Utah Admin. Code R414-302-3 - Citizenship

(1) The department implements 42 CFR 435.406, which requires applicants and members to be United States (U.S.) citizens or qualified non-citizens and to provide verification of their U.S. citizenship or lawful non-citizen status.

(2) The department elects to cover applicants and members who are under 19 years of age and lawfully present as defined in 42 U.S.C. 1396b(v) and 42 U.S.C. 1397gg(e)(1), and referenced in Section S89 of the Medicaid State Plan.

(3)

(a) The department shall decide if a public or private organization no longer exists or cannot meet a non-citizen's needs.

(b) The department shall base the decision on the evidence the non-citizen submits to support the claim, and the documentation must be sufficient to prove the claim.

(4) One adult household member must declare the citizenship status of household members who will receive Medicaid.

(5) A qualified non-citizen, as defined in Title 8 U.S.C. 1641 who was residing in the U.S. before August 22, 1996, may receive full services under the following programs:

(a) Medicaid;

(b) Qualified Medicare Beneficiaries (QMB);

(c) Specified Low-Income Medicare Beneficiaries (SLMB); or

(d) Qualifying Individuals (QI).

(6) A qualified non-citizen, as defined in Title 8 U.S.C. 1641 newly admitted into the U.S. on or after August 22, 1996, may receive full services under the following programs after five years have passed from the person's date of entry into the U.S.:

(a) Medicaid;

(b) QMB;

(c) SLMB; or

(d) QI.

(7) The department accepts as verification of citizenship, documents from federally recognized Indian tribes evidencing membership or enrollment, including tribes with international borders as required under Subsection 211(b)(1) of the Children's Health Insurance Program Reauthorization Act of 2009, Pub. L. No. 111 3, or as prescribed by the Secretary.

(8) The department provides reasonable opportunity for applicants or members to present satisfactory documentation of citizenship as required under Subsection 211(b)(2) of the Children's Health Insurance Program Reauthorization Act of 2009, Pub. L. No. 111 3.

(9)

(a) The department considers an infant born to a mother who is eligible for Medicaid at the time of the infant's birth to be satisfactory evidence of citizenship.

(b) The department does not require further verification of citizenship for the infant as required under Subsection 211(b)(3) of the Children's Health Insurance Program Reauthorization Act of 2009, Pub. L. No. 111 3.

(10)

(a) The department implements 42 CFR 435.949 and 42 CFR 435.952.

(b) The department shall verify citizenship and immigration status requirements through the Federal Data Services Hub or through other electronic match systems approved by the Secretary.

(c) If the department cannot verify citizenship or immigration status through an electronic match system or the electronic data is not reasonably compatible with the member statement, the member must provide verification of citizenship and identity as described in 42 CFR 435.407.

Notes

Utah Admin. Code R414-302-3

Amended by Utah State Bulletin Number 2016-14, effective 7/1/2016 Amended by Utah State Bulletin Number 2024-03, effective 1/22/2024