New guidelines for proof of citizenship based on Section 6036 of the Deficit Reduction Act of 2005 (“DRA”) will take effect for individuals seeking Medicaid coverage in New York on or after July 1, 2006.
The guidelines list four categories of documents that can be submitted as evidence of citizenship, from the most reliable to the least trustworthy. The best evidence is a United States passport or a certificate of naturalization.
The next category includes state and local birth certificates and State Department documents issued to children of citizens who are born outside of the United States.
The third category is comprised of non-government documents indicating place of birth. This category includes medical records from doctors, hospitals and clinics; nursing home admission papers; and records from life and health insurance companies.
The fourth category, utilized only if the above-described documentation cannot be obtained, includes two written affidavits establishing citizenship. These affidavits may be used only in rare circumstances. One of the affidavits must be submitted by someone who is unrelated to the applicant or recipient. The affiant must provide proof of his/her own citizenship and identity. Both affidavits must attest to having personal knowledge of the events establishing the applicant's or recipient's claim of citizenship. In addition, the applicant must also attest as to why other documentary forms of evidence cannot be obtained.
Before the new standards were issued, Medicaid applicants in many states who declared they were citizens did not have to support their claim. The intent behind the new guidelines is to prevent undocumented immigrants from claiming to be citizens in order to receive benefits.
Under Federal law, undocumented immigrants can receive only emergency care through Medicaid. Advocates for the elderly and disabled are concerned that a large number of Medicaid applicants will not be able to produce the requisite documentation. This is especially true for those who are mentally disabled or homeless, and it is feared that these applicants will have great difficulty receiving needed health care services. Furthermore, states have a strong incentive to enforce these requirements. If a state fails to do so, it runs the risk of losing federal matching funds.
Even if an individual is not currently receiving Medicaid benefits, or does not anticipate such a need in the near future, a diligent effort should be made to locate and secure the requisite proof of citizenship documents.
This is a proactive way to counter the harsh proof of citizenship requirements, and will ultimately be needed in the event of unexpected long-term care expenses.
Ronald A. Fatoullah, Esq. is the principal of Ronald Fatoullah & Associates, a law firm that concentrates in elder law, estate planning, Medicaid planning, guardianships, estate administration, trusts, wills and special needs planning. The firm has offices in Forest Hills, Great Neck, and Brooklyn, NY. Mr. Fatoullah has been named a “fellow” of the National Academy of Elder Law Attorneys and is a former member of its Board of Directors. He also serves on the Executive Committee of the Elder Law Section of the New York State Bar Association. Mr. Fatoullah has been certified as an Elder Law Attorney by the National Elder Law Foundation. Mr. Fatoullah is a co-founder of Senior Umbrella Network of Queens. This article was written with the assistance of Debby Rosenfeld, Esq., a senior staff attorney at the firm. The firm can be reached by calling (718) 261-1700 or toll free at 1-877-ELDER-LAW or 1-877-ESTATES.
