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Title 8: Medicaid Page 9 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Citizenship Revised October 10, 2025 Verifying Citizenship and Identity If a person who has been denied or canceled for another reason reapplies, begin a new 90-day ROP. This will be done automatically for cases in ELIAS. No extensions are allowed for the 90-day ROP for providing proof of citizenship and identity. However, reinstatement and grace period policies do apply when proof is provided before the effective date of cancellation or within 14 days of cancellation or denial. Continuous eligibility does not apply to children whose citizenship and identity is not verified within the 90-day ROP or the subsequent reinstatement and grace period. ELIAS generates notification to the household about the ROP and explains what qualifies as acceptable proof, tracks the 90-day period, and cancels with timely notice if information is not received. In ELIAS, the worker cannot see if an ROP has been granted. The worker can review past Notice of Actions to determine if an ROP has been granted. For information specific to the ROP for immigrants, see 8-L, Aliens. Loss of Exemption Policy: When a member who was previously exempt from the citizenship and identity verification requirements loses the exempt status, Medicaid eligibility continues during the 90-day ROP. Children losing an exempt status who are already continuously eligible are not required to verify citizenship and identity until the next annual review. Procedure: The system will need to be updated to reflect that the member is no longer exempt from verifying citizenship and identity. EXCEPTION: For a child who is continuously eligible but loses an exempt status, do not make updates until the annual review. Form 470-4909 or 470-4909(S), Request for Proof of Citizenship and Identity, will be system-generated to request proof of citizenship and identity from the person, and the 90-day ROP will begin. Continue Medicaid during the 90-day ROP. If acceptable proof is provided, record the documentation in the system.