined at subparagraph (e) below. However, an
unauthorized resident noncitizen who is pregnant is eligible for benefits under
Title XXI separate Children's Health Insurance Program (CHIP) for services that
benefit the unborn child, if the unborn child meets all eligibility
requirements.
(2)
Authorized
resident noncitizen, not qualified. An authorized resident noncitizen is
a foreign-born individual who is lawfully present in the United States (U.S.)
and is lawfully residing in the U.S., but who does not meet the definition of
qualified noncitizen, per 8
U.S.C. 1611(a) and
(b)(1)(A). The Oklahoma Medicaid program does
not exercise the CHIPRA 214 option; therefore, an authorized resident
noncitizen is ineligible for Title XIX or Title XXI Medicaid benefits except
for emergency Medicaid as defined at subparagraph (e) below. However, an
authorized resident noncitizen who is pregnant is eligible for benefits under
Title XXI separate CHIP for services that benefit the unborn child, if the
unborn child meets all eligibility requirements.
(3)
Qualified noncitizen. A
"qualified noncitizen" is an authorized resident noncitizen who, at the time of
applying for Medicaid, has a "qualified noncitizen" immigration status as
identified at 8 U.S.C.
1641, as may be amended from time to time.
Any qualified noncitizen is eligible for full Title XIX Medicaid benefits after
a five-year waiting period beginning on the date of the noncitizen's entry into
the U.S. with an immigration status identified as "qualified noncitizen" if the
noncitizen meets all other eligibility criteria at the end of the waiting
period. During the waiting period, as per
8 U.S.C.
1613(a), any qualified
noncitizen is eligible to receive emergency Medicaid as described in
subparagraph (e) below if the noncitizen meets all other eligibility
requirements, including but not limited to residency requirements.
(A)
Qualified noncitizen immigration
statuses. Immigration statuses identified by federal law as "qualified
noncitizen", as of November 2, 2021, include:
(i) A noncitizen who is lawfully admitted for
permanent residence under the Immigration and Nationality Act [INA], per
8 U.S.C.
1101 et seq.;
(ii) A noncitizen who is granted asylum under
INA section 208, per 8 U.S.C.
1158;
(iii) A noncitizen who is admitted to the
U.S. under INA section 207 refugee, per
8 U.S.C.
1157;
(iv) A noncitizen who is paroled into the
U.S. under INA section 212(d)(5), per
8 U.S.C.
1182(d)(5), for a period of
at least one (1) year;
(v) A
noncitizen whose deportation is being withheld under INA section 243(h), per
8 U.S.C.
1253 (as in effect immediately before the
effective date of section
307 of division C of
Public Law
104 B208) or section 241(b)(3) of such Act, per
8 U.S.C.
1231(b)(3) (as amended by
section
305 (a) of division C of
Public Law
104 B208);
(vi) A noncitizen who is granted conditional
entry before 1980 pursuant to INA section 203(a)(7), per
8 U.S.C.
1153(a)(7), as in effect
prior to April 1, 1980;
(vii) A
noncitizen who is a Cuban and Haitian entrant (as defined in section 501(e) of
the Refugee Education Assistance Act of 1980);
(viii) A noncitizen who, or whose parent or
child, has been battered or subjected to extreme cruelty in the U.S. by a U.S.
citizen or lawful permanent resident spouse or parent or by a member of the
spouse's or parent's family residing in the same household, except during any
period in which the individual responsible for such battery or cruelty resides
in the same household or family eligibility unit as the individual subjected to
such battery or cruelty and only when the alien meets all of the following
requirements:
(I) The noncitizen, if not the
individual subjected to battery or extreme cruelty, had no active participation
in the battery or cruelty;
(II) The
noncitizen is a credible victim; and
(III) The noncitizen is able to show a
substantial connection between the need for benefits sought and the batter or
extreme cruelty; and
(IV) The
noncitizen has been approved or has a petition pending which sets forth a prima
facie case for one of the following: status as a spouse or child of a U.S.
citizen under INA 204(a)(1)(A); classification under INA 204(a)(1)(B)(ii) or
(iii); suspension of deportation under INA 244(a)(3); status as a spouse or
child of a U.S. citizen under INA 204(a)(1)(A); or classification under INA
204(a)(1)(B); or cancellation of removal under INA
240A(b)(2).
(ix) A
noncitizen who is or has been a victim of a severe form of trafficking in
persons and who has been granted nonimmigrant status under INA 101(a)(15)(T) or
who has a pending application that sets forth a prima facie case for
eligibility for such immigration status; or
(x) Beginning December 27, 2020, a noncitizen
who lawfully resides in the state in accordance with the Compacts of Free
Association between the Government of the United States and the Governments of
the Federated States of Micronesia, the Republic of the Marshall Islands, and
the Republic of Palau.
(B)
Five-year wait exception for
refugees and asylees.
