Md. Code Regs. 10.09.24.05

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.09.24.05 - Nonfinancial Eligibility Requirements - Citizenship

A. Eligibility. To be eligible for federal coverage of full Medical Assistance benefits, an individual shall be:

(1) A citizen of the United States, including:

(a) An individual who was born in:

(i) One of the 50 states;

(ii) The District of Columbia;

(iii) Puerto Rico;

(iv) Guam;

(v) The Northern Mariana Islands; or

(vi) The Virgin Islands;

(b) A child born outside of the United States if:

(i) The federal requirements, including the requirements in the Child Citizenship Act of 2000 (Public Law 106-395), are met for the child to automatically acquire United States citizenship upon the child's lawful admission to the United States for permanent residence;

(ii) At least one of the child's natural, adoptive, or stepparents is a United States citizen by birth or naturalization;

(iii) The child is younger than 18 years old;

(iv) The child is residing in the United States in the legal and physical custody of the citizen or naturalized parent; and

(v) The child is a lawful permanent resident of the United States;

(c) An individual who has been naturalized as a United States citizen; or

(d) A national from American Samoa or Swain's Island;

(2) A qualified alien, as specified in §C of this regulation, who is eligible in accordance with the requirements related to the 5-year bar specified at §D of this regulation;

(3) An honorably discharged veteran of the armed forces of the United States;

(4) An alien on active duty in the armed forces of the United States;

(5) The lawfully admitted spouse, including a surviving spouse who has not remarried, or lawfully admitted unmarried dependent child of an:

(a) Honorably discharged veteran of the armed forces of the United States; or

(b) Alien on active duty in the armed forces of the United States; or

(6) An alien who is:

(a) Eligible for and receiving Supplemental Security Income (SSI);

(b) A member of a federally recognized Indian tribe, as defined in 25 U.S.C. § 450b(e); or

(c) An American Indian born in Canada to whom § 289 of the Immigration and Nationality Act (INA) applies.

B. Veterans. Veterans of the following foreign armed forces are considered under this regulation to be veterans of the armed forces of the United States:

(1) Individuals who served in the Philippine Commonwealth Army during World War II or as Philippine scouts following World War II; and

(2) Hmong and other Highland Lao veterans who fought under United States' command during the Vietnam War and who were lawfully admitted to the United States for permanent residence.

C. Qualified Aliens. According to § 431 of the Personal Responsibility and Work Opportunity and Reconciliation Act of 1996 (PRWORA), qualified aliens admitted to the United States shall include:

(1) The following types of aliens, who may be subject to the 5-year bar specified at §D of this regulation, depending on their most recent date of entry and their date of qualified alien status:

(a) Aliens who were lawfully admitted to the United States for permanent residence or who since admission were granted lawful permanent resident status in accordance with the INA;

(b) Aliens granted parole for at least 1 year under § 212(d)(5) of the INA; and

(c) A documented or undocumented immigrant who was battered or subjected to extreme cruelty by the individual's United States citizen or lawful permanent resident spouse or parent, or by a member of the spouse's or parent's family residing in the same household as the immigrant, if:

(i) The spouse or parent consented to, or acquiesced in, the battery or cruelty;

(ii) The abusive act or acts occurred in the United States;

(iii) The individual responsible for the battery or cruelty no longer lives in the same household as the victim;

(iv) A Violence Against Women Act immigration case or a family-based visa petition has been filed; and

(v) There is a substantial connection between the battery or cruelty and the need for Medical Assistance benefits; and

(2) The following types of aliens, who are not subject to the 5-year bar specified in §D of this regulation:

(a) Alien children and pregnant women who are lawfully residing in the United States, including legal permanent residents who have resided in the United States for less than 5 years as described under § 214 of the Children's Health Insurance Program Authorization Act of 2009 (CHIPRA);

(b) Aliens who were lawfully admitted to the United States for permanent residence as Amerasian immigrants under § 584 of the Foreign Operations, Export Financing and Related Programs Appropriations Act of 1988;

