5101:1-38-02 Medicaid: United States (U.S.) citizenship documentation.

(A) This rule sets forth acceptable documentary evidence of United States (U.S.) citizenship. All individuals applying for or receiving medical assistance and stating they are a U.S. citizen or national shall verify citizenship, in accordance with 42 C.F.R. 435.407 (as in effect on February 8, 2006. An individual who declares under penalty of perjury they are a U.S. citizen may be given a reasonable opportunity to verify U.S. citizenship.

(B) Individuals not subject to documenting their U.S. citizenship are defined in paragraphs (B)(4) to (B)(7) of this rule. An individual who is already receiving medicaid will remain eligible if the individual presents satisfactory evidence of citizenship or birth and identity. All documents must be originals or copies certified by the issuing agency.

(1) Citizenship shall be documented using this list:

(a) A U.S. passport, unless it was issued with a limitation; limited passports are issued through the department of homeland security (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;

(b) A certificate of naturalization (DHS form N-550 or N-570);

(c) A certificate of U.S. citizenship (DHS form N-560 or N-561);

(d) 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 from the applicant and verifies before certification that such number is valid and assigned to the individual, who is a citizen;

(e) A state match with the state data exchange (SDX) for supplemental security income (SSI) or social security disability insurance (SSDI) recipients, for states which do not provide medicaid to individuals by virtue of the individual's receipt of SSI or SSDI;

(f) 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.

(g) Native American tribal documents, including, but not limited to:

(i) A Seneca Indian tribal census record;

(ii) The bureau of Indian affairs tribal census records of the Navajo Indians;

(iii) A certificate of Indian blood;

(iv) U.S. American Indian or Alaska native tribal document; or

(v) Other native American tribal documents.

(2) If none of the documents from paragraph (B)(1) of this rule are available, the administrative agency shall verify U.S. citizenship using a combination of one birth or nationality document from paragraph (B)(2) of this rule and one identity document from paragraph (B)(3) of this rule. Although some documents may be listed as both birth and nationality documents and identity documents, a 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. 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 citizen 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) An American Indian card (I-872) issued by the department of homeland security (DHS) with the classification code "KIC." This card is issued by DHS to identify U.S. citizen members of the Texas band of Kickapoos living near the United States/Mexican border;

(i) 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;

(j) Evidence of civil service employment by the U.S. government prior to June 1, 1976;

(k) An official military record of service showing a U.S. place of birth;

(l) 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;

(m) Evidence showing an individual meets the requirements of the Child Citizenship Act of 2000, Pub. L. No. 106-295 (October 30, 2000). 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;

(ii) The child is under the age of eighteen years;

(iii) The child is residing in the United States in legal and physical custody of the U.S. citizen parent;

(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 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);

(n) An extract of a hospital record on hospital letterhead which was established at the time of the individual's birth, was created at least five years before the initial medicaid application date, and indicates a U.S. place of birth. For a child under sixteen, the document must have been created near the time of birth or five years before the application;

(o) A life insurance, health insurance, or other insurance record showing a U.S. place of birth and created at least five years before the initial medicaid application date. For a child under sixteen, the document must have been created near the time of birth or five years before the application;

(p) A religious record recorded in the U.S. within three months of birth, showing the birth occurred in the U.S. and showing either the date of the birth or the individual's age at the time the record was made. The record must be an official record recorded with a religious organization;

(q) An early school record showing a U.S. place of birth. The record must show the name of the individual, the date of admission to the school, the date of birth, a U.S. place of birth and the names and places of birth for the individual's parents;

(r) A federal or state census record showing U.S. citizenship or a U.S. place of birth, including the individual's age;

(s) An institutional admission paper from a nursing home, skilled nursing care facility or other institution which indicates a U.S. place of birth;

(t) A U.S. vital statistics official notification of birth registration;

(u) A delayed U.S. public birth record which was recorded more than five years after the individual's birth. For the purpose of this rule, in the state of Ohio, a corrected birth record as defined in section 3705.15 of the Revised Code, is the equivalent of a delayed U.S. public birth record;

(v) A statement signed by the physician or midwife who was in attendance at the time of birth;

(w) The roll of Alaska natives maintained by the bureau of Indian affairs;

(x) A medical record from a clinic, doctor, or hospital which was created at least five years before the initial medicaid application date and indicates a U.S. place of birth. For children under sixteen the document must have been created near the time of birth or five years before the date of application;

(y) 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 citizenship from another listing. If the documentation requirement needs to be met through affidavits, the following rules apply:

(i) The administrative agency must obtain a separate affidavit, from the individual or other knowledgeable person, explaining why the evidence does not exist or cannot be obtained; and

(ii) There must be at least two affidavits by people, who are U.S. citizens and who have personal knowledge of the event(s) establishing the individual's claim of citizenship. The two affidavits could be combined in a joint affidavit. At least one of the persons making the affidavit cannot be related to the individual and neither person can be the individual; and

(iii) Persons making the affidavit must be able to provide proof of their own U.S. citizenship and identity. If the persons making the affidavit have information that explains why documentary evidence establishing the individual's claim of citizenship does not exist or cannot be readily obtained, the affidavit should contain this information as well;

(z) 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.

