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Background

• On May 14, 1998, North Carolina submitted its Title XXI State plan, which created a separate State health insurance program to provide coverage to uninsured children whose family income does not exceed 200 percent of the Federal poverty level (FPL). Enrollees whose annual income increases above 200 percent of the FPL to 225 percent of the FPL will be allowed to buy into the program for one year at full cost.

Title XXI Amendments

• North Carolina submitted its first amendment request on October 21, 1998. This amendment reflected State legislation amending the definition of "uninsured" so that the State's required period of uninsurance would not apply to children who had coverage through the Caring Foundation, which coverage had ceased. This amendment was approved on January 15, 1999.

• North Carolina submitted a second amendment on March 26, 1999. This amendment reflected the change in North Carolina General Statute, which expands the acceptable sites for the delivery of clinic services to include School-Based Health Centers. This amendment was approved on June 23, 1999.

• North Carolina submitted a third amendment on July 12, 1999. This amendment reflected changes in North Carolina's General Statute, which allowed the expansion of the dental services benefit by providing fluoride applications, sealants, simple extractions, therapeutic pulpotomies, and prefabricated stainless steel crowns. This amendment was approved on September 30, 1999.

• North Carolina submitted its fourth amendment on August 3, 2000. This amendment eliminated cost sharing for documented Native Americans and exempted special needs children from the 2-month waiting period of uninsurance required for program eligibility if health insurance benefits have been terminated due to a long-term disability or substantial reduction in or limitation of lifetime medical benefits or benefit category. This amendment was approved on October 19, 2000.

• North Carolina submitted its fifth amendment on November 21, 2000. This amendment established a freeze on new program enrollment effective January 1, 2001, at which time enrollment was approximately 72,000. North Carolina lifted the freeze on new enrollment effective October 8, 2001.

• North Carolina submitted its sixth amendment on October 12, 2001. This amendment reopens the program to all eligible enrollees by ending the active waiting list effective October 8, 2001. The amendment also eliminates the 60-day period of uninsurance currently called for in the State's Title XXI plan.