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Louisiana Medicaid Eligibility Manual Eligibility Factors

Issued June 11, 2021

Page 1 of H-3010 Replacing May 22, 2014 Revised/added text indicated by underscore

Deleted text indicated by “**” H-3010 CHILDREN UNDER AGE 19 GROUP - DEEMED NEWBORN CHILDREN

H-3011 GENERAL INFORMATION

A child born to a woman determined eligible for Medicaid benefits in any category on the date the child is born shall be deemed Medicaid eligible for up to one year.

This includes a child ** born to a woman who is determined retroactively eligible for the date the child was born or to a non-citizen mother eligible for emergency services only.

Exceptions: • Do not deem the newborn if the mother is certified for Qualified Medicare Beneficiary (QMB)-only, Specified Low- Income Medicare Beneficiary (SLMB)-only, Qualified Disabled and Working Individuals (QDWI) or Qualifying Individuals Program (QI). • Do not deem the newborn if the mother is certified for a state-funded program only. (Refer to ** E-330 Category I.) Consider eligibility in another program.

An application for assistance or financial eligibility determination is not required for the deemed newborn.

Under the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), the deemed newborn’s eligibility is no longer dependent on: • The newborn coming home from the hospital to live with the mother, • The newborn remaining in the mother’s household, or • The mother remaining Medicaid eligible (or would be eligible if still pregnant).

The Patient Protection and Affordable Care Act of 2010 ** (ACA) combines all mandatory and optional eligibility groups for individuals under age 19 into one coverage group. The Children Under Age 19 Group includes those newborns covered under Deemed Newborn Children.