White, a British citizen and a legal permanent resident of the United States entered the United States in 1991.She was issued a green card and resided in the U.S. continuously. When she applied for Medicaid, she was denied eligibility because she had not resided in the U.S. cotinuously for five years as provided for in Georgia’s ABD Medicaid Manual. That decision was affirmed by an administrative law judge and adopted by the Commissioner of the Department of Community Health (DCH). The Superior Court reversed.

On appeal, the Court of Appeals reversed. It found that White was a qualified alien under the the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (“the Welfare Reform Act” or “the Act”). Pub. L. 104-193, 110 Stat. 2105 (1996), meaning se was lawfully admitted at the time she applied for Medicaid. It also found that qualified aliens may be required to wait five years before becoming eligible for Medicaid, but that Congress intended for those provisions to apply to qualified aliens entering the United States after the date the statute was enacted, which occurred on enacted Aug. 22, 1996. White entered the United States prior to that date, so the five year waiting period did not prevent her from becoming eligible for Medicaid prior to expiration of the five year waiting period.

DCH argued that its manual supported the five year waiting period. “But it is erroneous for a Georgia court to give the full “deference due a [state] statute, rule or regulation to a term in a departmental manual, the terms of which ha[ve] not undergone the scrutiny afforded a statute during the legislative process or the adoption process through which all rules and regulations must pass.” Pruitt Corp. v. Dept. of Community Health, 284 Ga. 158, 159-160 (2) (664 SE2d 223) (2008). And the federal interim guidance is directly on point and comports with the language of the federal statute. Under those provisions, White is entitled to Medicaid benefits. Cf. Andrianova v. Indiana Family & Social Svcs. Admin., 799 NE2d 5 (Ind. Ct. App. 2003) (in reliance on interim guidance, ruling that plaintiff who entered the United States before August 22, 1996, and obtained qualified alien status after that date was not exempt from the five-year waiting period because she was not continuously present in the United States). Because the final agency decision is based on an error of law, the superior court did not err in reversing that decision, and we affirm the superior court. See OCGA § 50-13-19 (h) (3).”

This case is significant because it clearly states that the Georgia ABD Manual is not entitled to deference if it conflicts with federal guidance.