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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M02 January 2024 Subchapter Subject Page ending with Page M0220.000 CITIZENSHIP & ALIEN REQUIREMENTS M0220.100 3

a. All foster care children and IV-E Adoption Assistance children; b. Individuals born to mothers who were eligible for MA in any state on the date of the individuals’ birth; c. Individuals entitled to or enrolled in Medicare, individuals receiving Social Security benefits on the basis of a disability and SSI recipients currently entitled to SSI payments. Former SSI recipients are not included in the exemption. The local department of social services (LDSS) must have verification from the Social Security Administration (such as a SVES response) of an individual’s Medicare enrollment, benefits entitlement or current SSI recipient status. When an individual loses an exception status and his C&I has not previously been verified, the individual must be given a reasonable opportunity to provide C&I. NOTE: A parent or caretaker who is applying for a child, but who is NOT applying for MA for himself, is NOT required to verify his or her C&I. 3. Verification Required One Time Once verification of C&I has been provided, it is not necessary to obtain verification again. Documentary evidence may be accepted without requiring the individual to appear in person. C&I documentation must be stored in the case record. 4. Enroll Under Good Faith Effort If an individual meets all other eligibility requirements and declares that he is a citizen, he is to be enrolled under a good faith effort. Do not request verification of C&I from the applicant, and do not delay or deny application processing for proof of C&I. If the applicant meets all other eligibility requirements: • Approve the application and enroll the applicant in MA, AND • Specify on the Notice that the individual may have to provide documentation of C&I if it cannot be obtained by other means, OR • Include the Reasonable Opportunity Insert, available at https://fusion.dss.virginia.gov/Portals/[bp]/Files/Medical%20Assistance %20Guidance/medicaid_reasonable_opportunity_insertrev_03-09- 10.pdf?ver=2019-06-04-151050-230 with the Notice. The individual remains eligible for MA while the agency attempts to verify C&I through the data matching process described in M0220.100 D below, or if necessary, requests verification from the individual. The same good faith effort requirements apply should an individual lose his exemption from providing C&I verification. Children enrolled under good faith effort are not eligible for 12 months of continuous eligibility. D. Procedures for Documenting C&I CHIPRA allows the option for verification of C&I for individuals newly enrolled in Medicaid or Family Access to Medical Insurance Security Plan (FAMIS) using a data match with SSA to confirm the consistency of a declaration of citizenship with SSA records in lieu of presentation of original documentation. This option, implemented in March 2010, allows for a monthly exchange of data between the Medicaid Management Information System