(i) Excepted
from the five-year waiting period per
8 U.S.C.
1612(b)(2)(A), the following
qualified noncitizens are immediately eligible for a Medicaid determination
upon the date:
(I) A noncitizen is admitted
to the U.S. as a refugee under INA section 207 [INA 207 Refugee], per
8 U.S.C.
1157;
(II) A noncitizen is granted asylum under INA
section 208, per 8 U.S.C.
1158;
(III) A noncitizen's deportation is withheld
under INA section 243(h), per 8 U.S.C. 1253 (as in effect
immediately before the effective date of
section
307 of division C of
Public Law
104 B208) or section 241(b)(3) of such Act, per
8 U.S.C.
1231(b)(3) (as amended by
section
305 (a) of division C of
Public Law
104 B208);
(IV) A noncitizen is granted status as a
Cuban and Haitian entrant (as defined in section 501(e) of the Refugee
Education Assistance Act of 1980); or
(V) A noncitizen is admitted to the U.S. as
an Amerasian immigrant under the Foreign Operations, Export Financing, and
Related Programs Appropriations Act, 1988, section 584.
(ii) This exception to the five-year waiting
period expires seven (7) years after the date of action indicated in the list
at (c)(3)(B)(i) above. Upon expiration of the exception, the five-year waiting
period must be calculated.
(C)
Five-year wait exception for
certain permanent resident noncitizens. The five-year waiting period
does not apply and the noncitizen is immediately eligible for a Medicaid
determination per 8 U.S.C.
1612(b)(2)(B), if:
(i) The noncitizen is lawfully admitted to
the U.S. for permanent residence;
(ii) The noncitizen has either:
(I) worked forty (40) qualifying quarters of
coverage as defined under the Act; or
(II) can be credited with such qualifying
quarters as provided under 8
U.S.C. 1645; and
(iii) In the case of any such qualifying
quarters creditable for any period beginning after December 31, 1996, the
noncitizen did not receive any federal means-tested public benefit during any
such period.
(D)
Five-year wait exception for veteran and active-duty noncitizens.
As per 8 U.S.C.
1612(b)(2)(C) and
1613, the five-year waiting period
does not apply, and the noncitizen is immediately eligible for a Medicaid
determination if the noncitizen is a qualified noncitizen who is lawfully
residing in the state and is:
(i) A veteran
(as defined at INA sections 101, 1101, or 1301, or as described at
38 U.S.C. section
107) with a discharge characterized as an
honorable discharge and not on account of noncitizenship and who fulfills the
minimum active-duty service requirements of
38 U.S.C. section
5303A(d);
(ii) On active duty (other than active duty
for training) in the Armed Forces of the United States; or
(iii) The spouse or unmarried dependent child
of an individual described herein as a veteran or active-duty noncitizen;
or
(iv) The unremarried surviving
spouse of an individual described herein as a veteran or active-duty noncitizen
who is deceased, if the marriage fulfills the requirements of
38 U.S.C. section
1304.
(E)
Five-year wait exception for COFA
migrants. Per 8 U.S.C.
1613(b)(3) and as of
December 27, 2020, any noncitizen who lawfully resides in the state in
accordance with the Compacts of Free Association between the Government of the
United States and the Governments of the Federated States of Micronesia, the
Republic of the Marshall Islands, and the Republic of Palau is, with regard to
the Medicaid program, are not subject to the five-year waiting period unless
and until the individual=s status is adjusted to lawful permanent resident
(LPR), at which time the five year waiting period must be calculated, unless
the individual meets a separate exception to the five-year waiting period:
(i) If the individual entered the U.S. before
December 27, 2020, and the date of adjustment to LPR status occurred before
December 27, 2020, then the waiting period begins on the date of adjustment and
ends after five (5) years;
(ii) If
the individual entered the U.S. before December 27, 2020, and the date of
adjustment to LPR status occurred after December 27, 2020, the waiting period
expires on December 27, 2025; and
(iii) If the individual entered the U.S.
after December 27, 2020, and the date of adjustment to LPR status occurred
after December 27, 2020, the waiting period begins on the date of entry into
the U.S. and ends after five (5) years.
(F)
Five-year wait exception for
qualified noncitizens receiving SSI. Per
8 U.S.C.
1612(b)(2)(F), a qualified
noncitizen who is receiving benefits under the supplemental security income
program (SSI) under Title XVI of the Act shall be eligible for medical
assistance under a state plan under Title XIX of the Social Security Act, per
42 U.S.C.
1396 et seq), under the same terms and
conditions that apply to other recipients of SSI benefits.
(4)
Special categories of noncitizens
and conferred benefits. For the following noncitizens, federal law has
expressly authorized Title XIX Medicaid benefits as described below and at law.
(A)
Certain American Indian / Alaskan
Native (AI/AN) noncitizens. The qualified noncitizen requirement and the
five-year waiting period do not apply to any individual who is:
(i) An American Indian born in Canada to whom
section 289 of the Immigration and Nationality Act apply, per
8 U.S.C.
1359; or
(ii) A member of a federally recognized
Indian tribe as defined at 25 U.S.C.
450b(e).
(B)
Certain Iraqi nationals.
