DEPARTMENT OF IlEALm " IIVM4N SERl'ICBS 
JIM.,' 
BMItb Can  A.......... 

Ceater tar Medic:IIId ...Stwte ~ 
7sao Scaarib Be..... 
........ MD2U44-1LqJ 

Dell' StIteN'eIIicai4 DireaoI. 
=0 
I am WIitioS to addras the tr~ofJee1l aliens who lire beiac cccludef;t &om en.try  the 

UIil:cd Stata 1Iec:ao._  ...at ODe lima. tit uemwconsKIered ro bB. at risk: ofbeccxnina a 

s.e
~c:bap"'. 'l'be Beahh Care PiIlllDC'iiD& AduaiDislratiou (HCfA) is aware that  ageecies 

lII&)' have reIeISId ~iafonDation pertaiaiag to iDdiWluals' past receipt ofcatUin 

bC'aIiIs 10 ftCIa:aI ~ In ad.diIiOD, dBe may bave been in5olD(;CS in. ~i1:tdi\rid:wals have 

hid. the apportuaity. or"'" IVaI heeD ~ to repay the value ofVec:lioaid benefits 

teeeiwd ill tile put. HCPA beliMIes that this it.. MI'ious problem. Del tbis ldkr is iD.tend.cd. to 

da1ilY ..law with respecl to tbIdisdorwe ofinComtation about an "iDdividuaI's n:cei.pt of 

Mecticaid' bede&s.  .It wiD also descr.Ite wily Sf.IIf.S eeaerallY J!IIY nor 8.CI!ept. """""5 &am 

iadMdbIls who attellipt ~o....y the StatetorMedicaid base8ts.  . 

~2U(aX4) oldie Iam:ai.tPMioD adNaticnIIity Ad (INA) ttares tbat.., ...wbo is likely 

to IteCume a ~-.is 4Cexdudablc: .... It..a..to our 1IIiIII!Cica'"tbe Stale 

DI!ptr~tbe 1m.............~SaWz (INS), aal Cflia iaai8JlIIiortjudges 

. ~nlJirw011 iIItbmJaIina PIO'Videcl by Stas repn.fiae past nFU!ipt atMcdialid lllistaace to 
...pdt1ie ...8IIdusion ...........,. ... ~it appean that __....-.,. ei.tlun
.....to rcimINne States for the amoum.ofpar Medicaid benefits pmvidaI to thera. or 
have voJanteerecJ to mltellUCb n:iIn'bI.uscm.t to S1ates. 
'I1IIo __......dui6cftioD. Ta. first isaaC is .......l1li uadt.r wktl cica...-.:a SIIleS 

..,JefaIIIC i.........CO tile INS. Stare.DIeJ*b......GamiltllioAjddaef......JKIIipt 

s..
afMeria,*, blIT.' Sec1k1119D2(1)(7) althe Sodal Sa:utly Not rcqaiI'a  to ~ 

...........ftel .........b  ..n:dpieutafllMildiv,  U  ..pr......4IiJc:fosuN 

f  ......
eftblt........fD _  awtide __.....itis 6cc:dy CODDCCted tD die adaIiaasatiaa of1he 

s...... We'"....1DiDed. t1II:t the INS ... RtiU Dep.ftnIeIIt pab1ic dIarae ....,...... 

would...cw:....fD dIe~of'lhe State ___such c:IfttfD.11ioas wilt 

0\1.""""
cliNcd111SlSi1ttha Stare ill ~outs1l11li"C debts from 1ft alien (dDSt ~~

CII' bul). 1le mere pat receipt of'MedicUl,. oa. tire otba' haacf. ill die Ihserxe of 

... ~or &ul. does nat aata. debt.  Such'IIIIIaIits.....us ha'VCbca.,t8iy 

lWCi~- ........1110~is DDl iJMIIb1er:l1O 'die StaDt.  . 

. ~is iaIpoctas&1O.._6icpa&c, is: co . *-wiIh ....434 oftMPct...t ~ 
or
..Wc:aaltti Otipcp=asrt.u.,a_ityJt.oanciJiItiOll Ad  19M (PllWOlA)2 wID P.Ivvides tIIIt State ad 
ba1  be pr~od.from st....iDIbnIwtkmwith the INS tibout the  State Medicaid Di:&ccitm - .PI.P l 
~stanIS ofaliena in the:; U1'J.ited. Stares.  Sec:Iiol1414 penliDr. tmIy to information 

~ra.ted to  peqon'51mmign1tion status. not to tbe M.ediaid infiH::madou pautectcd 

UDder Title XIX  Tbc:tefbtC; _~Medicaid restrietioas em States ~giltfbrmation 

abour apenitI'I~s Medicaid. staIuS CODtibuc in cfIi=Gt without dJul&. 

the second illSllC is whedler States mayaa;cpt ~by an iJ1dividual fOr Medic:aid IMDI&ts 
tbat were legilimatoly rccci~ The Medicaid p!'OBI'8IIl!as no ambority to coUect ~of 
bt:ndits fIorn c.:&ll"I'aI: orfbnnc:r beneficiaries acept in cues 1rIhete dtOIe beAe8ts wefe 
~llGatlyR:CIIIM:d. or..~his occurred:  'Ibis applies botI1 ta the "Federal ...the 
.sara strare Of.Medicaid. benefits 
 
fa ~ Safe Medicaid aaeaQeI aftDOt ambodzed to provide hdbrmatioa about tbe 
rectipt ofb=efits .m the dolt-amou:at ofthese bena&s ttl the INS. ~eState Dtpartmeot or 
immignaion~wUt:5$ dmr inhlDiltiw WI'I"tb8 State iD ~ourstIIzIdiag ddxs:. 
llven ifan i~requests documentAtiod. ofdle ImOUDt of'bcnefits received.. this iDformalion 
is DDt a:O be nl"*Sl"d hera_tile cfil!ido&uR is l10t dirdy \~to the Mraiaistration ofthe 
Mednut Stae plan..  FI!IIHy~ Smes 1ft DOt authorized to coOect ~oflegidmate 
Medicaid spnuting _  beIIalfoimmisnnts. 
I hope this infbmwioa is hetp1b1.  Ityou. have any cbn:her questions. please COIIhIC;t Bob 
TomIiDsoa.'at (410) 786-4463. 
cc; 

All HCPAB.q;oa8.l Adminisrratora 

.An HCPAA..-i.... JteaionI Aibniaisnton 
b:~lad StalltOpcnt.ioas 
Lee Parttidp 
'Dinetar. Health Poky Uait 
weren 
.A.Iaeric::Iu Public  Assocbtion 
Joy Wilson 
Director. Hafdl Coomrittec: 
NarioDd'COJI&I'euee ofSlate LePfatures 
Ieaaifer Ba.DdeU 
Natioaal Govatml'l Associatlon