martes, 22 de noviembre de 2016

Medicaid and CHIP Eligibility and Appeals Final Rule & Companion NPRM AND Section 1115 Demonstration Opportunity to Cover Former Foster Care Youth Who Have Moved from a Different State

Today the Centers for Medicare & Medicaid Services (CMS) issued a final rule that includes finalized Medicaid and the Children’s Health Insurance Program (CHIP) provisions associated with the eligibility changes under the Affordable Care Act of 2010 and previous legislation.  The final rule supports modernization of notices and appeals processes and the coordination of eligibility notices and appeals across insurance affordability programs.  Other provisions complement the simplification of eligibility and enrollment and the shift to MAGI-based financial methodologies codified in the final rule published in March 2012, including coverage for former foster care youth, optional eligibility pathways, and financial methodologies for medically needy individuals, and verification of citizenship and immigration status.  CMS also issued a Notice of Proposed Rulemaking (companion NPRM) relating to Medicaid and CHIP eligibility appeals processes which complements the final rule.
To view the final rule at the Federal Register (PDF) click here  and on 11/30/2016 available online at
To view the proposed rule at the Federal Register (PDF) click here  and on 11/30/2016 available online at
Along with the two rules, CMCS issued an Informational Bulletin to inform states how they can pursue a Medicaid demonstration project under section 1115 of the Social Security Act to continue to provide Medicaid coverage to former foster care youth who aged out of foster care under the responsibility of another state (and were enrolled in Medicaid while in foster care), and are now applying for Medicaid in the state in which they live. 
The Informational Bulletin is available on at
For more information on Eligibility, visit at

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