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UPDATED: JUNE 2010

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OTHER ELIGIBILITY REQUIREMENTS CITIZENSHIP AND IMMIGRATION STATUS UNDOCUMENTED/ILLEGAL ALIENS

TREATMENT OF AN EMERGENCY MEDICAL CONDITION

Description: An immigrant is here illegally or is undocumented if s/he entered the United States in a manner or in a place so as to avoid inspection, or was admitted on a temporary basis (certain non-immigrants) and the period of authorized stay has expired.

Policy: Medicaid shall be provided for the care and services necessary for the treatment of emergency medical conditions to otherwise eligible illegal or undocumented aliens.

References: SSL Sect 122

131-k

Dept. Reg. 360.3.2(f)(2)

ADMs 04 ADM-7 92 ADM-10

88 ADM-47

88ADM-22

88 ADM-4

88ADM-1

GISs 10 MA/012 08 MA/009

07 MA/ 017

Interpretation: If otherwise eligible, an A/R cannot be denied Medicaid coverage for treatment of an emergency medical condition because of his/her immigration status.

The term emergency medical condition is defined as: “a medical condition (including emergency labor and delivery) manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in:

(a) placing the patient’s health in serious jeopardy; (b) serious impairment to bodily functions; or (c) serious dysfunction of any bodily organ or part.”

Care and services related to an organ transplant procedure are not included in the federal definition of treatment for an emergency medical condition.

MRG