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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M02 July 2022 Subchapter Subject Page ending with Page M0220.000 CITIZENSHIP & ALIEN REQUIREMENTS Appendix 9 2

NOTE: Foreign visitors are not usually eligible for Medicaid because usually they do not meet the Virginia state residency requirement. 3. Entry date THIS FIELD MUST BE ENTERED. Enter the date on which the alien entered the U.S., except for asylees and deportees. For asylees, enter the date asylum was granted. For deportees, enter the date deportation withholding was granted. 4. App Dt In this field, application date, enter the date of the alien's Medicaid application upon which the eligibility coverage period is based. 5. Covered Dates Begin In this field, coverage begin date, enter the begin date of the emergency service(s). 6. Covered Dates End In this field, coverage end date, enter the date when the alien's emergency service(s) ends. When the emergency service(s) received was related to labor and delivery, the end date includes the day of discharge even though it is not counted to determine the length of stay for certification purposes. 7. AC Enter the code applicable to the alien’s covered group. D. Notices Appropriate notice must be sent to the applicant of the status of his application and the duration of his eligibility. The USCIS requires that all benefit applicants who are denied benefits based solely or in part on the SAVE response be provided with adequate written notice of the denial as well as the information necessary to contact USCIS, so that the individual may correct his records in a timely manner, if necessary. The fact sheet, “Information for Applicants: Verification of Immigration Status and How to Correct Your Record with USCIS” (Form # 032-03-0427-00) must be included with the Notice of Action when benefits are denied, including the approval of emergency-services-only Medicaid coverage, and with the Advance Notice of Proposed Action when benefits are subsequently cancelled based on the results of a SAVE inquiry. The fact sheet is available at https://fusion.dss.virginia.gov/Portals/[bp]/Files/SAVE/Inform%20for%20Applic ants%20Verification%20of%20Immigration%20Status.pdf?ver=2019-05-29- 135745-363. A Medicaid card will not be generated for an individual enrolled as an emergency services alien. The agency must contact the provider(s) and supply the eligibility dates and Medicaid number for billing purposes by sending a copy of the completed Emergency Medical Certification #DMAS Form 2019NR, to the provider(s).