California Health Department officials announced recently that they would delay implementation of the new Medicaid citizenship documentation requirements until they receive formal guidance from the federal government. The new documentation requirements were passed as part of the Deficit Reduction Act of 2005 and are scheduled to go into effect across the country on July 1, 2006 for new applicants and for renewal of benefits. States have little discretion on the issue, and have been warned that they will face the loss of federal matching funds for failure to implement the new law. However, the federal Health and Human Services Agency had not released guidelines on a timely basis and states like California are concerned about the impact on Medicaid beneficiaries.

California DHS officials, concerned that they would not have time to develop an implementation plan, train county workers and warn Medi-Cal consumers about the new law, have elected to delay implementation. Until California implements the new proof of citizenship rules, which could be in a couple of months, applicants and beneficiaries will not be penalized for failure to provide adequate documentation. Once the state receives federal guidance, rules will be distributed to the county social service agencies, and, according to DHS, the new rules will go into effect after the state and county agencies have had a chance to notify enrollees.

Meanwhile, on Friday, June 9, 2006, CMS finally released formal guidelines on the issue and a "Medicaid Fact Sheet" for consumers. For copies the Citizenship Guidelines for Medicaid Eligibility: See the CMS home page at www.cms.hhs.gov.