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Page 13 – State Health Official Letter Verification of Immigration Status or Category States must electronically verify an individual’s immigration status or category for all individuals who have declared to have a satisfactory immigration status, in accordance with section 1137(d)(3) of the Act and 42 C.F.R. §§ 435.956(a)(2) and 457.380(b).52 State electronic verification of immigration status or category occurs through DHS/USCIS’s SAVE program. In this section, we describe how states can access the DHS/USCIS’s SAVE program and use the SAVE response data to verify a noncitizen’s immigration status or category, as well as the upcoming changes to the Federal Data Services Hub (the “Hub”) to comply with the FFP limitations described in sections 1903(v)(5) and 2107(e)(1)(R) of the Act. DHS/USCIS’s SAVE Program, the Federal Data Services Hub, and the Graphical User Interface (GUI) CMS and DHS/USCIS make available three pathways to states to access SAVE: 1. the Hub Verify Lawful Presence (VLP) service; 2. a direct connection between the state’s eligibility system and SAVE; or 3. SAVE’s web-based GUI. States can also use a combination of these three SAVE pathways. DHS/USCIS’s SAVE program provides data to accurately reflect the current immigration status or category of a noncitizen for a new verification request based on the most up-to-date data available. The SAVE verification responses may include some combination of the following immigration information, depending on which of the three SAVE pathways the state uses (as described more below): Eligibility Statement Code (ESC)/Major codes, Class of Admission (COA) codes, Employment Authorization Document (EAD) Category codes, and grant date of verified immigration status or category. When redetermining eligibility for potentially affected beneficiaries, states would submit a new SAVE verification request for these beneficiaries to receive a response based on the most up-to-date immigration data available for the beneficiary. SAVE provides “point in time” verification and does not update past SAVE verification responses when there is a change in immigration status or category. Potentially affected beneficiaries may have applied for and been granted adjustment of status to that of an LPR or may have another qualifying immigration status or category (for example, could be considered a Cuban/Haitian entrant) such that they may be considered an FFP-eligible noncitizen for full Medicaid or CHIP benefits. Alternatively, potentially affected beneficiaries may be lawfully residing for purposes of Medicaid or CHIP eligibility under a state’s election of the CHIPRA 214 option.

52 Section 1137(d)(3) of the Act directs states “to verify with the Immigration and Naturalization Service the individual’s immigration status through an automated or other system (designated by the Service for use with States).” See also 42 C.F.R. §§ 435.956(a) and 457.380(b)(1)(i). DHS’s U.S. Citizenship and Immigration Services (USCIS) now performs this function, see: https://www.uscis.gov/save/about-save/save-governing-laws.