(c) Refugees admitted under § 207 of the INA;

(d) Aliens granted asylum under § 208 of the INA;

(e) Aliens whose deportation is being withheld under:

(i) § 243(h) of the INA as in effect prior to April 1, 1997; or

(ii) § 241(b)(3) of the INA, as amended;

(f) Cuban or Haitian entrants, as defined at § 501(e) of the Refugee Education Assistance Act of 1980;

(g) Aliens granted conditional entry under § 203(a)(7) of the INA in effect before April 1, 1980;

(h) Children receiving federal payments for foster care or adoption assistance under Part B or E of Title IV of the Social Security Act, if the child's foster or adoptive parent is considered a citizen or qualified alien; and

(i) Victims of a severe form of trafficking, in accordance with § 107(b)(1) of the Trafficking Victims Protection Act of 2000, who have been subjected to:

(i) Sex trafficking if the act is induced by force, fraud, or coercion, or the individual who was induced to perform the act was younger than 18 years old on the date that the visa application was filed; or

(ii) Involuntary servitude.

D. Five-Year Bar to Federal Medical Assistance for Qualified Aliens.

(1) Except for coverage of emergency medical services specified at Regulation .05-2 of this chapter, qualified aliens in the categories specified in §C(1) of this regulation who entered the United States on or after August 22, 1996, were not eligible for federally-funded Medical Assistance for 5 years from the date that the qualified alien:

(a) Entered the United States with the status of a qualified alien; or

(b) Obtained the status of a qualified alien, if the individual did not enter the United States as a qualified alien.

(2) The 5-year bar specified in §D(1) of this regulation shall also be applied to qualified aliens who entered the United States before August 22, 1996, but did not remain continuously present in the United States from the last date of entry before August 22, 1996 until the date of qualified alien status.

(3) An alien is not considered to be continuously present in the United States as specified in §D(2) of this regulation if, before the date of qualified alien status, the alien had:

(a) A single absence from the United States of more than 30 days; or

(b) Absences from the United States totaling more than 90 days.

(4) The 5-year bar to eligibility for federal Medical Assistance benefits, specified in §D(1) of this regulation, does not apply to:

(a) Qualified aliens in the categories specified at:

(i) §C(1) of this regulation, who are not subject to the 5-year bar in accordance with §D(1) or (2) of this regulation; or

(ii) §C(2) of this regulation;

(b) A qualified alien who is:

(i) An honorably discharged veteran of the armed forces of the United States;

(ii) On active duty in the armed forces of the United States; or

(iii) The lawfully admitted spouse, including a surviving spouse who has not remarried, or lawfully admitted unmarried dependent child of an honorably discharged veteran or individual on active duty in the armed forces of the United States; and

(c) Lawful permanent residents who:

(i) Entered the United States under another exempt category specified at §D(4)(a)-(b) of this regulation; and

(ii) Converted to lawful permanent resident status.

(5) Effective December 1, 2009, as authorized by the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), the 5-year bar will no longer apply to Medical Assistance or Children's Health Insurance Program eligibility for pregnant women and children who are qualified aliens.

Md. Code Regs. 10.09.24.05

Regulations .05A amended as an emergency provision effective October 3, 1997 (24:22 Md. R. 1550); amended permanently effective January 12, 1998 (25:1 Md. R. 16)
Regulations .05 and new Regulation .05 adopted effective September 24, 2007 (34:20 Md. R. 1737)
Regulation .05A amended effective April 14, 2003 (30:7 Md. R. 487)
Regulation .05C amended effective April 19, 2010 (37:8 Md. R. 614)
Regulation .05D amended effective March 11, 1985 (12:5 Md. R. 482); April 19, 2010 (37:8 Md. R. 614)
Regulation .05E amended effective March 11, 1985 (12:5 Md. R. 482); March 24, 1997 (24:6 Md. R. 485)
Regulation .05H amended effective June 2, 1997 (24:11 Md. R. 793)