SR 10-28 Dated 11/10

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

 

DFA SIGNATURE DATE:

November 2, 2010

FROM:

OFFICE OF THE DIRECTOR, DFA Terry R. Smith

AT (OFFICE):

Division of Family Assistance

TO:

DFA Supervisors

 

SUBJECT:

Elimination of the Requirement That to Receive Coverage Under Medicaid, Newborns Must Live with the Mother Following Birth

EFFECTIVE DATE:

November 5, 2010

?Á*This SR releases a policy change in the medical assistance eligibility criteria for newborns born to a mother who was receiving Medicaid at the time of the child’s birth. The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), mandates automatic enrollment in Medicaid for 1 year for these newborns, whether or not the baby continues to reside with the biological mother after birth and whether or not the biological mother retains Medicaid eligibility for herself. In summary, the provisions under CHIPRA:

 

·   eliminate the Medicaid requirement that in order to receive coverage under Medicaid, newborns coming home from the hospital must live with the mother, remain a member of the mother’s household, and that the mother remain eligible for Medicaid (or would remain eligible if still pregnant); and

·   clarify that automatic Medicaid coverage for the full year also applies to a child born in the United States to a mother covered under Emergency Medicaid Services provided to certain non-qualified aliens.

 

FORMER POLICY

NEW POLICY

If the pregnant woman was eligible for and receiving medical assistance on the day her child was born, medical assistance for the newborn was continued for up to 12 months from the baby’s birth, as long as:

§   the hospital or mother verified at the time of the newborn’s birth that the child would be living with the mother following the child’s birth; and

§   the mother:

-   completed the redetermination process and remained eligible for medical assistance or would have been eligible if she were pregnant; or

-   failed or refused to complete the redetermination process.

Babies born to women covered by Medicaid at the time of the child’s birth are automatically enrolled in Medicaid for 1 year whether or not the child continues to reside with the biological mother after birth, and whether or not the biological mother retains eligibility for Medicaid. This policy applies to a baby born in the United States to a mother covered under Emergency Medicaid Services provided to certain non-qualified aliens.

Note: Policy released in SR 10-11, dated 1/10, regarding verification requirements for newborns born to a mother who was receiving Medicaid at the time of the child’s birth, remains unchanged: these newborns are considered to have met citizenship and identity verification requirements, and no further citizenship or identity documentation for the newborn is required at subsequent redeterminations.

 

POLICY

 

All newborns born to mothers receiving Medicaid at the time of the baby’s birth will now receive Medicaid coverage until attaining the age of one, whether or not the baby remains in the biological mother’s household and whether or not the biological mother retains Medicaid eligibility. The baby’s automatic eligibility for Medicaid for 1 year is based solely on the mother’s eligibility for Medicaid at the time of the baby’s birth; a separate application does not need to be filed at birth on the child’s behalf and no further action needs to be taken for a determination of eligibility.

 

Note: If the child does not reside with the biological mother after the child’s birth, the child will be considered the casehead in his/her own case, however an authorized representative will need to be designated for the baby’s case.

 

DISTRICT OFFICE AND NEW HEIGHTS SYSTEMS PROCEDURES AND IMPLEMENTATION

 

New HEIGHTS will incorporate the changes in this SR when funding and resources permit. Until the automation of the policy becomes available, Family Service Specialists are to contact the Medicaid Program Specialist at State Office for further instructions about how to ensure continued medical coverage for the child if the child does not reside with the biological mother after the child’s birth.

 

POLICY MANUAL REVISIONS

 

Revised Family Assistance Manual Topics

 

Section 161.07  Termination at Redetermination/Recertification

Section 221.03  Continuation of Medical Assistance Following Pregnancy

 

IMPLEMENTATION

 

The policies released in this SR are effective November 5, 2010.

 

CLIENT NOTIFICATION

 

No special client notification is planned.

 

TRAINING

 

No training is planned.

 

DISPOSITION

 

This SR may be destroyed or deleted after its contents have been noted and the revised manual topics released by this SR have been posted to the On-line manuals.

 

DISTRIBUTION

 

This SR will be distributed according to the electronic distribution list for Division of Family Assistance policy releases. This SR, and revised On-Line Manuals, will be available for agency staff in the On-Line Manual Library, and for public access on the Internet at www.dhhs.nh.gov/DFA/publications.htm, effective December 6, 2010. Additionally, this SR, and printed pages with posting instructions, will be distributed under separate cover to all internal hard copy holders of the Family Assistance Manual.

 

DFA/JT:s