4-001.02A Emergency Medical Services for Aliens

469 NAC 4-001.02A

Aliens who are not lawfully admitted for permanent residence in the United States, or are not granted temporary resident status under P.L. 99-603 are eligible for medical assistance for payment of emergency medical services if the following conditions are met:

1. The alien has the sudden onset of a medical condition (including emergency labor and delivery) manifesting itself by acute symptoms of sufficient severity (including severe pain) where the absence of immediate medical attention could reasonably be expected to result in -

a. Serious jeopardy to the patient's health;

b. Serious impairment to bodily functions; or

c. Serious dysfunction of any bodily organ or part; and

2. The alien meets all eligibility requirements in 469 NAC 2-000 ff. except -

a. Citizenship and alien status (see 469 NAC 2-002);

b. Referral to SSA for determination of blindness or disability (see 469 NAC 2-007.03A). The SRT completes the review of blindness or disability (see 469 NAC 2-007.03B); or

c. Referral to SSI for potential income (see 469 NAC 2-010.01B6c(1)).

The determination that the client has an emergency medical condition in accordance with the guideline in number 1 and the review of blindness or disability is the responsibility of the State Review Team (SRT). The worker must submit current medical information (Form DM-5 and/or a narrative report) and Form DM-12D to the SRT. The SRT uses Form DM-5R to report to the worker the determination of medical emergency and the date by which this must be reviewed.

(7/20/2000)