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New Medicaid Citizenship Requirements - Send Comments to CMS Today!

Exempt Foster and Adoptive Children from New Citizenship Requirements for Medicaid!

New requirements obligating patients on Medicaid to prove their identity and citizenship are being put in place by the federal Center for Medicare and Medicaid Services (CMS) at the Department of Health and Human Services. These requirements will apply to children in foster care and special needs adoptive children. If a child doesn’t have a passport, then the child must prove their citizenship in addition to also proving their identity. Failure to prove citizenship and identity could result in a loss of coverage.

CMS is accepting written comments on the new requirements until Friday, August 11, 2006. They will consider these comments before issuing final regulations later this year. Please write to CMS and urge them to exempt foster and adoptive children from these new requirements.


*Write to CMS. You can submit comments electronically to Click on the link “Submit electronic comments on CMS regulations with and open comment period”.

*The deadline to submit written comments is Friday, August 11, 2006.


*Exempt foster and adoptive children from the new citizenship requirements for Medicaid eligibility.

Please feel free to use the CWLA comments as a guide in developing your comments to CMS. The CWLA comment letter is available on the CWLA website. Also, be sure to include in your comments information that is specific to your state or community related to the burden, and negative impact on the well being of children in foster care, that these regulations would create.


On July 12, the Department of Health and Human Services (HHS) issued an interim final rule on new eligibility requirements to determine nearly every Medicaid patient’s proof of citizenship and proof of identity,

The requirements will create major challenges for children in foster care. The requirements are a result of the package of budget cuts that were enacted in February (P.L. 109-171). All current patients on Medicaid or future Medicaid patients will have to prove they are citizens of the United States and their identity.

A passport will establish both a person’s citizenship and their identity. If a child does not have a passport, they must establish their citizenship through a series of other documents. States must follow in order of importance the type of documents that must be used to prove citizenship. Secondly, the child must prove their identity through a second set of documents. It is highly unlikely that a child in foster care will have a passport, so other documentation will be required to first prove that child’s citizenship and then to prove their identity.

These new requirements to prove U.S. citizenship or nationality and identity will create a tremendous burden on foster children, foster families, and an already overburdened child welfare system. Furthermore, the new requirements are duplicative in the case of foster children, as according to federal law, foster children already must have documented citizenship to receive Title IV-E assistance.

The interim final rule provides an opportunity to make our case that foster and adoptive children should be exempt from these new eligibility requirements. This may be our last and best chance to secure such an exemption. CWLA is urging CMS to use any and all discretionary power to protect these children from further harm. Issuing an exemption meets this goal.

For more information about the new eligibility requirements go to the same website or contact Tim Briceland-Betts, Co-Director of Government Affairs at Tim Briceland-Betts, or 202/942-0256.

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