Path to PRUCOL: Undocumented Residents Now Eligible For Medicaid

Nursing homes and other healthcare facilities have long grappled with complex questions regarding Medicaid eligibility for residents who lack legal immigration status.

In many cases, a facility may not even be aware that an individual has a potentially problematic immigration status until after the resident has been granted admission. Fortunately, New York’s Medicaid regulations permit otherwise Medicaid-eligible individuals who lack legal immigration status to qualify for non-emergency medical assistance if they can establish what is commonly known as PRUCOL status. PRUCOL stands for “Permanently Residing Under Color of Law” and requires an individual applying for medical assistance to demonstrate that they are living openly in the United States with the “knowledge and acquiescence” of the federal immigration agency. Previously, establishing PRUCOL status could be a lengthy and uncertain process, with the resident’s application depending on the response of federal immigration authorities.   

However, New York recently enacted new rules expanding Medicaid eligibility. Beginning on January 1, 2024, Medicaid applicants seeking PRUCOL status who do not receive a response from the federal immigration agency within fifteen (15) business days of the initial request will be considered PRUCOL. In addition, individuals over the age of 65 who previously only qualified for temporary emergency Medicaid, may be eligible for full Medicaid benefits even if they do not qualify for PRUCOL status. The new rules may streamline the process for many undocumented nursing home residents and provide greater certainty for the healthcare facilities providing residential care and services to such individuals. 

Cona Elder Law’s experienced attorneys continue to monitor the most recent developments regarding this legislation as well as other important legal matters concerning the skilled nursing facility, assisted living and CCRC industry. Contact us at 631.390.5000 or click here to learn more about how our firm can help your facility preserve its bottom line and ensure your ability to continue to provide quality services to your residents. 

Originally published in the February 2024 edition of LeadingAge NY’s ‘Solutions’ Newsletter.