Page 72

MRG UPDATED: JUNE 2010 70 CATEGORICAL FACTORS CHILD HEALTH PLUS Description: The federal Balanced Budget Act (BBA) of 1997 (Public Law 105-33) created the State Children’s Health Insurance Program as Title XXI of the Social Security Act (Child Health Plus in New York State). Policy: Title XXI provides health care coverage to low-income children who are currently uninsured. Pursuant to Title XXI, New York State enhanced its existing Child Health Plus program. Any child who is determined financially ineligible for Medicaid is referred to Child Health Plus (CHPlus). References: Public Health Law – Title 1-A of Article 25 Dept. Reg. 360-4.8 ADMs 10 OHIP/ADM-4 98 OMM/ADM-8 91 ADM-18 91 ADM-11 89 ADM-40 Interpretation: As part of the process of applying for CHPlus children are screened to ascertain whether they appear to be Medicaid eligible. Any applying children who appear to be Medicaid eligible will be required to apply for Medicaid. This process also applies to children who are currently enrolled in CHPlus and appear potentially Medicaid eligible at the time of annual CHPlus recertification. State law requires significant outreach efforts for both CHPlus and Medicaid. These efforts include public education campaigns and the designation of community-based enrollers who will assist children applying for and enrolling in CHPlus or Medicaid, whichever is appropriate. The enroller will submit applications to the local department of social services (LDSS). If an LDSS receives an application for a child who is ineligible for Medicaid due to excess income or immigration status and a plan selection has been made, the LDSS must, on a daily basis, mail the application and documentation, including a copy of the ineligible Medicaid budget for cases denied for excess income, directly to the selected CHPlus plan. If a plan selection has not been made and there is only one CHPlus plan in the county, the application and supporting documentation is mailed directly to that plan. If a plan selection was not made and there are multiple CHPlus plans available in the county, the LDSS must send the application and supporting information to the Corning Tower, Room 1619, Empire State Plaza, Albany, New York 12237.