Posted on August 4, 2005

Citizenship Often not Checked for Medicaid

Kevin Freking, AP, Aug. 4

A majority of states don’t verify claims of U.S. citizenship by those seeking Medicaid, which creates the potential for illegal aliens to access the health care program, an inspector general’s report has found.

“The quality assurance checks aren’t there. That’s how we see it,” said Jodi Nudelman, an acting regional inspector general for the Department of Health and Human Services. “And it’s our sense the people may not be aware of that.”

Federal law says that, with a few exceptions, a person must be a citizen to receive Medicaid benefits. States can accept a signed declaration as proof of U.S. citizenship. Forty-six states and the District do.

Only Montana, New York, New Hampshire and Texas require applicants to submit documents verifying citizenship.

One reason the federal government allows for self-declaration of citizenship with Medicaid is that doing so speeds access to health care.

In a letter last month to Dr. Mark McClellan, administrator of the federal Center for Medicare and Medicaid Services (CMS), HHS Inspector General Daniel R. Levinson wrote that CMS “has encouraged the practice of self-declaration in an effort to simplify Medicaid application procedures.”


“While the policy to allow applicants to self-declare citizenship can result in rapid enrollment, it can also result in inaccurate eligibility determinations for applicants who provide false citizenship statements,” the inspector general’s report said.

Of the states that allow self-declaration of citizenship before accessing Medicaid, 27 did not conduct subsequent auditing that would verify an applicant’s statements were true.