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.