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Model Application Template for the State Children’s Health Insurance Program

Effective Date:

Approval Date: 6 the ARKids B 1115 demonstration because section 2110(b)(II) of the SCHIP legislation and CMS Q&A 14(a) provide that states, which expanded Medicaid through an 1115 demonstration after June 1, 1997 may claim the enhanced match rate for such children. The ARKids B program was implemented on September 1, 1997. C. Overview of ARKids B 1115 Demonstration (Medicaid and SCHIP) The Arkansas Department of Human Services administers regular Medicaid and the ARKids B demonstration, which will be funded by Titles XIX and XXI.

The essential elements of the ARKids B program, without regard to the funding source, are as follows:

• Covers children under 19.

• Family income must be at or below 200% of the poverty level.

• There is no asset test.

• Children must have been uninsured for the preceding 6 months or insurance was lost through “no-fault” such as parent is no longer employed and health insurance was lost.

• The benefit package is the Secretary approved Medicaid 1115 demonstration benefit package granted for ARKids B. The benefit package will be the same for all ARKids B enrollees without regard to the funding source.

• Cost-sharing is required for services that are not categorized as well-health.

Notes: Generally, in this document, the 1115 demonstration is referenced as ARKids B, even though it was known as ARKids First until August 4, 2000.

The Division of Medical Services (DMS) and the Division of County Operations (DCO) are divisions of the Department of Human Services. DMS is responsible for the administration of the Medicaid and SCHIP programs except for eligibility, which is the responsibility of DCO.

The SCHIP definition of a targeted low-income child excludes children