17-1723.1

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1723.1-1
HAWAII ADMINISTRATIVE RULES
TITLE 17
DEPARTMENT OF HUMAN SERVICES
SUBTITLE 12
MED-QUEST DIVISION
CHAPTER 1723.1
EMERGENCY MEDICAL ASSISTANCE FOR NON-CITIZENS
Subchapter 1 	General Provisions
§17-1723.1-1 	Purpose
§17-1723.1-2 	General requirements
§§17-1723.1-3 to 17-1723.1-7 	(Reserved)
Subchapter 2 	Eligibility Requirements
§17-1723.1-8 	Purpose
§17-1723.1-9 	Basic requirements
§17-1723.1-10 	Categorical requirements
§17-1723.1-11 	Income requirements
§17-1723.1-12 	Asset requirements
§§17-1723.1-13 to 17-1723.1-17 	(Reserved)
Subchapter 3 	Freedom of Choice, Coverage, and
Benefits
§17-1723.1-18 	Purpose
§17-1723.1-19 	Freedom of choice
§17-1723.1-20 	Coverage
§17-1723.1-21 	Benefits
§§17-1723.1-22 to 17-1723.1-26 	(Reserved)
SUBCHAPTER 1
GENERAL PROVISIONS

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§17-1723.1-1 	Purpose. 	The purpose of this
chapter is to establish the requirements for
eligibility and participation in emergency medical
assistance for a non-citizen who is ineligible for
Medicaid. 	[Eff 	09/30/13] 	(Auth: HRS §§346-14, 346-
56; 42 C.F.R. §435.139) (Imp: HRS §§346-14, 346-56; 42
C.F.R. §435.139)
§17-1723.1-2 	General requirements. 	The
confidentiality, administrative appeal, fraud, medical
assistance recovery, application processing,
eligibility review, and adverse action notice
provisions described in subtitle 12 shall pertain to
an individual who applies or is eligible under this
chapter. 	[Eff 	09/30/13] 	(Auth: 	HRS §§346-14,
42 C.F.R. §§431.200, 431.206, 431.221, 431.230,
431.300, 435.139, 435.907, 435.916, 455.1) (Imp: 	HRS
§§346-14; 42 C.F.R. §§431.200, 431.206, 431.221,
431.230, 431.300, 435.139, 435.907, 435.916, 455.1)
§§17-1723.1-3 to 17-1723.1-7 	(Reserved)
SUBCHAPTER 2
ELIGIBILITY REQUIREMENTS
§17-1723.1-8 	Purpose. 	This subchapter describes
the eligibility requirements for coverage of emergency
medical services for a non-citizen under this chapter.
[Eff 	09/30/13] 	(Auth: 	HRS §346-14; 42 C.F.R.
§§435.10, 435.139, 435.406(c), 440.255) (Imp: 42
C.F.R. §§435.139, 435.406(c), 440.255)
§17-1723.1-9 	Basic requirements. 	A non-citizen
applying for assistance under this chapter shall meet
the following basic requirements, which include but
are not limited to non-citizen status, state
residency, verification of identity, not residing in a
public institution and, when applicable, the provision

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of a social security number. 	[Eff 	09/30/13] 	(Auth:
HRS §346-14; 42 C.F.R. §§435.10, 435.139, 435.400,
435.406(c), 435.910) (Imp: 42 C.F.R. §§435.139,
435.400, 435.910)
§17-1723.1-10 	Categorical requirements. 	(a)
Coverage of emergency services may be provided to an
individual who is ineligible for Medicaid, meets the
conditions of subsections (b) and (c), and is:
(1) 	Illegally residing in the United States;
(2) 	A lawfully present non-citizen, including a
citizen of a COFA nation, who is age
nineteen or over and not pregnant;
(3) 	A non-citizen who was never legally admitted
to the U.S. for any period of time, or was
admitted for a limited time and did not
leave when the time expired; or
(4) 	Lawfully admitted for a temporary or a
specified time period as a legal non-
immigrant such as a:
(A) 	Visitor;
(B) 	Tourist;
(C) 	Diplomat;
(D) 	Student who enters the U.S. temporarily
with no intention of abandoning
residence in a foreign country.
(b) 	Has a sudden onset of a medical condition,
including emergency labor and delivery, manifesting
itself in acute symptoms of sufficient severity
(including severe pain) such that the absence of
immediate medical attention could be expected to
result in:
(1) 	Placing the individual’s health in serious
jeopardy;
(2) 	Serious impairment to bodily functions; or
(3) 	Serious dysfunction of any bodily organ or
part.
(c) 	Meets all other categorical and financial
eligibility criteria for Medicaid with the exception
of citizenship, lawfully present non-citizen status,
and a SSN for an illegal non-citizen. 	Otherwise, the
following conditions shall apply:

