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4.4. Describe the procedures that assure that:

4.4.1. Through the screening procedures used at intake and follow-up eligibility determination, including any periodic redetermination, that only targeted low- income children who are ineligible for Medicaid or not covered under a group health plan or health insurance coverage (including a state health benefits plan) are furnished child health assistance under the state child health plan. (Section 2102)(b)(3)(A)) (42CFR 457.350(a)(1) and 457.80(c)(3))

Applicants will be asked if the child has had health insurance coverage within the past 6 months. Enrollment in group health plan or health insurance group health plan or coverage within the last six months may remove the child from the low-income target group. (See Section 4.4.4.1.)

By using a joint Medicaid/KCHIP application process, the child is determined eligible for and enrolled or referred to the appropriate program. If the income and age limitations are not met, the child will be ineligible for either program.

Providers contracting with KCHIP will be required contractually to notify the Department for Medicaid Services whenever they have reason to believe a member has coverage other than KCHIP. The Department for Medicaid Services will then verify coverage with the insurance carrier and notify the family that they will be disenrolled if other coverage is verified.

4.4.2. The Medicaid application and enrollment process is initiated and facilitated for children found through the screening to be potentially eligible for medical assistance under the state Medicaid plan under Title XIX.

(Section 2102)(b)(3)(B)) (42CFR 457.350(a)(2))

Outreach efforts utilizing various community organizations will target low income families with children and provide them with information about the application process. . A joint application process is used to determine eligibility for Medicaid and KCHIP. The DCBS is the agency that does all eligibility determination for the Department for Medicaid Services.

4.4.3. The State is taking steps to assist in the enrollment in SCHIP of children determined ineligible for Medicaid. (Sections 2102(a)(1) and (2) and 2102(c)(2)) (42CFR 431.636(b)(4))

Using a joint Medicaid/KCHIP application process, children determined ineligible for Medicaid are identified for KCHIP, if the income and age limitations are met.

4.4.4 The insurance provided under the state child health plan does not substitute for coverage under group health plans. Check the appropriate box. (Section 2102)(b)(3)(C)) (42CFR 457.805) (42 CFR 457.810(a)-(c))