(i)
Public Law
110-181 ,
Section
1244 , while in force and as amended from time
to time, created a new category of special immigrant for Iraqi nationals,
including:
(I) Principal noncitizens who have
provided relevant service to the U.S. government, while employed by or on
behalf of the U.S. government in Iraq, for not less than 1 year beginning on or
after March 20, 2003, and who have experienced or are experiencing an ongoing
serious threat as a consequence of that employment;
(II) The spouse or surviving spouse of a
principal noncitizen; and
(III) The
child of a principal noncitizen.
(ii)
Public Law
111-118 ,
Section
8120 , while in force and as amended from time
to time, extended Iraqi special immigrant eligibility for medical assistance to
the same extent as INA 207 Refugees are eligible for medical assistance [see
subparagraph (c)(3)(B) above] as of December 19, 2009.
(iii) As of August 3, 2021, pursuant to the
Office of Refugee Resettlement Policy Letter 21-07, while in force and as may
be amended, Iraqi nationals granted special immigrant parole, noncitizens with
applications pending for special immigrant status, are also eligible for
medical assistance to the same extent as INA 207 Refugees are eligible for
medical assistance [see subparagraph (c)(3)(B) above];
(C)
Certain Afghan nationals.
(i)
Public Law
111-8 ,
Section
602 , while in force and as amended from time
to time, created a new category of special immigrant for Afghan nationals,
including:
(I) Principal noncitizens who have
provided relevant service to the U.S. government or the International Security
Assistance Force, while employed by or on behalf of the U.S. government in
Afghan, for not less than one (1) year beginning on or after October 7, 2001,
and who have experienced or are experiencing an ongoing serious threat as a
consequence of that employment;
(II) The spouse or surviving spouse of a
principal noncitizen; and
(III) The
child of a principal noncitizen.
(ii)
Public Law
111-118 ,
Section
8120 , while in force and as amended from time
to time, amended Public Law
111-8 ,
Section
602 , to extend Afghan special immigrant
eligibility for medical assistance to the same extent as INA 207 Refugees are
eligible for medical assistance [see subparagraph (c)(3)(B) above] as of
December 19, 2009;
(iii) As of
August 3, 2021, pursuant to the Office of Refugee Resettlement Policy Letter
21-07, while in force and as may be amended, Afghan nationals granted special
immigrant parole, noncitizens with applications pending for special immigrant
status, are also eligible for medical assistance to the same extent as INA 207
Refugees are eligible for medical assistance [see subparagraph (c)(3)(B)
above];
(iv) Pursuant to
Public Law
117-43 ,
Section
2502 , while in force and as may be amended
from time to time, "applicable individuals" have time-limited eligibility for
medical assistance to the same extent as INA 207 Refugees are eligible for
medical assistance [See subsection (c)(3)(B) above], until March 21, 2023, or
the term of parole, whichever is later. In this subparagraph, the term
"applicable individual" includes only:
(I) A
citizen or national of Afghanistan or a person with no nationality who last
habitually resided in Afghanistan, if the individual is paroled into the U.S.
between July 31, 2021, and September 30, 2022;
(II) The spouse or child of an individual
described at (c)(3)(C)(iv)(I) of this section, if the spouse or child is
paroled into the U.S. after September 30, 2022; and
(III) The parent or legal guardian of an
individual described at (c)(3)(C)(iv)(I) who is determined to be an
unaccompanied child, if the parent or legal guardian is paroled into the U.S.
after September 30, 2022.
(D)
Certain Ukrainian nationals.
Public Law
117-128 ,
Section
401 , while in force and as amended from time
to time, created a new category of special immigrant for Ukraine nationals,
including:
(i) A citizen or national of
Ukraine, or a person who last habitually resided in Ukraine, who was paroled
into the United States between February 24, 2022 and September 30, 2023;
or
(ii) A citizen or national of
Ukraine, or a person who last habitually resided in Ukraine, who was paroled
into the United States after September 30, 2023, and is the spouse or child of
an individual described in (D)(i)(I) above, or is the parent, legal guardian,
or primary caregiver of an individual described in (D)(i)(I) above who is
determined to be an unaccompanied child; and
(iii) The individual's parole has not been
terminated by the Secretary of Homeland
Security.
(d)
Continuing conformance with federal
law. Notwithstanding any other provision of this section, any noncitizen
population that federal law or authority, as amended from time to time,
identifies as eligible for medical assistance under Title XIX is eligible for
such benefits to the same extent, under the same conditions, and for the same
period of time as indicated in the relevant federal law or official federal
guidance documents, including any amendments to the law or guidance.
(e)
Emergency Medicaid.
Emergency Medicaid in this section means medical assistance provided to a
noncitizen under Title XIX for care and services that are necessary for the
treatment of an emergency medical condition, as defined by section 1903(v)(3)
of the Act and including labor and delivery but not related to organ transplant
procedure, of the noncitizen involved if the noncitizen otherwise meets
eligibility requirements for medical assistance under the state plan, including
but not limited to residency requirements.
Notes
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