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(1) 	An individual who is aged, blind, or
disabled (ABD) shall meet the categorical
requirements for aged, blind, or disabled
individuals described in chapter 17-1719;
(2) 	A non-ABD individual shall meet the
categorical eligibility requirements
described in chapters 17-1715, 17-1716, 17-
1717, 17-1718 or 17-1730.1 as applicable.
[Eff 	09/30/13] 	(Auth: 	HRS §346-14; 42
U.S.C. §1320b-7(d), 42 C.F.R. §§435.10,
435.139, 435.406(c), 440.255) (Imp: 	42
U.S.C. §1320b-7(d), 42 C.F.R. §§435.139,
435.406(c), 440.255)
Historical note: 	§17-1723.1-10 is based substantially
upon repealed §17-1723-5. 	[Eff 08/01/94; am 05/17/97;
am 12/27/97; am 09/17/07; R 09/30/13]
§17-1723.1-11 	Income requirements. 	The
following income standards must be met to be eligible
for emergency medical assistance for non-citizens:
(1) 	For an ABD individual, apply the income
requirements described in chapter 17-1719.
(2) 	For a non-ABD individual, apply the income
requirements described in chapters 17-1715,
17-1716, 17-1717, 17-1718 or 17-1730.1 as
appropriate.
(3) 	For an individual determined ineligible for
Medicaid, the department shall transfer the
individual's application information for other
insurance affordability programs as
appropriate pursuant to 42 C.F.R.
§435.1200(e). 	[Eff 	09/30/13] 	(Auth: HRS
§346-14; 42 C.F.R. §§435.10, 435.139,
435.406(c), 435.1200, 440.255) (Imp: 42 C.F.R
§§435.139, 435.406(c), 435.1200, 440.255)
§17-1723.1-12 	Asset requirements. 	Assets shall
be considered as follows:

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(1) 	For an ABD individual, apply the asset
provisions described in chapter 17-1719.
(2) 	For a non-ABD individual, apply the asset
provisions described in chapters 17-1715,
17-1716, 17-1717, 17-1718 or 17-1730.1 as
appropriate. 	[Eff 	09/30/13] 	(Auth: 	HRS
§346-14; 42 C.F.R.§§ 435.139, 435.406(c),
440.255) (Imp: 	42 C.F.R. §§435.139,
435.406(c), 440.255)
§§17-1723.1-13 to 17-1723.1-17 	(Reserved).
SUBCHAPTER 3
FREEDOM OF CHOICE, COVERAGE, AND BENEFITS
§17-1723.1-18 	Purpose. 	This subchapter
addresses and refers to the provisions of freedom of
choice, coverage and benefits for an individual who is
eligible for emergency medical services under this
chapter. 	[Eff 	09/30/13] 	(Auth: HRS §346-14; 42
C.F.R. §§431.10, 431.40, 435.406(c), 440.255) (Imp: 42
C.F.R §§431.10, 431.40, 435.406(c), 440.255)
§17-1723.1-19 	Freedom of choice. 	An individual
eligible under this chapter shall choose a department
approved provider as described in section 17-1736-3.
[Eff 	09/30/13] 	(Auth: 	HRS §§346-14, 346-56; 42
C.F.R. §§431.51) (Imp: 	HRS §346-56; 42 C.F.R.
§431.51)
§17-1723.1-20 	Coverage. 	Coverage will be
provided no earlier than the tenth calendar day
immediately prior to the date the application is
received by the department. 	[Eff 	09/30/13] (Auth:
HRS §§346-14, 346-56; 42 C.F.R. §§431.10,

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431.51, 440.255(c)) (Imp: HRS §346-56; 42 C.F.R.
§§431.10, 431.51, 440.255(c))
§17-1723.1-21 	Benefits. 	(a) 	An individual
eligible under this chapter shall be provided benefits
on a fee-for-service basis as described in chapter 17-
1737.
(b) 	Benefits shall be limited to coverage of
emergency medical services to stabilize the emergency
medical condition described in section 17-1723.1-
10(b).
(c) 	Services related to organ transplant
procedures are not covered. 	[Eff 	09/30/13] 	(Auth:
HRS §§346-14, 346-56; 42 C.F.R. §§ 431.40, 440.255)
(Imp: 	HRS §346-56, 42 C.F.R. §§431.40, 440.255)
Historical note: 	§17-1723.1-21 is based substantially
upon repealed §17-1723-6. 	[Eff 08/01/94; am 05/17/97;
am 01/31/09; am 06/11/09; R 09/30/13]
§§17-1723.1-22 to 17-1723.1-26 	(Reserved).