OAR 461-115-0704: Required Verification of Citizenship and Noncitizen Status; Medicare Savings Programs and OSIPM

This rule describes the requirements for verifying citizenship and noncitizen status for Medicare Savings Programs (see OAR 461-001-0000) and Oregon Supplemental Income Program Medical (OSIPM). (1) The Department must verify an individual’s declaration of citizenship or qualified noncitizen status (see OAR 461-120-0130): (a) At initial application; (b) When a change is reported; and (c) When the Department has received reliable information indicating a potential change in the individual’s citizenship or qualified noncitizen status. (2) The Department must verify citizenship through one of the following: (a) A U.S. passport, including a U.S. Passport Card issued by the Department of State, without regard to any expiration date as long as such passport or card was issued without limitation. (b) A Certificate of Naturalization. (c) A Certificate of U.S. Citizenship. (d) A valid state-issued driver's license if the state issuing the license requires proof of U.S. citizenship, or obtains and verifies a Social Security Number (SSN) from the applicant who is a citizen before issuing such license. (e) Documentary evidence issued by a federally-recognized American Indian or Alaska Native tribe identified in the Federal Register by the Bureau of Indian Affairs within the U.S. Department of the Interior, and including tribes located in a state that has an international border, which: (A) Identifies the federally recognized American Indian or Alaska Native tribe that issued the document; (B) Identifies the individual by name; and (C) Confirms the individual's membership, enrollment, or affiliation with the tribe. (f) Documents described in subsection (e) of this section include, but are not limited to: (A) A tribal enrollment card. (B) A "Certificate of Degree of Indian or Alaska Native Blood." (C) A tribal census document. (D) Documents on tribal letterhead, issued under the signature of the appropriate tribal official, that meet the requirements of subsection (e) of this section. (g) A data match with the Social Security Administration. (3) If an individual does not provide documentary evidence from the list in section (2) of this rule, the following must be accepted as satisfactory evidence to establish citizenship if also accompanied by an identity document listed OAR 461-115-0700(6): (a) A U.S. public birth certificate showing birth in one of the 50 states, the District of Columbia, Guam, American Samoa, Swain's Island, Puerto Rico (if born on or after January 13, 1941), the Virgin Islands of the U.S. or the Commonwealth of the Northern Mariana Islands (CNMI) (if born after November 4, 1986 (CNMI local time)). The birth record document may be issued by a state, commonwealth, territory, or local jurisdiction. If the document shows the individual was born in Puerto Rico or the Northern Mariana Islands before the applicable date referenced in this paragraph, the individual may be a collectively naturalized citizen. The following will establish U.S. citizenship for collectively naturalized individuals: (A) Puerto Rico: Evidence of birth in Puerto Rico and the applicant's statement that the applicant was residing in the U.S., a U.S. possession, or Puerto Rico on January 13, 1941. (B) Northern Mariana Islands (NMI) (formerly part of the Trust Territory of the Pacific Islands (TTPI)): (i) Evidence of birth in the NMI, TTPI citizenship and residence in the NMI, the U.S., or a U.S. territory or possession on November 3, 1986 (NMI local time) and the applicant's statement that the applicant did not owe allegiance to a foreign State on November 4, 1986 (NMI local time). (ii) Evidence of TTPI citizenship, continuous residence in the NMI since before November 3, 1981 (NMI local time), voter registration before January 1, 1975, and the applicant's statement that the applicant did not owe allegiance to a foreign State on November 4, 1986 (NMI local time). (iii) Evidence of continuous domicile in the NMI since before January 1, 1974, and the applicant's statement that the applicant did not owe allegiance to a foreign State on November 4, 1986 (NMI local time). Note: If an individual entered the NMI as a nonimmigrant and lived in the NMI since January 1, 1974, this does not constitute continuous domicile and the individual is not a U.S. citizen. (b) At state option, a cross match with a state vital statistics agency documenting a record of birth. (c) A Certification of Report of Birth, issued to U.S. citizens who were born outside the U.S. (d) A Report of Birth Abroad of a U.S. Citizen. (e) A Certification of Birth in the United States. (f) A U.S. Citizen I.D. card. (g) A Northern Marianas Identification Card issued by the U.S. Department of Homeland Security (or predecessor agency). (h) A final adoption decree showing the child's name and U.S. place of birth, or if an adoption is not final, a statement from a state-approved adoption agency that shows the child's name and U.S. place of birth. (i) Evidence of U.S. Civil Service employment before June 1, 1976. (j) U.S. Military Record showing a U.S. place of birth. (k) A data match with the Department of Homeland Security's SAVE Program or any other process established by the Department of Homeland Security to verify that an individual is a citizen. (l) Documentation that a child meets the requirements of section 101 of the Child Citizenship Act of 2000 as amended (8 U.S.C. 1431). (m) Medical records, including, but not limited