Citizenship, Family-Related Medicaid Eligibility Determination Process, Family-Related Medicaid General Eligibility Criteria
DEPARTMENT OF CHILDREN AND FAMILY SERVICES
Economic Self-Sufficiency ProgramRULE NO: RULE TITLE
65A-1.301: Citizenship
65A-1.704: Family-Related Medicaid Eligibility Determination Process
65A-1.705: Family-Related Medicaid General Eligibility CriteriaNOTICE OF CHANGE
Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 33, No. 33, August 17, 2007 issue of the Florida Administrative Weekly.
IF REQUESTED WITHIN 14 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW (IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):
DATE AND TIME: May 14, 2008, 1:30 p.m.
PLACE: 1317 Winewood Boulevard, Building 3, Room 455, Tallahassee, FL 32399
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULES IS: Pat Whitford, Economic Self-Sufficiency Services, phone (850)410-3479
TEXT OF THE PROPOSED RULE CHANGES:
65A-1.301 Citizenship.
(1) The individual whose needs are included must meet the citizenship and noncitizen alien status established in: P.L. 104-193, The Personal Responsibility and Work Opportunity Reconciliation Act of 1996; P.L. 105-33, the Balanced Budget Act of 1997; P.L. 105-185, the Agricultural Research, Extension, and Education Reform Act of 1998; P.L. 105-306, the Noncitizen Benefit Clarification and Other Technical Amendments Act of 1998; P.L. 109-171, the Deficit Reduction Act of 2005; and, the Immigration and Nationality Act.
(2) For Medicaid, an individual who indicates they are a U.S. citizen, and who is not subject to an exemption as specified in 42 C.F.R. 435.406 (2007) (incorporated by reference), must provide proof of U.S. citizenship and identity as specified in 42 C.F.R. 435.407 (2007) (incorporated by reference) P.L. 109-171, the Deficit Reduction Act of 2005 as amended by P.L. 109-432, Tax Relief and Health Care Act of 2006. The Department will assist with obtaining documentation if the applicant or recipient indicates they are having a problem obtaining the documentation.
(3) The eligibility specialist must verify the immigration status of noncitizens through the United States Citizenship and Immigration Service (USCIS), formerly the United States Bureau of Citizenship and Immigration Services. Verification will be requested electronically using the alien number, or based on a USCIS or prior Immigration and Naturalization Services (INS) document provided by the applicant. The system of verification is known as the Verification Information System-Customer Processing System (VIS-CPS), which is part of the Systematic Alien Verification for Entitlements (SAVE) Program. When the noncitizen provides neither an alien number nor USCIS document to indicate their status, the noncitizen must contact the USCIS to obtain documentation or verification of noncitizen status. The department will assist in obtaining documentation if requested. If the noncitizen provides any form of USCIS documentation, regardless of the expiration date, showing an eligible Immigration Act section, the eligibility specialist must accept the documentation and verify the individual’s status. Electronic verification of an eligible immigrant status is acceptable proof of the individual's eligible status for all programs. Automated verification is attempted first. If automated verification cannot be obtained, noncitizenship status must be verified manually (i.e., secondary verification) through use of a USCIS form. Benefits will not be withheld when VIS-CPS indicates secondary (i.e., manual) verification is required and response from the secondary verification is pending, provided all other technical factors of eligibility are met. Benefit recovery is required when such individuals are determined to not have been in an eligible noncitizen status.
(4) Noncitizens who would experience an undue hardship in obtaining current USCIS documentation, hospitalized noncitizens or noncitizens with a medical disability will be considered eligible for benefits on the noncitizen factor of eligibility while awaiting the return of USCIS secondary or manual verification. Undue hardship includes living a prohibitive distance from the USCIS office, lack of transportation, inability to travel to or attend appointments due to a medical condition, or a long waiting period for an appointment with the USCIS. However, these individuals are subject to recoupment for any benefits issued while verification is pending should they subsequently be determined to have been in an ineligible noncitizen status.
