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Title 8: Medicaid Page 6 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Citizenship Revised October 10, 2025 Persons Exempt from Verification Procedure: Maintain any documentation needed to support the exempt status in the permanent section of the person’s case file. Examples of documents showing an exempt status include:  State Data Exchange (SDXD) printout showing current receipt of SSI.  Benefit award letter from Social Security Administration.  Income and Eligibility Verification System (IEVS) printout or copy of Medicare card showing current receipt of Medicare.  Mother’s SSNI screen print showing Medicaid eligibility in the month of the birth or other proof that the person had deemed “newborn” status.  Other documents showing the person meets one of the exempt statuses. Verifying Citizenship and Identity Legal reference: 42 CFR 435.406, 435.407, and 435.949; 441 IAC 75.11(2)“c”; Sections 211(a) and 211(b)(3) of Public Law 111-3 Policy: Unless specifically exempted, all Medicaid applicants or members claiming to be United States citizens are required to have their citizenship and identity verified as a condition of eligibility. In most cases, Medicaid is available while the client is verifying citizenship and identity. See Reasonable Opportunity Period. Documentation that citizenship and identity has been verified for each person subject to this requirement must be maintained in the Department’s records. A hard copy of the document does not need to be retained. For this purpose, the Department’s records include:  The Inquiry Citizenship (ICIT) screen when proof was obtained electronically through the IEVS match with the Social Security Administration.  The Vital Statistics List page in ELIAS.  Copies of paper documents maintained in the Medicaid or Hawki case file.  Notation in the Medicaid or Hawki electronic case file of the type of citizenship and identity verification received in either electronic or paper format. Procedure: Electronic data matching is the primary method of verifying attested U.S. citizenship status. When possible, proof of citizenship and identity will be obtained via an automated match either through electronic data sources (EDS) in ELIAS or through Income and Eligibility Verification System (IEVS). When using the Vital Statistics Detail page in ELIAS, the verification will be displayed on the Vital Statistics List page.