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Chapter: 2000 Coverage Groups Program: MSSI, SFP 19 2040.0810.03 Definition of a Noncitizen (MSSI) A noncitizen for this coverage group is any unnaturalized foreign resident of the U.S., noncitizen awaiting assignment of official USCIS status, and noncitizen without legal status. 2040.0810.04 Emergency Medical Condition (MSSI) A medical condition of sufficient severity (including severe pain) must exist such that, without immediate medical attention, it could result in placing the individual's health in serious jeopardy. This includes emergency labor and delivery. 2040.0810.05 Technical Criteria for EMA (MSSI) The following technical criteria apply to this coverage group:

1. The noncitizen is not required to be lawfully admitted for permanent residence or permanently residing in the U.S. under color of law. 2. The noncitizen is not required to meet the enumeration requirements. 3. The noncitizen must be aged, blind, or disabled as defined by SSI. 4. The noncitizen must assign to the state the right to any payments for medical care and cooperate with the state in obtaining such third party payments. 5. The noncitizen must be a Florida resident. 6. The noncitizen is not required to file for Social Security benefits. 2040.0810.06 Financial Criteria - EMA (MSSI) The noncitizen must meet the financial requirements for the SSI-Related Medicaid or SSI Medically Needy Programs. Refer to Chapter 2400 for the income levels for these two groups. 2040.0810.07 Administrative Policy for EMA (MSSI) The medical provider (generally a hospital) will initiate the referral process. The referral source will attach the necessary documentation for establishing the emergency and the time period of the emergency. If possible, a signed and dated application will also be attached.

If self-referred, the application must be pended until documentation of the emergency medical services can be obtained. If this is not provided, the application must be rejected.

If the time period of the emergency was originally over or under the estimated time, then the referral source must submit additional documentation to adjust the period.

Upon approval, a Medicaid Notice of Case Action must be provided to the applicant.

The administrative policies of the SSI-Related Medicaid Program will apply to this coverage group except as specified below.

1. An ex parte determination is not required for individuals in this program. 2. The ten days advance notice of termination is not required in this program. 3. Dates of entitlement will be for the time period of the emergency only. 2040.0812.01 Retroactive Medicaid (MSSI) Medicaid may be authorized for up to three months prior to the date of application for children under age 21 and pregnant women, including their postpartum period when the requirements are met. 2040.0812.02 Requirements for Retroactive Coverage (MSSI) The following requirements must be met in order to be eligible for retroactive Medicaid coverage, for children under age 21 and pregnant women, including their postpartum period: