Citizenship and Alien Status Requirements for the Medicaid Program



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STATE OF NEW YORK 

DEPARTMENT OF HEALTH

 

 

 Corning 



Tower 

The Governor Nelson A. Rockefeller Empire State Plaza 

Albany, New York 12237 

 

Antonia C. Novello, M.D., M.P.H., Dr. P.H. 



 

Dennis P. Whalen 



 Commissioner     

Executive Deputy Commissioner 

 

 



 

  

 

 

TRANSMITTAL:  04 OMM/ADM-7 

ADMINISTRATIVE DIRECTIVE

 

 TO:  Commissioners of DIVISION: 

 

Office of Medicaid 



   

Social Services 



 

Management 



 

  

 

 

DATE:  October 26, 2004 

 

 SUBJECT:  Citizenship and Alien Status Requirements for the Medicaid 

  

 

Program 



 

 

 SUGGESTED 

   DISTRIBUTION:  Medicaid Staff 

   

  Temporary Assistance Staff 

  

 Legal 



Staff 

  

 



   

  Staff Development Coordinators 

Fair 


Hearing 

Staff 

 

  

CONTACT 

  

PERSON: Bureau of Local District Support 

   


  Upstate:  (518) 474-8216 

   


  NYC:      (212) 268-6855 

 

  



ATTACHMENTS: See Appendix I for a listing of attachments 

 

 

FILING REFERENCES 

 

  Previous 

Releases 

Dept. Regs. 

Soc. Serv. 

Manual Ref.  Misc. Ref. 

  ADMs/INFs 

Cancelled   

Law & Other 

   


 

 

Legal Ref. 



 

   

 

 

P.L.103-322 

88 OMM/ADM-22 

 351.2(c)

 

P.L.104-193



 

92 OMM/ADM-10 

 360-1.2 

P.L.104-208



 

00 OMM/ADM-9  00 OMM/ADM-9  360-3.2(j) 

P.L.105-33 

   


GIS 01 MA/015   

P.L.106-386 



 

GIS 01 MA/026 



   

GIS 01 MA/025   

SSA 1903(v)(3) 

 

GIS 01 MA/030 



   

GIS 02 MA/022   

SSL 134-a(2), 122 

 

GIS 01 MA/033 



   

GIS 02 MA/027   

Aliessa v. Novello   

GIS 02 MA/002 

   

GIS 03 MA/005   



 

96 NY2d 418 (2001)   

GIS 02 MA/016 

   


GIS 03 MA/011   

 

 



 

GIS 03 MA/007 

   

GIS 03 MA/015   



 

 

 



GIS 03 MA/008 

   


GIS 04 MA/003   

 

 



 

GIS 04 MA/002 

   

GIS 04 MA/016   



 

 

 



GIS 04 MA/014 

 



Date:  October 26, 2004 

 

 



Trans. No.  04 OMM/ADM-7  

Page 

No.2

 

 



APPENDIX I 

 

Attachment A-1  

Agency Letter Request for Social Security Number 

 

Attachment A-2  



Social Security Number Attestation Form 

 

Attachment B-1  



PRUCOL Narrative 

 

Attachment B-2  



Documentation Guide For PRUCOL Alien Categories 

 

Attachment C 



Aliens: Qualified/PRUCOL: Alien/Citizenship Codes(ACI 

 Codes) 


 

Attachment D-1 

Documentation Guide Immigrant Eligibility for Health 

 

Coverage in New York State 



 

Attachment D-2 

Secondary Documentation of U.S. Citizenship 

 

Attachment D-3 



Key to I-766, I-688B Employment Authorization Documents  

 (EAD) 


 

Attachment D-4 

Key to I-94 Arrival Departure Record 

 

Attachment E-1  



DSS 3955-Certification of Treatment for Emergency 

 

Medical Condition (Upstate) (9/04) 



 


Date:  October 26, 2004 

 

 



Trans. No.  04 OMM/ADM-7  

Page 

No.3

 

 I. PURPOSE

 

The purpose of this Office of Medicaid Management Administrative 



Directive (OMM/ADM) is to provide local Departments of Social Services 

(LDSS) with a comprehensive document that clarifies and defines the 

various types of immigration statuses. This ADM outlines the 

citizenship/immigration documentation requirements for individuals in 

the Medicaid program, and provides specific desk aids that identify the 

United States Citizenship and Immigration Services (USCIS) codes which 

are important to the eligibility worker when determining the 

appropriate Medicaid coverage to be provided.  In addition, this 

directive also defines otherwise eligible immigrants who are 

“Permanently Residing in the United States Under Color of Law” (PRUCOL) 

and those immigrants who are in satisfactory immigration status. 

 

 II.  BACKGROUND 

 

The Personal Responsibility and Work Opportunity Reconciliation Act of 



1996, P.L.104-193 (PRWORA-Welfare Reform) substantially restricted 

immigrants’ eligibility for means-tested benefits programs, including 

Medicaid. 

 

Prior to PRWORA, immigrants were eligible for full Medicaid coverage 



only if they were lawfully admitted for permanent residence or 

permanently residing in the United States under color of law (PRUCOL 

immigrants). The PRWORA created new eligibility criteria for 

immigrants.  The previous “PRUCOL” categories were no longer relevant 

to determining an immigrant’s eligibility for benefits.  After the 

enactment of Welfare Reform, states could choose to cover the cost of 

these benefits with state-only money. New York opted not to do so, with 

certain exceptions, and enacted a statute conforming to the federal act 

(Social Services Law (SSL) Section 122). 

 

On June 5, 2001, the New York State Court of Appeals decision, Aliessa 



v. Novello, held Social Services Law Section 122 unconstitutional to 

the extent it denied Medicaid to lawful permanent residents and persons 

“permanently residing under color of law” (PRUCOL).  The Aliessa 

decision restored Medicaid coverage in New York State to both lawful 

permanent residents who came to the United States on or after August 

22, 1996 and PRUCOLs regardless of when they entered the U.S.  As a 

result of the ruling, New York must now provide Medicaid coverage to 

lawful immigrants who meet the Medicaid program’s other eligibility 

criteria.  The Aliessa decision does not cover undocumented immigrants 

or other temporary nonimmigrants (i.e., short term visa holders; 

foreign students; tourists) who remain eligible only for the treatment 

of an emergency medical condition. 

 

Therefore, the local Departments of Social Services were notified that 



effective June 1, 2001, State and local Medicaid eligibility, for 

otherwise eligible immigrants, was no longer dependent on whether the 

immigrant was a qualified or non-qualified immigrant or the date on 

which the immigrant entered the United States. 

 

As a result of the Aliessa decision, districts must not deny, reduce or 

discontinue qualified immigrants' and PRUCOL immigrants' eligibility 

for Medicaid, Family Health Plus or Child Health Plus A based on SSL 

Section 122. 

 



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