Kansas Department of Health & Environment

Kansas Family Medical Assistance

Manual (KFMAM)


Eligibility Policy - 9/20/2019

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2045 Documentation of U.S. Citizenship and Identity - Documentation of U.S. citizenship and identity is required prior to receiving Title 19 Medicaid and Title 21 CHIP coverage for individuals claiming to be U.S. citizens. This requirement does not apply to the following individuals:

(1) - Current or former SSI recipients

(2) - Current or former Medicare beneficiaries

(3) - Current or former recipients of Social Security Disability benefits

(4) - Children in foster care or recipients of foster care maintenance

(5) - Children who are recipients of adoption support payments

(6) - Children born on or after July 1, 2006 to a Medicaid recipient as outlined in 2320.

Note: Newborns born to a Title XXI recipient are not required to provide the verification of citizenship and identity to initially receive coverage. Verification of citizenship and identity is required at the end of their continuous eligibility period.

Documentation of citizenship and identity may be maintained in paper or electronic format. Electronic records may include databases or other records that meet the requirements of acceptable documentation as further outlined below. When the case file is maintained in a paper format, all documents used to verify citizenship and identity must be recorded on the ES-3850, Record of Identity and Citizenship. For those cases maintained in an electronic format, an electronic version of the ES-3850 is sufficient.

When an electronic case file is converted to a paper case file, the ES-3850 must be completed. For those electronic records which cannot be printed, the ES-3850 must indicate what source was used to verify the information, along with indication of when it was verified.

All documents used to verify citizenship and identity must be recorded in the case file indefinitely per 1602 (8).

Note: For verification of citizenship and identity, it is acceptable to access the file in Tier 3 to determine if documentation has previously been provided before accessing the Tier 2 sources. Both Tier 2 and Tier 3 must be followed before proceeding to Tier 4.


Acceptable documents and the hierarchical protocol for obtaining acceptable documents are described in the KEESM Appendix Item A-12. When obtaining documents the following applies:

2045.01 Primary Document - A document that verifies both citizenship and identity as defined in KEESM Appendix Item A-12. The availability of a Primary Document shall be explored prior to using a secondary or other document. Persons born outside of the United States who were not citizens at birth per 2040 must submit a Primary Document.

2045.02 Secondary Documents - If a primary document is not used, two different documents must be used to establish citizenship and identity. The statement of the applicant/recipient that a Primary Document is not available is sufficient to seek a secondary or other document. In addition, the receipt of a secondary or other document indicates that a primary document is not available.

2045.03 Third and Fourth Level Documents - These may only be used if primary or secondary documents are not available. The document provided for citizenship must show a place of birth and it must match the place of birth reported by the applicant/recipient. A second document verifying identity is also needed.

If a second, third, or fourth level document is received this is accepted as a statement from the consumer that no other primary document was available.

2045.04 Written Declaration of Citizenship - A written declaration may be used as verification of citizenship if no other documents are available. The EES Program Administrator/KanCare Clearinghouse Manager or designee must approve the declaration in order for it to be considered acceptable verification.

Declarations must be provided by at least two individuals, one of whom is not related to the individual, who have personal knowledge of the event(s) establishing the claim of citizenship. KEESM Appendix P-8, Third Party Declaration of Citizenship, may be used for this purpose. The person(s) making the declaration must:

(a) provide proof of his/her own citizenship and identity,

(b) provide information regarding why documentary evidence establishing the individual's claim of citizenship does not exist or cannot be readily obtained as part of the declaration, and

(c) sign the declaration under penalty of perjury in the presence of a witness.

When a declaration is used to document citizenship, the original must be retained in the case file indefinitely.

2045.05 Written Declaration of Identity - A written declaration may be used to establish identity for children under age 16 or disabled adults if no other documents are available. If a declaration is used to establish citizenship it cannot also be used to establish identity. KEESM Appendix item P-7, Declaration of Identity for Children and item P-9, Declaration of Identity for Disabled Adults, must be used for this purpose. The EES Program Administrator/KanCare Clearinghouse manager must approve the declaration in order for it to be considered acceptable verification.

The person making the declaration must:

(a) be a United States citizen,

(b) sign the declaration under penalty of perjury in the presence of a witness, and

(c) for children, must be the parent, legal guardian, or caretaker relative of the child;

(d) for disabled adults, must be the director or administrator of a residential care facility where the individual resides.

When a declaration is used to document identity, the original must be retained in the case file indefinitely.

2045.06 Multiple Documents - When none of the above items of identity are available, a consumer may submit three or more of the following documents as verification of identity:

(a) employer identification cards
(b) high school or college diplomas, including GED
(c) marriage certificates
(d) divorce decrees
(e) property deeds/titles

Multiple documents can only be used for identity if a second or third level of citizenship has been provided.

2045.07 Reasonable Opportunity to Provide Documentation - The following provisions apply when an applicant or recipient declares U.S. citizenship, but is unable to provide verification.

The agency may not request verification of citizenship and identity from the applicant or recipient if that information is available through an available resource. The agency shall make every effort to verify citizenship and identity through those resources. The following automated and manual verification resources shall be utilized:

Tier 1 – The Federal Data Services Hub. The Hub accesses the Social Security Administration (SSA) database in real-time to verify citizenship and identity status.

The Electronic Access to Social Security (EATSS) database. If the Hub is not available, EATSS may be accessed to verify citizenship and identity status for those individuals who are current or former recipients of SSI, Medicare or Social Security disability benefits (2045). EATSS may not be used to verify citizenship or identity of individuals who do not meet that criteria.

Tier 2 - The Kansas Immunization Register (KSWebIZ) database. The KSWebIZ interface is a statewide database that includes immunization records for all Kansas residents that may be used to verify identity only for children.

The Department of Revenue (Driver’s License) database. The Driver’s License interface may be accessed to verify identity only of an individual with a valid Kansas license.

Tier 3 – Research by the agency. If the agency has been unable to verify citizenship and identity through the available automated and manual interfaces, staff shall review the case file and imaged documents to determine whether a hard copy verification has already been provided.

Tier 4 – Contact with the applicant or recipient. If the agency is unable to verify citizenship and identity via any of the means above, verification shall initially be waived and a reasonable opportunity period applied as described below. The individual shall be contacted to provide verification and notified of the reasonable opportunity period.

An application shall not be delayed or denied because the agency was unable to verify citizenship or identity. If otherwise eligible, the application shall be processed and approved granting a reasonable opportunity period to the individual to provide the verification. The reasonable opportunity period shall be three (3) calendar months commencing from the date the case is authorized. If the individual fails to provide verification (or the agency is unable to independently verify) by the end of the reasonable opportunity period, coverage shall end allowing for timely notification. If verification is provided within the month after the month coverage ends, eligibility may be reinstated without a new application/request. The following examples illustrate:

Note: The reasonable opportunity period may be extended in situations where the individual is making a bona fide effort to obtain the verification but circumstances outside his/her control are delaying the effort. A decision to extend the period must be thoroughly documented and supported in the case file.

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