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Issue Alert - 10-01-04

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Date:

01/05/2010

Program Area:

Adult Medical Program (AMP) and Medicaid (MA)

Issue Summary:

The Department of Human Services (DHS) policy on proof of identity and citizenship for Medicaid does not comply with federal law, and now has been extended to the Adult Medical Program (AMP)

Persons Affected:

AMP and Medicaid applicants and recipients who need time to gather verification of identity or citizenship, and those who received Medicaid as a newborn because Medicaid covered their birth

For More Information:

Center for Civil Justice 320 S. Washington, 2nd Floor Saginaw, MI 48607 (989) 755-3120, (800)724-7441 Fax: (989) 755-3558 E-mail: info@ccj-mi.org

Michigan Poverty Law Program 611 Church Street, Suite 4A Ann Arbor, MI 48104-3000 (734) 998-6100 (734) 998-9125 Fax
Background
 The Adult Medical Program (AMP) provides “bare bones” medical coverage to a limited number of very low income individuals who do not qualify for Medicaid (MA).   AMP recipients must have income below 35% of the federal poverty level ($316 a month for a single person).  AMP previously was funded in large part by a portion of Michigan’s Children’s Health Insurance Program (CHIP) allotment, under a waiver from the federal government.  Beginning January 1, 2010, AMP is funded by Medicaid dollars, under a different waiver.
What's Happening?
Because of the change in funding for AMP, AMP applicants and recipients who claim to be U.S. citizens are required to meet the citizenship documentation requirements that apply to the Medicaid program effective January 1, 2010.  AMP recipients will be required to meet these requirements when their eligibility is redetermined.  DHS is not currently enrolling new applicants in AMP; therefore, the citizenship and identity verification requirements will not currently affect AMP applicants (they will be denied based on closed enrollment without consideration of other eligibility factors).  For AMP and Medicaid, only certain documents specified in policy (and federal law) will be accepted as verification of identity and citizenship.  Policy on verifying identity is in BEM 221 p. 2-4 http://www.mfia.state.mi.us/olmweb/ex/bem/221.pdf and policy on verifying citizenship is in BEM 225 p. 17-21 http://www.mfia.state.mi.us/olmweb/ex/bem/225.pdf.

 

Under federal law that went into effect on February 2009, DHS is required to provide Medicaid (and Medicaid funded AMP) to individuals while they gather their proof of identity and citizenship.   DHS also is prohibited from requiring proof of identity and citizenship from anyone who qualified for Medicaid as a newborn because his or her mother was on Medicaid at the time of the birth.   See 12/28/09 CMS State Health Official Letter, available online at  http://www.cms.hhs.gov/smdl/downloads/SHO09016.pdf. DHS policy violates these new federal requirements.  DHS policy does not exempt individuals who received automatic newborn eligibility from citizenship/identity requirements and it does not allow individuals to be approved for AMP or Medicaid (if otherwise eligible) while they are gathering their verifications. 
What Should Advocates Do?
1.     Help clients understand and comply with these new requirements. 

2.     Read Issue Alert 10-01-05 for information on fee waivers for individuals who are unable to pay the $10 fee for a state ID card.  (But note that some individuals will be able to verify identity using other documents under PEM 221.)

3.     Contact CCJ (information at the top of this alert) about individuals who are denied or terminated from Amp or MA because DHS is not complying with federal law.

What Should Clients Do?
1.      If DHS asks for proof of identity and citizenship, give them copies of all proof you have. (Do not give DHS your originals.)  If you were born in Michigan, ask them to try to verify your citizenship through a computer match

2.      Return requested verifications with the mid-certification form.  Paystubs or a statement from your employer are most important.  If you have CDC for education or training that is not being approved and monitored by the Michigan Works Agency (Jet or Work First), submit verification of your hours, such as a class schedule.

3.        Seek legal help if DHS denies or stops your benefits because you did not verify identity or citizenship.  If your benefits are being stopped, read the last page of your notice carefully and request a hearing by the date given in the notice (usually 11 days from the date of the notice). 

See below for information about finding legal help.
Finding Help

Most legal aid and legal services offices handle these types of cases, and they do not charge a fee.

You can locate various sources of legal and related services, including the free legal aid office that serves your county, at MichiganLegalAid.org.

You can also look in the yellow pages under "attorneys" or call the toll-free lawyer referral number, (800) 968-0738.
Online Partners
State Bar of Michigan Michigan State Bar Foundation