8111.3 Limited Pre-release Benefit Plan for Certain Incarcerated Youth and Adults

While the Medicaid inmate payment exclusion applies to incarcerated individuals in most cases, federal legislation under the Consolidated Appropriations Act (CAA) of 2023 requires that certain services must be covered by Medicaid and CHIP for incarcerated youth and adults up to 21 who are post-adjudication (or sentencing) and within 30 days of their release date if they qualify for Medicaid and CHIP programs. This means that when a Medicaid/CHIP recipient or an individual who qualifies for Medicaid/CHIP under the age of 21, or an AGO eligible individual age 26 or under becomes incarcerated, the facility must ensure that certain services are provided for the required timeframe and that the Medicaid/CHIP agency is billed for these services.

The population qualifying for special services under this policy are defined as eligible juveniles and children or young adults who meet the following criteria:

Eligible for Medicaid (either currently in a CE period or determined eligible based on an application)

Eligible for CHIP (either currently in a CE period or determined eligible within 30 days prior to release.)

Under 21 years of age or between the ages of 18-26 if aged out of the foster care system, including the Kansas Department of Corrections Juvenile Services (KDOC-JS)

Are being held in a carceral/correctional facility after being convicted

Received specific services (see below) during the 30 days prior to their official release

The special services referred to above consist of screening and diagnostic services (also referred to as EPSD) and targeted case management (TCM) or case management only for CHIP.