Effective this Saturday, July 1st , individuals applying for Medicaid, or upon their first re-determination, will have to provide satisfactory documentation of their citizenship or nationality. American citizenship, or a legal immigration status, has always been a requirement for Medicaid eligibility, but up to now beneficiaries were allowed to “self-attest” their citizenship and identities. That’s changed with Section 6036 of the Deficit Reduction Act going into effect.
On June 9th , the Centers for Medicare & Medicaid Services issued new guidelines for state agencies to follow in the implementation of the new rules, providing for “a range of ways citizenship status and personal identity may be documented in recognition of the diversity of beneficiaries served by Medicaid.” (CMS site)
The guidelines set up a hierarchy in which documentary evidence of citizenship & identity can be made, sought first from a list of primary documents and progressing to, in weakest form and then only in “rare circumstances,” written affidavits, signed under penalty of perjury by two citizens, one of whom cannot be related to the individual in question, having specific knowledge of the recipient’s citizenship status.