(3) The administrative agency must use one of the following identity documents in combination with a birth or nationality document listed in paragraph (B)(2) of this rule.

(a) A driver's license or similar document issued for the purpose of identification by a state, if it 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 federal, state, or local government agencies or entities, provided it contains a photograph or other information such as: name, date of birth, gender, height, eye color and address;

(c) A U.S. military card or draft record;

(d) A military dependent's identification card;

(e) A U.S. coast guard merchant mariner card;

(f) A school identification card with a photograph;

(g) A cross match with a federal or state governmental office, public assistance agency, law enforcement agency, or corrections agency data system to establish identity, if the agency establishes and certifies true identity of individuals;

(h) An affidavit of identity, signed under penalty of perjury, by a residential care facility director or administrator on behalf of an institutionalized individual in the facility. All other means of verifying identity should be pursued prior to accepting this type of affidavit. The affidavit does not need to be notarized;

(i) Three or more documents that together reasonably corroborate the identity of an individual, provided such documents have not been used to establish the individual's birthplace or nationality. The administrative agency must first ensure no other evidence of identity is available to the individual prior to accepting such documents. Such documents must at a minimum contain the individual's name, plus any additional information establishing the individual's identity. All documents used must contain consistent identifying information. These documents include, but are not limited to: employer identification cards, high school diplomas, general education and high school equivalency diplomas, college diplomas from accredited institutions, marriage certificates, divorce decrees, and property deeds and titles;

(j) An affidavit on behalf of an individual under the age of eighteen years, when school identification cards and drivers' licenses are not available to the individual. The affidavit does not need to be notarized;

(k) In the case of individuals under sixteen years of age, in a state which does not provide for the issuance of an identification document (other than a driver's license) a parent, legal guardian, authorized representative, or representative of a nonprofit organization, association or program may provide documentation for the individual, including:

(i) A school record or report card;

(ii) A childcare or nursery school record;

(iii) A clinic, doctor, or hospital record;

(iv) An affidavit signed under penalty of perjury by a parent, caretaker relative or guardian, stating the date and place of birth of the child. An individual cannot use an affidavit for identity if he or she also submitted an affidavit for proof of birth or nationality. The affidavit does not need to be notarized; or

(l) 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.

(4) The citizenship verification requirement shall not apply to the following groups, because these individuals have already satisfied the citizenship verification requirement in order to receive the following assistance:

(a) Individuals enrolled in medicare;

(b) Individuals who are receiving supplemental security income (SSI);

(c) Individuals receiving social security disability insurance (SSDI);

(d) Individuals to whom adoption or foster care assistance is made available under Title IV-E of the Social Security Act;

(e) Individuals in foster care to whom child welfare services are made available under Title IV-B of the Social Security Act; and

(f) 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.

(5) Individuals who are not applying for medical assistance for themselves, but are applying for medical assistance for other individuals, are not required to verify their own U.S. citizenship.

(6) A child who is deemed eligible under rule 5101:1-40- 02.2 of the Administrative Code is not required to verify citizenship.

(C) Administrative agency responsibilities.

(1) The administrative agency shall first verify U.S. citizenship through the social security administration (SSA) electronic state verification and exchange system (SVES) pursuant to rule 5101:1-38-01.8 of the Administrative Code.

(2) The U.S. citizenship condition of eligibility is met when the:

(a) Administrative agency receives a valid data match from SSA for the individual, or

(b) Individual has provided satisfactory documentation, as described in paragraph (B) of this rule.

(3) The U.S. citizenship condition of eligibility is not met when the administrative agency receives an invalid data match from SSA for an individual.

(a) When the match is invalid, the administrative agency shall give the individual reasonable opportunity to present satisfactory documentation of U.S. citizenship.

(b) The administrative agency shall approve medical assistance for ninety days, provided the individual satisfies all other conditions of eligibility outlined in rule 5101:1-38-01.8 of the Administrative Code.

(c) The administrative agency shall terminate medical assistance for the individual who fails to present satisfactory documentation of U.S. citizenship after the reasonable opportunity period expires.

(4) The administrative agency shall require U.S. citizenship to be verified only once.

(D) Individual responsibility. The individual shall present satisfactory documentation of U.S. citizenship when the administrative agency cannot validate U.S. citizenship through SSA's SVES.

Effective: 07/17/2011
R.C. 119.032 review dates: 10/01/2014
Promulgated Under: 111.15
Statutory Authority: 5111.01 , 5111.011 , 5111.02
Rule Amplifies: 5111.01 , 5111.011 , 5111.02
Prior Effective Dates: 10/1/75, 9/1/82, 8/1/86 (Emer.), 10/3/86, 10/1/87 (Emer.), 12/24/87, 4/1/88 (Emer.), 6/30/88, 10/1/88 (Emer.), 12/20/88, 3/1/89 (Emer.), 5/28/89, 10/1/91 (Emer.), 12/20/91, 5/1/97, 7/1/00, 10/6/03, 9/25/06, 8/1/07, 7/1/08, 10/15/09