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MEDICAL SERVICES POLICY MANUAL,SECTION D D-200 General Citizenship and Alien Status Requirements

D 222 Public Charge

the U.S., unless they are exempt from the five-year bar. Alien groups exempt from the five-year bar are discussed at MS D-224. • Non-qualified Alien - an alien who is living in the U.S. as an illegal alien or a legal alien who does not meet one of the conditions at MS D-223 or MS D-224. Conditions of eligibility for emergency medical services for non-qualified aliens are discussed at MS B-500. For additional information regarding Non-Qualified Aliens see (MSD-230).

D-222 Public Charge MS Manual 01/01/18 “Public Charge” has been apart of U.S. immigration law for more than 100 years as grounds for inadmissibility and deportation. Identification by the United States Department of Homeland Security (USDHS) as a public charge can be grounds for denying admission into the United States, for denying an application for permanent resident status, and in rare cases for deportation. In 1999, the Justice Department issued regulations to clarify that receipt of most forms of Medicaid would not result in a public charge finding. To be considered a public charge by the USDHS, an alien must: • Have become or be likely to become primarily dependent on the government for survival through receipt of public cash assistance, or • Be institutionalized at government expense in a long-term care facility. Institutionalization in a long-term care facility includes residing in a nursing home or mental health institution. Short-term institutionalization for rehabilitation is not considered as public charge. The receipt of cash assistance or being institutionalized for long-term care does not automatically cause the individual to be considered a public charge. The USDHS also considers a number of other factors, such as the individual’s age, health, financial status, education, and skills. Each determination is made on a case by case basis.