Specific Authority 409.919, 414.45 FS. Law Implemented 409.903, 409.904, 410.033, 414.095(3), 414.31 FS. History–New 4-9-92, Amended 11-22-93, Formerly 10C-1.301, Amended 4-18-99,_________.
65A-1.704 Family-Related Medicaid Eligibility Determination Process.
(1) No change.
(2) Simplified Eligibility for Pregnant Women.
(a) The application form for a pregnant woman applying only for Medicaid and only for herself based on pregnancy is CF-ES Form 2700, Health Insurance Application for Pregnant Women, 08/2006 July 2003 (incorporated by reference).
(b) No change.
(c) The following information must be verified or obtained, as indicated below, prior to approval for Medicaid for a pregnant woman.
1. through 3. No change.
4. A declaration of citizenship is required. The applicant’s statement on the Health Insurance Application for Pregnant Woman, CF-ES 2700, 04/2007, is acceptable as a declaration of citizenship. U.S. citizens must provide proof of their U.S. citizenship and identity, if they are not subject to an exemption as specified in 42 C.F.R. 435.406 (2007) (incorporated by reference) P.L. 109-171, the Deficit Reduction Act of 2005 as amended by P.L. 109-432, Tax Relief and Health Care Act of 2006.
5. Noncitizens must provide proof of immigration status through the United States Citizenship and Immigration Service (USCIS), formerly the United States Bureau of Citizenship and Immigration Services. The department will request verification of immigration status of noncitizens electronically through the Verification Information System-Customer Processing System (VIS-CPS), which is part of the Systematic Alien Verification for Entitlements (SAVE) Program, using the noncitizen’s alien number. If the pregnant woman is a non-citizen, she may provide her alien number to the eligibility specialist on the application. If the information is not on the application, it may be provided by telephone. The pregnant woman’s eligibility as a non-citizen will be determined in accordance with Section 1137 of the Social Security Act.
6.5. No change.
7.6. No change.
(d) No change.
(3) through (5) No change.
Specific Authority 409.919 FS. Law Implemented 409.902, 409.903, 409.904, 409.919 FS. History–New 10-8-97, Amended 2-7-01, 10-21-01, 4-1-03, 2-4-04,_________.
65A-1.705 Family-Related Medicaid General Eligibility Criteria.
(1) through (2) No change.
(3) The child must be living with a specified relative as defined in paragraph 65A-1.705(7)(a) 65A-1.705(8)(a), F.A.C., unless specified that the child may be living with a non-relative.
(4) No change.
(5) The individual must be a resident of Florida as provided by s. 1902(a) and (b) of the Social Security Act.
(6) through (7) No change.
(8) Medicaid Applications Due to KidCare.
(a) through (b) No change.
(c) Prior to approval for Medicaid:,
1. Children who are U.S. citizens must have their citizenship and identity verified unless they are exempt from the requirement as specified in 42 C.F.R. 435.406 (2007) (incorporated by reference). P.L. 109-171, the Deficit Reduction Act of 2005 as amended by P.L. 109-432, Tax Relief and Health Care Act of 2006:
2. Vverification of immigration status will be required for children who are not citizens. Immigration status will be verified through the Verification Information System-Customer Processing System (VIS-CPS) Ssystem, which is part of the Systematic Alien Verification for Entitlements Program, and completion of a KidCare Program Immigration Status Statement, CF-ES 2083, Oct. 2002 (incorporated by reference). Information about immigration status and the receipt of Medicaid will be sent to parents when they are asked to complete the Immigration Status Statement form. If the requested information is not provided within thirty (30) days, the application will be denied, unless a request for an extension is made or there are extenuating circumstances known to the department justifying an extension. If the verification or information is difficult for the parent or caretaker to obtain, the eligibility specialist must provide assistance obtaining the verification or information when requested.
(d) through (h) No change.
(9) No change.
Specific Authority 409.8918, 409.919 FS. Law Implemented 409.902, 409.903, 409.904, 409.818, 409.919 FS. History–New 10-8-97, Amended 9-28-98, 4-5-99, 11-23-99, 2-15-01, 9-24-01, 4-1-03,________.
