CHIPRA documentation changes 'good news' for Medicaid
CHIPRA documentation changes 'good news' for Medicaid
There are some "immediate, dramatic improvements" made by the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) in the way the citizenship documentation requirement in Medicaid is implemented, according to Julia Paradise, a principal policy analyst for the Kaiser Commission on Medicaid and the Uninsured in Washington, DC.
"This assures that eligible citizens don't have to wait for Medicaid coverage while they gather citizenship documents," says Ms. Paradise.
Whereas earlier policy required states to delay coverage until the required documents were submitted, CHIPRA now requires states to provide Medicaid benefits as soon as they determine an applicant is otherwise eligible for Medicaid, and applicants have a reasonable period to submit their citizenship documents.
The new law also exempts newborns whose birth in U.S. hospitals was covered by Medicaid, since they are U.S. citizens by definition. States are now allowed to accept certain additional tribal documents as evidence of citizenship for Native Americans.
"These immediate changes are all good news, especially considering the increased needs for Medicaid coverage due to the recession," says Ms. Paradise.
Paperwork could be reduced
Effective Jan. 1, 2010, states have a new option to implement the citizenship documentation requirement by conducting a data match with the Social Security Administration (SSA).
"In addition to easing Medicaid enrollment for eligible low-income families and children, this option could substantially reduce the paperwork and costs that states face in complying with the citizenship documentation requirement," says Ms. Paradise.
Document requirements extended
CHIPRA extends the citizenship documentation requirement to CHIP as well, beginning Jan. 1, 2010. "This means new administrative burdens and costs for states with separate CHIP programs," says Ms. Paradise.
The SSA data match option also takes effect then, but states that adopt it will need additional resources to invest in and run a new system.
"Happily, CHIPRA provides for extra federal help for states that take up the SSA data match option, in the form of enhanced matching funds," says Ms. Paradise. The law provides for a 90% federal match for the costs associated with developing a system for matching data with SSA and a 75% federal match for the maintenance and operation of those systems.
Delaware compliant
Delaware's Medicaid program already complies with the CHIPRA provisions requiring verification of citizenship and identity of CHIP applicants, according to David Michalik, senior administrator of the Division of Medicaid & Medical Assistance.
"When applicants declare U.S. citizenship, our system requires our workers to confirm their citizenship and identity before eligibility can be approved," says Mr. Michalik.
Where individuals are not citizens, their coverage will only be opened in permitted categories such as a state-only program or the federal program for nonqualified individuals who receive labor and delivery and emergency services only.
"Of course, under federal CHIP law, clients must be made eligible for Medicaid if they qualify before they can be considered for CHIP eligibility," says Mr. Michalik.
The state's eligibility system is structured as a "cascade" where applicants are slotted into the appropriate eligibility categories. Someone cannot simply apply for CHIP and be made eligible if they actually qualify for Medicaid. "So, the good news for us is that we do not have to make any costly systems changes for this new requirement," says Mr. Michalik.
Contact Mr. Michalik at (302) 255-9577 or [email protected], and Ms. Paradise at (202) 347-5270 or [email protected].
There are some "immediate, dramatic improvements" made by the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) in the way the citizenship documentation requirement in Medicaid is implemented, according to Julia Paradise, a principal policy analyst for the Kaiser Commission on Medicaid and the Uninsured in Washington, DC.Subscribe Now for Access
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