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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M02 July 2024 Subchapter Subject Page ending with Page M0220.000 CITIZENSHIP & ALIEN REQUIREMENTS M0220.202 6a

A separate form must be completed for each alien. Completely legible copies (front and back) of the alien immigration documents must be stapled to the upper left corner of Form G-845. Copies of other documents used to make the initial alien status determination such as marriage records or court documents must also be attached. Once the requirement to obtain secondary verification is determined, the agency must initiate the request within ten work days. The USCIS mailing address is subject to frequent changes. Obtain the current mailing address from the SAVE web site at http://www.uscis.gov. Click on “Direct Filing Addresses for Form G-845.” A photocopy of the completed G-845 form must be filed in the record as evidence that the form has been forwarded to USCIS. The USCIS maintains a record of arrivals and departures from the United States for most legal entrants, and LDSS can obtain the required information from their USCIS office. The USCIS does not maintain an arrival and departure record for Canadian and Mexican border crossers. For these immigrants, as well as immigrants whose status was adjusted and whose original date of entry cannot be verified by USCIS, LDSS will need to verify continuance presence by requiring the immigrant to provide documentation showing proof of continuous presence. Acceptable documentation includes: • letter from employer • school or medical records • series of pay stubs • shelter expense receipts, such as utility bills in the immigrant’s name that verify continuous presence for the period of time in question. C. Agency Action When the primary verification response requires the eligibility worker to initiate a secondary verification from USCIS, do not delay, deny, reduce or terminate the individual’s eligibility for Medicaid on the basis of alien status. If the applicant meets all other Medicaid eligibility requirements, approve the application and enroll the applicant in Medicaid. Allow 90 calendar days for the secondary verification to be received. If the secondary verification or the individual do not provide the information necessary to meet the documentation requirements by the 90th day, coverage may be canceled. Send an advance notice and cancel coverage at the end of the month in which the 90th day occurs. If the individual provides part of the information or is in the process of getting the information, a new reasonable opportunity period should be provided. Upon receipt of the G-845 or response to the on-line query, compare the information with the case record. Timely notice must be given to the individual when Medicaid benefits are denied or reduced.