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State Children’s Health Insurance Program

Phase 1 Effective Date: April 1, 1998

Revised: 1/26/98, 2/19/98, 3/3/98, 3/6/98 Phase 2 Effective Date: July 1, 1998

Revised: 8/20/98, 8/24/98, 10/1/99, 7/28/00, 1/31/01, 7/02/02, 7/22/02, 1/3/03, 2/13/04, 9/27/04, 11/15/04, 8/11/05, 10/1/06, 7/1/09, 7/1/10, 7/1/11, 7/1/12 85 be included in the childcare plan.

These are activity therapies intended to encourage children to express fear and anxiety related to their life-limiting condition, treatment, prognosis, or to their ability to cope with what is happening in their life, including family, school, siblings, and friends. These therapies assist the child in expressing the negative fears and anxieties that may be felt but cannot be expressed verbally. 6.2.25.  Premiums for private health care insurance coverage (Section 2110(a)(25)) 6.2.26.  Medical transportation (Section 2110(a)(26)) Healthy Kids covers emergency medical transportation only. 6.2.27.  Enabling services (such as transportation, translation, and outreach services (See instructions) (Section 2110(a)(27)) 6.2.28.  Any other health care services or items specified by the Secretary and not included under this section (Section 2110(a)(28))

These services will be provided to CMSN Title XXI enrolled children with life-threatening conditions and will include supportive over-lay services such as counseling, respite, and other services typically provided by hospice per 42 CFR Ch. IV, Part 418, Subpart F.

6.2.-D The State will provide dental coverage to children through one of the following. Dental services provided to children eligible for dental-only supplemental services must receive the same dental services as provided to otherwise eligible CHIP children (Section 2103(a)(5)):

6.2.1.-D ∼  State Specific Dental Benefit Package. The State assures dental services represented by the following categories of common dental terminology (CDT) codes are included in the dental benefits: 1. Diagnostic (i.e., clinical exams, x-rays) (CDT codes: D0100-D0999) (must follow periodicity schedule) 2. Preventive (i.e., dental prophylaxis, topical fluoride treatments, sealants) (CDT codes: D1000-D1999) (must follow periodicity schedule) 3. Restorative (i.e., fillings, crowns) (CDT codes: D2000-D2999) 4. Endodontic (i.e., root canals) (CDT codes: D3000-D3999) 5. Periodontic (treatment of gum disease) (CDT codes: D4000-D4999)