Citizenship

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Citizenship Identity for Medicaid
June 22, 2006 DSS/DMMA Staff Development
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Effective July 1, 2006, we are required to
document citizenship identity For all
Medicaid applicants and recipients At the time
of application or redetermination.
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• Primary Documentation Includes
• U. S. Passport
• Certificate of Naturalization
• Certificate of U.S. Citizenship

One of these documents will verify both
citizenship and identity!
Applicants or recipients born outside the U. S.
who were not citizens at birth must submit a
document listed under primary evidence.
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U. S. Passport
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Certificate of Naturalization N-550 or N-570
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Certificate of Citizenship N560 or N561
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• Acceptable secondary documentation
• to verify proof of citizenship
• (A second document to verify identity is also
  required!)
• A U.S. birth certificate
• Final adoption decree showing childs name U.S.
  birthplace
• Evidence of civil service employment by the U.S.
  government before June 1976
• An official military record of service showing a
  U.S. place of birth
• A match with Social Security Administration
  through State Data Exchange (SDX) (For SSI
  recipients only)
• Medicare card or proof of receipt of Medicare

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• A Certification of birth issued by the Department
  of State
• (Form DS-1350) DSDepartment of State
• A Report of Birth Abroad of a U.S. Citizen (Form
  FS-240)
• FS Foreign Service
• A Certification of Birth Abroad (FS-545)
• A U.S. Citizen I.D. card (DHS Form I-197or
  (I-179)
• DHS Department of Homeland Security
• I Immigration Nuturalization Service
• An American Indian Card (I-872) issued by the
  Department of Homeland Security with the
  classification code "KIC". (Issued by DHS to
  identify U.S. citizen members of the Texas Band
  of Kickapoos living near the U.S./Mexican border)
• A Northern Mariana Identification Card.
  I-873(Issued by the INS to a collectively
  naturalized citizen of the United States who was
  born in the Northern Mariana Islands before
  November 4, 1986)
• INS Immigration Naturalization Service

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(No Transcript)
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Acceptable Third Level documentation to verify
proof of citizenship (A second document to
verify identity is also required!)

• Extract of U.S. hospital record of birth on
  hospital letterhead established at the time of
  the person's birth that was created at least 5
  years before the initial application date and
  indicates a U.S. place of birth
• Life or health or other insurance record showing
  a U.S. place of birth that was created at least 5
  years before the initial application date

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Acceptable Fourth Level documentation to verify
proof of citizenship (A second document to
verify identity is also required!)

• Federal or State census record showing U.S.
  citizenship or a U.S. place of birth
• U.S. State Vital Statistics official notification
  of birth registration
• BVS system.
• Institutional admission papers from a nursing
  home, skilled nursing care facility or other
  institution that was created at least 5 years
  before the initial application date and indicates
  a U.S. place of birth
• Medical (clinic, doctor, or hospital) record that
  was created at least 5 years before (unless the
  application is for a child under 5) the initial
  application date and indicates a U.S. place of
  birth

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• Other document that was created at least five
  years before the application for Medicaid. These
  documents are Seneca Indian tribal census record,
  Bureau of Indian Affairs tribal census records of
  the Navaho Indians
• An amended U.S. public birth record that is
  amended more than 5 years after the person's
  birth or a statement signed by the physician or
  midwife who was in attendance at the time of
  birth
• Written affidavit

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Documents Acceptable as Verification of Identity

• A current state driver's license
• bearing the individual's picture
• or State I.D. also with the individual's picture
• Certificate of Indian Blood, or other U.S.
  American Indian/Alaska Native tribal document

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• Military dependent's identification card
• School I.D. card with photograph
• U. S. Military card or draft record
• Clinic, doctor or hospital record showing date of
  birth
• Daycare or nursery school record showing date of
  birth
• Affidavit signed under penalty of perjury by a
  parent or guardian attesting to the child's
  identity

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An individual who is already enrolled in Medicaid
will remain eligible if he/she continuously shows
a good faith effort to present satisfactory
evidence of citizenship and identity within the
45-day time frame. An additional 45 days will
be given if the individual continues to make a
good faith effort to provide the documentation
We must provide assistance to those trying to
meet these requirements especially those who have
no one else to help..
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An applicant for Medicaid should not be made
eligible until they have presented the required
evidence
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• Procedures
• Application applicant is not eligible until
  they provide verification of
• citizenship and identity for everyone in the
  case.
• Accept documents, copy and file in vital
  statistics section
• Give 45 45 days for client to complete
  requirements.
• Complete Case Comment and link to window
• Please note System support is scheduled to be
  available by mid-August. We do
• not have to deny anyone until September 30th at
  the earliest even if a
• person applies July 1, 2006.

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• Case Comment
• Linked to Additional Individual Demographics
  Window
• Remarks Title Citizenship
• The comment must indicate what was verified, for
  whom and
• describe what documents were used
• Level 1, 2, 3, 4, 5 (Identity)

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Enter case number and hit retrieve.
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(No Transcript)
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• Procedures
• Redetermination
• If the recipient has the necessary documents,
  copy and
• place in Vital Statistics and add the case
  comment linked
• to the Additional Individual Demographic Window..
  
• If the recipient does not have necessary
  documents,
• complete the redetermination and confirm
• Then
• Use the Expected Change window to track 45 45
  days
• For documents and you will send yourself an
  alert.

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Expected Change
Date Change is expected Type of change
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NOW
Verification
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NEW
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Websites Where You or Your Customer May Find
Helpful Information
http//www.azdhs.gov/vitalrcd/states.htm Link to
all 50 States-Vital Statistics
http//www.uscis.gov/graphics/index.htm US
Immigration Services
http//www.travel.state.gov/passport/passport_1738
.html U. S. Dept of State, Division of Consular
Affairs
http//www.cdc.gov/nchs/howto/w2w/w2welcom.htm Nat
ional Center for Health Statistics Where to write
for Vital Records