<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05-3" citation="COMAR 10.09.24.05-3" title_num="10" subtitle_num="09" chapter_num="24" heading="Nonfinancial Eligibility Requirements — Residency.">
  <paragraph num="A.">
    <text>To be eligible for the Maryland Medical Assistance Program, an applicant or recipient shall be a Maryland resident.</text>
  </paragraph>
  <paragraph num="B.">
    <text>An individual is a Maryland resident if the individual resides in Maryland with the intent of remaining permanently or for an indefinite period, regardless of whether the individual maintains the residence permanently or at a fixed address.</text>
  </paragraph>
  <paragraph num="C.">
    <text>Residency in a state begins on the day that an individual:</text>
    <paragraph num="(1)">
      <text>Enters the state with the intent to remain permanently or for an indefinite period; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Decides to remain in the state permanently or for an indefinite period after entering for another purpose.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>An individual is not a resident of a state if the individual:</text>
    <paragraph num="(1)">
      <text>Is temporarily residing in or visiting the state without the intent of remaining, except as specified under §I(2)(b)(ii) or §I(3) of this regulation;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Came into the state for a specific, time-limited purpose and does not intend to remain, except as specified under §I(2)(b)(ii) or §I(3) of this regulation; or</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Entered the state voluntarily to obtain noninstitutional medical care, such as for acute hospital inpatient services.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Residency in a state established on any day in a calendar month shall constitute residency for the full month.</text>
  </paragraph>
  <paragraph num="F.">
    <text>Retaining Residency.</text>
    <paragraph num="(1)">
      <text>Residency is retained until abandoned.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Temporary absence from a state, with the intent to return to the state when the purpose of the absence is accomplished, does not interrupt continuity of residency, unless another state's Medical Assistance program determines that the individual is a resident of the other state.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>An individual who is routinely absent from a state for a protracted period of time retains residency in that state if the individual:</text>
      <paragraph num="(a)">
        <text>Declares the intent to remain a resident of the state;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Has an established residential address in the state; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Is not certified for Medical Assistance or receiving public assistance in another state.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Residency in a state is not affected by an absence for:</text>
      <paragraph num="(a)">
        <text>Unanticipated medical care; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Out-of-state medical treatment preauthorized by the state's Medical Assistance Program.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>An individual is ineligible for a state's Medical Assistance Program for any month in which the individual is not a resident of the state.</text>
  </paragraph>
  <paragraph num="H.">
    <text>State Supplementary Payment for a Recipient of Supplemental Security Income (SSI).</text>
    <paragraph num="(1)">
      <text>Notwithstanding any other provisions of this regulation, the state of residence for a recipient of a state supplementary SSI payment is the state making the supplementary payment.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>An individual receiving a state supplementary payment from another state who moves to Maryland with the intent of remaining in Maryland is not eligible for Maryland Medical Assistance until:</text>
      <paragraph num="(a)">
        <text>The individual's change of state residence is verified; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Changes, if any, in the individual's payment amount are made with the Social Security Administration.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="I.">
    <text>Additional Residency Criteria for Noninstitutionalized Individuals.</text>
    <paragraph num="(1)">
      <text>Noninstitutionalized Child.</text>
      <paragraph num="(a)">
        <text>Except as otherwise specified in this regulation, a noninstitutionalized, unmarried individual younger than 21 years old is considered a resident of the state where the child lives:</text>
        <paragraph num="(i)">
          <text>With the child's parent or other caretaker relative; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>In another living arrangement if the child is not living with the child's parent or other caretaker relative, and the child's parent or other caretaker relative is not responsible for the child's day-to-day care and supervision.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>For a child receiving federal payments for foster care or adoption assistance under Title IV-E of the Social Security Act, the child's state of residence is the state where the child lives, even if it is not the state making the payments.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>If a noninstitutionalized child's Medical Assistance eligibility is determined based on blindness or disability, the child's state of residence is the state where the child lives.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Noninstitutionalized Adult. A noninstitutionalized adult, including an individual younger than 21 years old who is married or otherwise emancipated from the individual's parents, is considered a resident of the state where the individual lives:</text>
      <paragraph num="(a)">
        <text>Voluntarily with the intent to remain permanently or for an indefinite period; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>At the time of Medical Assistance application, if the individual is:</text>
        <paragraph num="(i)">
          <text>Determined as incapable of indicating intent, in accordance with §K of this regulation; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Not receiving assistance from another state and entered the state with a job commitment or seeking employment, whether or not the individual is currently employed.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>The exclusion of Medical Assistance eligibility under §D of this regulation for individuals who temporarily reside in the state without the intent of remaining shall be waived for members of an assistance unit that includes a migrant worker, in MAGI Exempt coverage groups.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Notwithstanding any other provision of this regulation, the state of residence for an individual placed by a state government in another state is the state that arranges or makes the placement for medical or other publicly funded services.</text>
    </paragraph>
  </paragraph>
  <paragraph num="J.">
    <text>Additional Residency Criteria for Institutionalized Individuals.</text>
    <paragraph num="(1)">
      <text>For an institutionalized adult, including an individual younger than 21 years old who is married or otherwise emancipated from the individual's parents, the state of residence is the state where the individual is institutionalized, if the individual indicates the intent to remain in the long-term care facility indefinitely.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If an institutionalized adult became incapable of indicating intent when the individual was 21 years old or older, the individual's state of residence is the state where the individual is institutionalized.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>An institutionalized child younger than 21 years old, or an institutionalized adult who became incapable of indicating intent when younger than 21 years old, is a resident of the state in which the:</text>
      <paragraph num="(a)">
        <text>Individual's parent or other legal guardian resided at the time of the individual's placement in the long-term care facility;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Individual's parent or other legal guardian currently resides, who applied for Medical Assistance on the individual's behalf; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Individual is institutionalized if the individual was abandoned by the individual's parents and does not yet have a legal guardian.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Notwithstanding any other provision of this regulation, the state of residence for an individual institutionalized by a state government in an out-of-state facility is the state that arranges or makes the placement.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>The Department may not deny Medical Assistance eligibility to an institutionalized individual who satisfies the residency requirements of this regulation, on the grounds that the individual did not establish Maryland residency before entering the long-term care facility.</text>
    </paragraph>
  </paragraph>
  <paragraph num="K.">
    <text>An adult is considered incapable of indicating intent if the individual:</text>
    <paragraph num="(1)">
      <text>Has an Intelligence Quotient of 49 or less, or a mental age of 7 years old or younger, based on tests acceptable to the Department's Developmental Disabilities Administration;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Is judged legally incompetent; or</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Is found incapable of indicating intent based on medical documentation obtained from a physician, psychologist, or other person licensed by the state in the field of intellectual disabilities.</text>
    </paragraph>
  </paragraph>
</regulation>