Verification of U.S. Citizenship and Identity

Acceptable verification of citizenship status and identity must be obtained for all non-exempt U.S. citizens/U.S. national applicants and clients. If verification from the Federal Data Services Hub (Federal Hub) or MEDS can be obtained, no other verification is required from the client. [Refer to “Federal Data Services Hub,” page 16-3]

Note: Children born in the U.S. to foreign sovereigns or diplomatic officers are not U.S. citizens.

Proof Already Provided

If the applicant or client’s proof of citizenship/identity is on file (i.e., applicant provided acceptable proof at initial intake interview), but it was not previously entered, it must be entered into CalSAWS and sent to MEDS. If the DRA requirement was previously provided on a different case, that information must be entered into the current case without the need for the client to provide the documents again. This will satisfy the DRA requirements.

A birth record match for California-born individuals can be requested at any time. A successful birth record match will not be overwritten by a verified or an unverified SSA Citizenship/Identity result.

Electronic Verification

The EW must grant full-scope benefits, without delay to clients who claim to be U.S. citizens/nationals, or to have satisfactory immigration status if all other eligibility criteria are met (i.e. income, residency, etc.)

Verified by Federal Hub

Citizenship and Identification information are now verified through the Federal Hub. When an application is submitted or a critical data element is changed the information is checked against the Federal Hub. The verifications status will display Pass, Fail, Pending or, Not Verified, depending on whether the citizenship and identification can be verified electronically through the Federal Hub.

Not Verified by Federal Hub

The following process must be followed if the client’s citizenship/identification cannot be initially verified via CalHEERS through the federal data hub:

Citizenship and Identification Electronic Verification

If Citizenship/Identification Status...

Then the EW Must...

Cannot be initially verified via CalHEERS through the federal data hub (i.e. because the hub is down) or the application information is not “reasonably compatible” with information from the Federal Hub,

First use the information provided on the application to attempt verification of citizenship or satisfactory immigration status.
Initiate SAVE.
Submit a copy of the SAVE results and documents to be scanned into the case’s IDM file.

Cannot be verified through SAVE,

Provide the applicant a 90-day ROP to resolve the inconsistency.
Grant full-scope MC benefits while verification of citizenship or immigration status is being obtained to otherwise eligible applicants.
If citizenship or identification cannot be verified within the 90-day ROP, then the scope of benefits must be reduced (to restricted-scope) until the verification is provided.

Note: This does not apply to individuals aged 0-25 and 50 and older. Refer to SB75, SB104 and AB133.

Electronic Birth Record Match

The Department of Health Care Services (DHCS) has implemented a process to perform an automated birth record match with the California Department of Vital Records database for individuals born in California. Information from Medi-Cal Eligibility Data System (MEDS), Statewide Client Index (SCI) and CalSAWS is used to obtain an electronic record of U.S. citizenship.

The “Request for California Birth Record” (DHCS 0004) is used to obtain the necessary information from the client to initiate an electronic birth record match. It may be completed by the client or by the EW over the phone.

Note: The DHCS 0004 must be scanned into IDM. [Refer to UGSS Chapter 2.8.1 “Batch AP19 Process,” ]

Social Security Number Data Match

DHCS implemented a Social Security Number (SSN) matching process to verify the citizenship and identity of MC applicants and clients who are subject to the citizenship/identity requirements.

A successful SSN data match fulfills the citizenship AND identity requirements. No further verification is needed from the applicant or client.

The EW does not have to complete the “Proof of Acceptable Citizenship or Identity Documents” (DHCS 0011) when there is a successful SSA Citizenship/Identity verification match.

Note: After approving full-scope MC for an eligible non-exempt applicant, review SSN data match results available on MEDS two business days later before requesting acceptable citizenship/identity documentations from the individual.

Frequency of Verification

Verification of citizenship and identity is only required once for MC. Once verification is provided or verified electronically, it does not need to be requested again, even if the client moves from one county to another, has a break in aid, or can show that he or she has already verified citizenship and identity in another state’s Medicaid program (the equivalent to Medi-Cal in California).

Reminder: PRUCOL is not an immigration status and must be verified at intake, annual redetermination and if the client reports a change in citizenship/immigration.