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3 • On October 29, 2003, the State submitted its seventh amendment to impose premiums of $20 per family per month for families with incomes from 151 through 200 percent of the FPL. In addition, the amendment revises KCHIP performance goals to increase consistency with available performance data, to make the goals more achievable given current performance in meeting the initial goals and to bring one performance goal in line with the State’s “Healthy Kentuckian” initiative.

• On April 27, 2006, Kentucky submitted its eighth amendment to change benefits, cost- sharing requirements, and care delivery system for children with family income above 150 percent of the FPL up to 200 percent of the FPL. Kentucky removed coverage for inpatient and outpatient substance abuse services. Delivery of services for all children will be through a Medicaid managed care capitated system, except for those children living in Louisville and the surrounding counties who will remain enrolled in a Health Care Partnership, known as the Passport Health Care Plan. In addition to the current $20 per month premium that families pay, cost sharing is added for all children in the form of copayments for prescription drugs, office visits and testing for allergy services, and non- emergency use of the emergency room. Total annual out-of-pocket expenses for medical costs and for pharmacy costs are capped at $225 each for a total of $450.

• On November 1, 2008, Kentucky submitted its ninth SCHIP amendment to simplify the enrollment process. Note: This amendment was withdrawn on December 20, 2008.

• On December 10, 2008, Kentucky submitted its tenth CHIP amendment to streamline its enrollment process by removing the requirement for a face-to-face interview for its KCHIP. The applicant may now apply through a mail-in application and there are many agencies available to assist families in determining what information is needed. The applications can be downloaded from the KCHIP website, by calling a toll-free number, or obtained at a variety of localities throughout the State including the local Department of Community Based Service (DCBS) Office, health departments, physician offices, primary care centers and hospitals. The SPA also adds a 30-day grace period for an enrollee to return the eligibility recertification form.

• The State submitted its eleventh CHIP amendment, on September 7, 2010, to eliminate the $20 monthly premium charged to children enrolled in the State’s separate CHIP.

• Kentucky submitted its twelfth CHIP amendment on December 28, 2010 to extend CHIP eligibility to children of employees of public agencies who are otherwise eligible under the State plan. The State will provide this coverage under the hardship exception to the exclusion of employees of a public agency of a State, in accordance with section 10203 of the Affordable Care Act of 2010. Through this expansion, Kentucky anticipates covering an addition 750 children under title XXI in FFY 2011.

Children Covered Under Program

• The State reported that 79,380 children were ever enrolled in CHIP during FY 2010.