to, hospital, clinic, or doctor records or admission papers from a nursing facility, skilled care facility, or other institution that indicate a U.S. place of birth. (n) Life, health, or other insurance record that indicates a U.S. place of birth. (o) Official religious record recorded in the U.S. showing that the birth occurred in the U.S. (p) School records, including pre-school, Head Start and daycare, showing the child's name and U.S. place of birth. (q) Federal or state census record showing U.S. citizenship or a U.S. place of birth. (r) If the applicant does not have one of the documents listed in section (2) of this rule subsections (a) through (q) of this section, the applicant may submit an affidavit signed by another individual under penalty of perjury who can reasonably attest to the applicant's citizenship, and that contains the applicant's name, date of birth, and place of U.S. birth. The affidavit does not have to be notarized. (4) The following individuals who make a declaration of citizenship are exempt from the requirement to provide documentary evidence of citizenship: (a) Individuals receiving Supplemental Security Income (SSI). (b) Individuals entitled to or enrolled in any part of Medicare. (c) Individuals receiving Social Security Disability Insurance (SSDI). (d) Individuals who are in foster care and who are assisted under Title IV-B of the Act, and individuals who are beneficiaries of foster care maintenance or adoption assistance payments under Title IV-E of the Act. (e) Newborns of an assumed eligible individual (see OAR 461-135-0010). (5) The Department must attempt to verify a declaration by or on behalf of an individual of qualified noncitizen status using an electronic service. (a) Individuals who make a declaration of qualified noncitizen status are exempt from the requirement to provide documentary evidence if they are receiving SSI. (b) The Department must promptly resolve all discrepancies between the electronic information and information provided by the or on behalf of the individual and resubmit corrected information through the electronic service. (c) For purposes of verifying the veteran and active duty exemption from the five-year waiting period (see OAR 461-120-0125), the Department must verify that: (A) The individual is an honorably discharged veteran. (B) The individual is in active military duty status. (C) The individual is a spouse (see OAR 461-001-0000), unmarried dependent child, or an un-remarried surviving spouse of an individual qualifying for this waiting period exemption. (D) If the Department is unable to verify such status, the Department may accept self-attestation (see OAR 461-115-0700). (6) Individuals who declare non-qualified or undocumented noncitizen status and who meet the criteria of OAR 461-135-1070 are not required to present an SSN or verify noncitizen status. (7) The Department must retain a record of having verified citizenship or noncitizen status according to the applicable retention period. (8) Unless a change in citizenship has been reported, the Department may not re-verify or require the individual to re-verify at redetermination or upon a subsequent application following a break in coverage. (9) If the Department cannot promptly verify citizenship or qualified noncitizen status: (a) The Department must provide a reasonable opportunity period (see section (10) of this rule); and may not delay, deny, reduce, or terminate benefits for an individual who is otherwise eligible during the reasonable opportunity period. (b) If a reasonable opportunity period is provided and the individual is otherwise eligible, the Department may approve benefits effective the month of in which the date of request falls. (10) Reasonable opportunity period. (a) The Department must provide a reasonable opportunity period to individuals who declare citizenship or qualified noncitizen status which the Department cannot independently verify. (b) During this period, the Department must continue efforts to verify the individual’s citizenship or qualified noncitizen status. (c) Notice of the reasonable opportunity period must be sent that is accessible to those with limited English proficiency and individuals with disabilities. (d) The Department must assist individuals declaring citizenship who do not have an SSN with obtaining an SSN and attempt to verify citizenship once it is obtained. (e) The Department must provide the individual with information about how to contact the electronic data source so that the individual can try to resolve inconsistencies that prevented electronic verification and then pursue electronic verification once the individual reports the inconsistencies have been resolved. (f) The reasonable opportunity period begins on the date the reasonable opportunity period notice is received by the individual, which is considered to be five days after the date of the notice, unless the individual can show that the individual did not receive the notice within the five-day period. (g) The reasonable opportunity period ends either when the Department verifies citizenship or qualified noncitizen status, or 90 days from the date the notice is received, whichever is earlier. For individuals who declare qualified noncitizen status, the reasonable opportunity period may be extended if the individual is making a good faith effort or the Department needs more time. (h) If the reasonable opportunity period ends and the verification has not been received, the Department must take action within 30 days to terminate eligibility.