United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2007-06-28 monographic deposited born digital 43 p. GA 1.13:GAO-07-889 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-07-889 P0b002ee18039eb74 f:d07889 DGPO 2010-08-12 2011-03-24 GAOREPORTS-GAO-07-889 machine generated eng fdlp REPORT GAOREPORTS-GAO-07-889 GAO-07-889 Administrative costs Beneficiaries Citizenship Documentation Eligibility determinations Federal law Federal/state relations Health care programs Medicaid Program evaluation Reporting requirements Surveys Program implementation Savings estimates Other Written Product A71629 The Deficit Reduction Act of 2005 (DRA) included a provision that requires states to obtain documentary evidence of U.S. citizenship or nationality when determining eligibility of Medicaid applicants and current beneficiaries; self-attestation of citizenship and nationality is no longer acceptable. The Centers for Medicare & Medicaid Services (CMS) issued regulations states must follow in obtaining this documentation. Interested parties have raised concerns that efforts to comply with the requirement will cause eligible citizens to lose access to Medicaid coverage and will be costly for states to implement. GAO was asked to examine how the requirement has affected individuals' access to Medicaid benefits and assess the administrative and fiscal effects of implementing the requirement. To do this work, GAO surveyed state Medicaid offices in the 50 states and the District of Columbia about their perspectives on access issues and the administrative and fiscal effects of the requirement. GAO obtained complete responses from 44 states representing 71 percent of national Medicaid enrollment in fiscal year 2004. GAO also reviewed federal laws, regulations, and CMS guidance. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-07-889/html/GAOREPORTS-GAO-07-889.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-07-889/pdf/GAOREPORTS-GAO-07-889.pdf GAO-07-889 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-07-889 Other Written Product GAO-07-889; Medicaid: States Reported That Citizenship Documentation Requirement Resulted in Enrollment Declines for Eligible Citizens and Posed Administrative Burdens; Administrative costs Beneficiaries Citizenship Documentation Eligibility determinations Federal law Federal/state relations Health care programs Medicaid Program evaluation Reporting requirements Surveys Program implementation Savings estimates Volume 100 Page 3359 100 Stat. 3359 Volume 120 Page 4 Volume 120 Page 80-81 Volume 120 Page 81-92 Volume 120 Page 2922 120 Stat. 4 120 Stat. 80-81 120 Stat. 81-92 120 Stat. 2922 Public Law 99-603 Public Law 109-171 Public Law 109-432