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7.2.4.4 Reasonable Opportunity Period for Verification of Citizenship Applicants who are otherwise eligible for Medicaid or other health care benefits and are only waiting for verification of U.S. citizenship must be certified for health care benefits within the normal application processing timeframe (see SECTION 2.7 APPLICATION PROCESSING PERIOD). They can continue receiving health care benefits for which they are eligible while the IM agency waits for U.S. citizenship verification. Applicants have 90 days after receiving a request for U.S. citizenship verification to provide the requested documentation. This 90-day period is called the reasonable opportunity period (ROP). The 90- day ROP starts on the date after the member receives the notice informing them of the need to provide U.S. citizenship verification by the end of the reasonable opportunity period. Federal regulations require that states assume a minimum five-day time frame for applicants to receive notices. For this reason, the end of the ROP must be no less than 95 days after the date on the notice, even when the member receives the notice in less than five days. If a member shows that a notice was received more than five days after the date on the notice, the deadline must be extended to 90 days after the date the member received the notice. The 90-day ROP applies when citizenship verification is needed from a person at any time: applications, reviews, and when a person is newly requesting benefits on an existing case. Applicants are not eligible for backdated health care benefits while pending for citizenship verification. Once citizenship verification is provided, the applicant’s eligibility must then be determined for backdated health care benefits if they have been requested. The ROP ends on the earlier of the date the agency verifies the person’s citizenship or identity or on the 95th day following the date the reasonable opportunity period notice was sent (unless receipt of the notice was delayed). If the requested verification is not provided by the end of the 95 days, the worker must take action within 30 days to terminate eligibility. Extensions of the reasonable opportunity period are not allowed for verification of U.S. citizenship. When a person is terminated from health care benefits for failure to provide verification of citizenship or identity by the end of the reasonable opportunity period, they are not eligible to have their benefits continued if they request a fair hearing. If a person later reapplies for health care benefits, they may receive another reasonable opportunity period to provide verification of citizenship or identity. Benefits issued during a reasonable opportunity period (including benefits issued due to timely notice requirements) to a person otherwise eligible for Medicaid or BadgerCare Plus are not subject to recovery, even if the person never provides citizenship verification. 7.2.5 Agencies Paying for Documentation The worker can authorize payment for a birth certificate from the state where the applicant was born and/or a Wisconsin State ID if an applicant or member: • Has no documentation of citizenship or identity, • Needs either an out-of-state birth certificate and/or has no identity documentation, and • Requests financial assistance. Note If a member has obtained and already paid for his or her own documentation and later asks the IM agency for reimbursement of those costs, the IM agency should not provide reimbursement. If an individual was born in Wisconsin and not found in the Wisconsin online birth query, agencies may authorize payment for a Wisconsin birth certificate to verify citizenship.