<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 10.09.24.05" title_num="10" subtitle_num="09" chapter_num="24" heading="Nonfinancial Eligibility Requirements — Citizenship.">
  <paragraph num="A.">
    <text>Eligibility. To be eligible for federal coverage of full Medical Assistance benefits, an individual shall be:</text>
    <paragraph num="(1)">
      <text>A citizen of the United States, including:</text>
      <paragraph num="(a)">
        <text>An individual who was born in:</text>
        <paragraph num="(i)">
          <text>One of the 50 states;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The District of Columbia;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Puerto Rico;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Guam;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>The Northern Mariana Islands; or</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>The Virgin Islands;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>A child born outside of the United States if:</text>
        <paragraph num="(i)">
          <text>The federal requirements, including the requirements in the Child Citizenship Act of 2000 (Public Law 106-395), are met for the child to automatically acquire United States citizenship upon the child's lawful admission to the United States for permanent residence;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>At least one of the child's natural, adoptive, or stepparents is a United States citizen by birth or naturalization;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The child is younger than 18 years old;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>The child is residing in the United States in the legal and physical custody of the citizen or naturalized parent; and</text>
        </paragraph>
        <paragraph num="(v)">
          <text>The child is a lawful permanent resident of the United States;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>An individual who has been naturalized as a United States citizen; or</text>
      </paragraph>
      <paragraph num="(d)">
        <text>A national from American Samoa or Swain's Island;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>A qualified alien, as specified in §C of this regulation, who is eligible in accordance with the requirements related to the 5-year bar specified at §D of this regulation;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>An honorably discharged veteran of the armed forces of the United States;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>An alien on active duty in the armed forces of the United States;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>The lawfully admitted spouse, including a surviving spouse who has not remarried, or lawfully admitted unmarried dependent child of an:</text>
      <paragraph num="(a)">
        <text>Honorably discharged veteran of the armed forces of the United States; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Alien on active duty in the armed forces of the United States; or</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>An alien who is:</text>
      <paragraph num="(a)">
        <text>Eligible for and receiving Supplemental Security Income (SSI);</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A member of a state or federally recognized Indian tribe, as defined in 25 U.S.C. §450b(e); or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>An American Indian born in Canada to whom §289 of the Immigration and Nationality Act (INA) applies.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Veterans. Veterans of the following foreign armed forces are considered under this regulation to be veterans of the armed forces of the United States:</text>
    <paragraph num="(1)">
      <text>Individuals who served in the Philippine Commonwealth Army during World War II or as Philippine scouts following World War II; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Hmong and other Highland Lao veterans who fought under United States' command during the Vietnam War and who were lawfully admitted to the United States for permanent residence.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Qualified Aliens. According to §431 of the Personal Responsibility and Work Opportunity and Reconciliation Act of 1996 (PRWORA), qualified aliens admitted to the United States shall include:</text>
    <paragraph num="(1)">
      <text>The following types of aliens, who may be subject to the 5-year bar specified at §D of this regulation, depending on their most recent date of entry and their date of qualified alien status:</text>
      <paragraph num="(a)">
        <text>Aliens who were lawfully admitted to the United States for permanent residence or who since admission were granted lawful permanent resident status in accordance with the INA;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Aliens granted parole for at least 1 year under §212(d)(5) of the INA; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>A documented or undocumented immigrant who was battered or subjected to extreme cruelty by the individual's United States citizen or lawful permanent resident spouse or parent, or by a member of the spouse's or parent's family residing in the same household as the immigrant, if:</text>
        <paragraph num="(i)">
          <text>The spouse or parent consented to, or acquiesced in, the battery or cruelty;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The abusive act or acts occurred in the United States;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The individual responsible for the battery or cruelty no longer lives in the same household as the victim;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>A Violence Against Women Act immigration case or a family-based visa petition has been filed; and</text>
        </paragraph>
        <paragraph num="(v)">
