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2 Date Amendment #11 Submitted: September 7, 2010 Date Amendment #11 Approved: October 21, 2010 Date Amendment #11 Effective: July 1, 2010

Date Amendment #12 Submitted: December 28, 2010

Date Amendment#12 Approved: February 24, 2011 Date Amendment #12 Effective: October 1, 2010

Background

• Kentucky’s initial Medicaid expansion provided coverage for children ages 14 through 19 in families up to 100 percent of the Federal Poverty Level (FPL). Coverage was further expanded to children ages 1 to 19 in families up to 150 percent of the FPL.

• Children 0 to 19 years of age in families up to 200 percent of the FPL who are not otherwise eligible for Medicaid are enrolled in a separate child health program (KCHIP).

Amendments

• Kentucky implemented its first amendment on July 1, 1999, expanding eligibility for its SCHIP Medicaid expansion to 150 percent of the FPL for children from birth to age 19.

• On June 19, 2000, Kentucky submitted its second amendment to change the service delivery mechanism by substituting the existing Medicaid infrastructure, and to create a separate child health program for children with family income between 150 and 200 percent of the FPL. Eligibility and health care services are provided through the existing Medicaid service delivery system. Cost sharing was deleted.

• On August 28, 2001, Kentucky submitted a third amendment to its title XXI plan to change the enrollment and recertification process in both the Medicaid expansion and separate child health programs. Beginning June 1, 2001, the Department for Medicaid Services (DMS) resumed requiring written verification of income and proof of child-care expenses with the KCHIP/Medicaid initial mail-in application. DMS also resumed face- to-face interviews and verification of income and expenses for recipients at the time of their KCHIP recertification. The amendment also updated the description of the State's service delivery model.

• On June 27, 2002, Kentucky submitted a fourth amendment that updates and amends the State plan to indicate the State’s compliance with the final SCHIP regulations and to change the initial application and renewal processes.

• On September 24, 2002, Kentucky submitted a fifth amendment to charge 18-year olds a $1 copayment for pharmacy prescriptions.

• On July 25, 2003, Kentucky submitted its sixth amendment to charge 18-year olds $2 copayments for office visits to dentists (except for preventive dental visits), optometrists, opticians, audiologists, hearing aid dealers, chiropractors and podiatrists.