2525 Twelve-Month Continuous Eligibility

Official source

A. Act 128 of the First Extraordinary Session of the 1998 Louisiana Legislature authorized the Department to adopt the guaranteed eligibility option for children, pursuant to §4731 of the Balanced Budget Act (BBA) of 1997. These provisions allow states to guarantee Medicaid eligibility for children, under age 19, for up to 12 months from the date of determination.

B. Children who are under age 19 and certified in a child-related or family-related category of assistance are entitled to 12 months of continuous Medicaid eligibility as long as eligibility does not extend beyond the child’s nineteenth birthday.

C. A child’s eligibility may not be terminated during a continuous eligibility period, regardless of any changes in circumstances, unless the child meets an exception set forth in 42 CFR 435.926(d) or 42 CFR 457.342.

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 34:253 (February 2008), amended by the Department of Health, Bureau of Health Services Financing, LR 47:737 (June 2021), LR 49:1394 (August 2023).

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2525 Twelve-Month Continuous Eligibility

Official source

A. Act 128 of the First Extraordinary Session of the 1998 Louisiana Legislature authorized the Department to adopt the guaranteed eligibility option for children, pursuant to §4731 of the Balanced Budget Act (BBA) of 1997. These provisions allow states to guarantee Medicaid eligibility for children, under age 19, for up to 12 months from the date of determination.

B. Children who are under age 19 and certified in a child-related or family-related category of assistance are entitled to 12 months of continuous Medicaid eligibility as long as eligibility does not extend beyond the child’s nineteenth birthday.

C. A child’s eligibility may not be terminated during a continuous eligibility period, regardless of any changes in circumstances, unless the child meets an exception set forth in 42 CFR 435.926(d) or 42 CFR 457.342.

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 34:253 (February 2008), amended by the Department of Health, Bureau of Health Services Financing, LR 47:737 (June 2021), LR 49:1394 (August 2023).