          <text>There is a substantial connection between the battery or cruelty and the need for Medical Assistance benefits; and</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>The following types of aliens, who are not subject to the 5-year bar specified in §D of this regulation:</text>
      <paragraph num="(a)">
        <text>Alien children and pregnant women who are lawfully residing in the United States, including legal permanent residents who have resided in the United States for less than 5 years as described under §214 of the Children's Health Insurance Program Authorization Act of 2009 (CHIPRA);</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Aliens who were lawfully admitted to the United States for permanent residence as Amerasian immigrants under §584 of the Foreign Operations, Export Financing and Related Programs Appropriations Act of 1988;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Refugees admitted under §207 of the INA;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Aliens granted asylum under §208 of the INA;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Aliens whose deportation is being withheld under:</text>
        <paragraph num="(i)">
          <text>§243(h) of the INA as in effect prior to April 1, 1997; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>§241(b)(3) of the INA, as amended;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(f)">
        <text>Cuban or Haitian entrants, as defined at §501(e) of the Refugee Education Assistance Act of 1980;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Aliens granted conditional entry under §203(a)(7) of the INA in effect before April 1, 1980;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Children receiving federal payments for foster care or adoption assistance under Part B or E of Title IV of the Social Security Act, if the child's foster or adoptive parent is considered a citizen or qualified alien; and</text>
      </paragraph>
      <paragraph num="(i)">
        <text>Victims of a severe form of trafficking, in accordance with §107(b)(1) of the Trafficking Victims Protection Act of 2000, who have been subjected to:</text>
        <paragraph num="(i)">
          <text>Sex trafficking if the act is induced by force, fraud, or coercion, or the individual who was induced to perform the act was younger than 18 years old on the date that the visa application was filed; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Involuntary servitude.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Five-Year Bar to Federal Medical Assistance for Qualified Aliens.</text>
    <paragraph num="(1)">
      <text>Except for coverage of emergency medical services specified at Regulation .05-2 of this chapter, qualified aliens in the categories specified in §C(1) of this regulation who entered the United States on or after August 22, 1996, were not eligible for federally-funded Medical Assistance for 5 years from the date that the qualified alien:</text>
      <paragraph num="(a)">
        <text>Entered the United States with the status of a qualified alien; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Obtained the status of a qualified alien, if the individual did not enter the United States as a qualified alien.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>The 5-year bar specified in §D(1) of this regulation shall also be applied to qualified aliens who entered the United States before August 22, 1996, but did not remain continuously present in the United States from the last date of entry before August 22, 1996 until the date of qualified alien status.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>An alien is not considered to be continuously present in the United States as specified in §D(2) of this regulation if, before the date of qualified alien status, the alien had:</text>
      <paragraph num="(a)">
        <text>A single absence from the United States of more than 30 days; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Absences from the United States totaling more than 90 days.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>The 5-year bar to eligibility for federal Medical Assistance benefits, specified in §D(1) of this regulation, does not apply to:</text>
      <paragraph num="(a)">
        <text>Qualified aliens in the categories specified at:</text>
        <paragraph num="(i)">
          <text>§C(1) of this regulation, who are not subject to the 5-year bar in accordance with §D(1) or (2) of this regulation; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>§C(2) of this regulation;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>A qualified alien who is:</text>
        <paragraph num="(i)">
          <text>An honorably discharged veteran of the armed forces of the United States;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>On active duty in the armed forces of the United States; or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The lawfully admitted spouse, including a surviving spouse who has not remarried, or lawfully admitted unmarried dependent child of an honorably discharged veteran or individual on active duty in the armed forces of the United States; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>Lawful permanent residents who:</text>
        <paragraph num="(i)">
          <text>Entered the United States under another exempt category specified at §D(4)(a)—(b) of this regulation; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Converted to lawful permanent resident status.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>Effective December 1, 2009, as authorized by the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), the 5-year bar will no longer apply to Medical Assistance or Children's Health Insurance Program eligibility for pregnant women and children who are qualified aliens.</text>
    </paragraph>
  </paragraph>
</regulation>