General Information

0110.020.00 Citizenship/Alien Status

IM-#12, January 31, 2017, IM-#60 October 28, 2014, IM-#54 July 21, 2009, IM-#31 April 6, 2007, IM-#66 June 23, 2006

Section 6036 of the Deficit Reduction Act of 2005 amended section 1903 of the Social Security Act effective July 1, 2006 to require states to obtain satisfactory documentation of citizenship and identity prior to approving Medicaid benefits. Individuals receiving Medicaid benefits in July 2006 were required to provide verification of citizenship and identity at the next reinvestigation.

Section 211 of the Children’s Health Insurance Program Reauthorization Act (CHIPRA) signed February 4, 2009, amended section 1903(x) of the Social Security Act. The law allows an individual declaring to be a citizen or national of the United States who is required to present documentary evidence of citizenship or nationality a reasonable opportunity to present the documentation. A reasonable opportunity is defined as 90 days from the date of approval.

Per 42 CFR 435.407 presentation of evidence documentation for citizenship and identity is a onetime activity. Once a person’s citizenship and identity has been verified and recorded in any Family Support Division – Income Maintenance database subsequent changes in eligibility should not require repeating the documentation unless later evidence raises a question of the person’s citizenship.

Documentation must be maintained in the case record and as allowed by 42 CFR 435.407 may be copies of documents, unless the copy is questionable. The copy may be submitted in person, via fax, scan or other readily acceptable electronic formats.

The following individuals are exempt from having to provide documentation of citizenship/identity:

  • Individuals receiving SSI,
  • Individuals receiving Medicare,
  • Individuals receiving Social Security Disability Insurance (SSDI), and
  • Individuals receiving Old Age Survivors Disability Insurance (OASDI) benefits based upon their own disability.
  • Children added to MO HealthNet as Newborns, as these children are deemed to have applied for and been found eligible as a result of the mother being an active participant at the time of birth.