Kansas Family Medical Assistance
Manual (KFMAM)
Eligibility Policy - 12/26/2024
2044
2045 Documentation of U.S. Citizenship and Identity - When verification of citizenship and identity cannot be obtained via the Federal Data Hub, documentation of U.S. citizenship and identity must be obtained for individuals claiming to be U.S. citizens who are otherwise eligible for Medicaid or CHIP. This requirement does not apply to the following individuals:
(1) - Current or former SSI recipients
(2) - Current or former Medicare beneficiaries
(3) - Current or former recipients of Social Security Disability benefits
(4) - Children currently in foster care or recipients of foster care maintenance
(5) - Children who are recipients of adoption support payments
(6) - Children born on or after July 1, 2006 to a Medicaid recipient as outlined in 2320.
2045.01 Primary Documents - A document that verifies both citizenship and identity as defined in KDHE Eligibility Policy Appendix Item A-12. The availability of a Primary Document shall be explored prior to using a secondary or other document. Persons born outside of the United States who were not citizens at birth per 2040 must submit a Primary Document.
2045.02 Secondary Documents - If a primary document is not used, two different documents must be used to establish citizenship and identity. The statement of the applicant/recipient that a Primary Document is not available is sufficient to seek a secondary or other document. In addition, the receipt of a secondary or other document indicates that a primary document is not available.
2045.03 Third and Fourth Level Documents - These may only be used if primary or secondary documents are not available. The document provided for citizenship must show a place of birth and it must match the place of birth reported by the applicant/recipient. A second document verifying identity is also needed.
If a second, third, or fourth level document is received this is accepted as a statement from the consumer that no other primary document was available.
2045.04 Written Declaration of Citizenship - A written declaration may be used as verification of citizenship if no other documents are available. The EES Program Administrator/KanCare Clearinghouse Manager or designee must approve the declaration in order for it to be considered acceptable verification.
Declarations must be provided by at least two individuals, one of whom is not related to the individual, who have personal knowledge of the event(s) establishing the claim of citizenship. KDHE Eligibility Policy Appendix P-8, Third Party Declaration of Citizenship, may be used for this purpose. The person(s) making the declaration must:
(a) provide proof of his/her own citizenship and identity,
(b) provide information regarding why documentary evidence establishing the individual's claim of citizenship does not exist or cannot be readily obtained as part of the declaration, and
(c) sign the declaration under penalty of perjury in the presence of a witness.
When a declaration is used to document citizenship, the original must be retained in the case file indefinitely.
2045.05 Written Declaration of Identity - A written declaration may be used to establish identity for children under age 16 or disabled adults if no other documents are available. If a declaration is used to establish citizenship it cannot also be used to establish identity. KDHE Eligibility Policy External forms item P-7, Declaration of Identity for Children and item P-9, Declaration of Identity for Disabled Adults, must be used for this purpose. The EES Program Administrator/KanCare Clearinghouse manager must approve the declaration in order for it to be considered acceptable verification.
The person making the declaration must:
(a) be a United States citizen,
(b) sign the declaration under penalty of perjury in the presence of a witness, and
(c) for children, must be the parent, legal guardian, or caretaker relative of the child;
(d) for disabled adults, must be the director or administrator of a residential care facility where the individual resides.
When a declaration is used to document identity, the original must be retained in the case file indefinitely.
2045.06 Multiple Documents - When none of the above items of identity are available, a consumer may submit three or more of the following documents as verification of identity:
(a) employer identification cards
(b) high school or college diplomas, including GED
(c) marriage certificates
(d) divorce decrees
(e) property deeds/titles
Multiple documents can only be used for identity if a second or third level of citizenship has been provided.
2045.07 Reasonable Opportunity Period to Provide Documentation (ROP) - The following provisions apply when an applicant or recipient declares U.S. citizenship or an eligible alien status but is unable to provide verification. For information pertaining to qualifying non-citizens, see 2040.
The agency may not request verification of citizenship and identity or alien status from the applicant or recipient if that information is available through an available resource. The agency shall make every effort to verify citizenship and identity or alien status through those resources. The following automated and manual verification resources shall be utilized:
Tier 1 – The Federal Data Services Hub. The Hub accesses the Social Security Administration (SSA) database in real-time to verify citizenship and identity status.
The Electronic Access to Social Security (EATSS) database. If the Hub is not available, EATSS may be accessed to verify citizenship and identity status for those individuals who are current or former recipients of SSI, Medicare, or Social Security disability benefits (2045). EATSS may not be used to verify citizenship or identity of individuals who do not meet those criteria.
Tier 2 - The Kansas Immunization Register (KSWebIZ) database. The KSWebIZ interface is a statewide database that includes immunization records for all Kansas residents that may be used to verify identity only for children.
The Kansas Department of Revenue (Driver’s License) database. The Driver’s License interface may be accessed to verify identity only of an individual with a valid Kansas license.
Tier 3 – Research by the agency. If the agency has been unable to verify citizenship and identity or alien status through the available automated and manual interfaces, staff shall review the case file and imaged documents to determine whether a hard copy verification has already been provided.
Tier 4 – Contact with the applicant or recipient. If the agency is unable to verify citizenship and identity via any of the means above, verification shall initially be waived, and a reasonable opportunity period applied as described below. The individual shall be contacted to provide verification and notified of the reasonable opportunity period.
An application shall not be delayed or denied because the agency was unable to verify citizenship or identity or eligible alien status. If otherwise eligible, the application shall be processed and approved granting a reasonable opportunity period to the individual to provide the verification. The reasonable opportunity period shall be three (3) calendar months commencing from the date the case is authorized. If the individual fails to provide verification (or the agency is unable to independently verify) by the end of the reasonable opportunity period, coverage shall end allowing for timely notification. If verification is provided within the month after the month coverage ends, eligibility may be reinstated without a new application/request. The following examples illustrate:
Example: The agency is unable to verify citizenship or identity for an applicant for medical assistance. Since the individual is otherwise eligible, assistance is approved on 03/11 with notification that verification must be provided by 06/11. Verification is provided within the reasonable opportunity period on 04/23. Eligibility continues without interruption.
If the individual failed to provide verification (and the agency was unable to independently verify) by 06/11, coverage would end effective 06/30 (assuming action was taken by timely notice deadline).
Example 2: The agency is unable to verify a qualifying non-citizen status for an applicant for medical assistance. Since the individual has attested to a qualifying non-citizen status and is otherwise eligible, assistance is approved on 09/29 with notification that verification must be provided by 12/29. The recipient fails to provide verification within the reasonable opportunity period. Coverage ends effective 01/31.
If the individual provides verification by 02/28 (the month after the month coverage ends) eligibility may be reinstated without a new application/request for assistance. If verification is provided after 02/28, a new application/request is required.
Note: An extension of the ROP will be provided if the individual is making a good faith effort to resolve any inconsistencies or obtain necessary documentation, or if the agency needs more time to complete the verification process through the Federal Data Hub or Verification of Lawful Presence (VLP) interfaces. A decision to extend the period must be thoroughly documented and supported in the case file.