1860.005.00 Legal Basis – DSS Manuals

IM-135 August 28, 2019 ; IM-152 November 30, 2017 ; IM-125 December 31, 2013

The Social Security Act 1902 (e)(4) provides automatic Medicaid eligibility to newborns.

13 CSR 40-2.260 provides that newborns of a woman eligible for Title XIX (Medicaid known as MO HealthNet in Missouri) on the date the child is born are deemed to have filed an application and been found eligible for Title XIX.

The Omnibus Budget Reconciliation Act of 1990, Section 4603, provides that newborns born on or after January 1, 1991, are eligible for Title XIX, for one year, if they are a member of their mother’s household and she remains eligible (or if still pregnant would remain eligible) for MO HealthNet. Missouri Rule 13 CSR 40-2.260 has been amended to provide for this coverage.

The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), Public Law 111-3 included provisions in section 111, 113, and 211 designed to ensure immediate coverage for newborn babies born to mothers who are enrolled in Medicaid or the Children’s Health Insurance Program.

Code of Federal Regulations (42 CFR 435.117, amended Nov. 30, 2016) established guidelines for mandatory coverage Deemed Newborn Children. The section implements sections of 1902(e)(4) and 2112(e) of the Social Security Act.