Page 3

below 192 percent of the FPL. The State also reduced cost-sharing requirements and added new benefits to CHPlus.

• New York submitted its third amendment on March 21, 2001, to expand income eligibility in CHPlus to children with gross family incomes at or below 250 percent of the FPL or the net equivalent of 200 percent of the FPL after application of income disregards.

• New York submitted its fourth amendment on March 27, 2002, to provide coverage for children ages 6 through 18 with net family income at or below 133 percent of the FPL in the State’s CHIP Medicaid expansion effective April 1, 2002. These children were previously covered under the State’s separate child health program. The State also implemented two temporary modifications to its program as a result of the events of September 11, 2001, and added a benefit to its state plan.

• New York submitted its fifth amendment on March 31, 2003. This amendment updated and amended the CHIP State plan to indicate the State’s compliance with the final CHIP regulations and to add a hospice benefit.

• The State submitted its sixth amendment on March 22, 2004, to revise the CHIP plan to implement a simplified renewal application, provide a 2-month grace period of eligibility at renewal, change the income verification process at renewal, and update other portions of the State plan.

• The State submitted its seventh amendment on March 30, 2005, to begin the phase-out of the CHIP Medicaid expansion program effective April 1, 2005, for children ages 6 through 18 with family income between 100 percent and 133 percent of the FPL and transition them into either Medicaid or the separate child health program at the annual redetermination of eligibility. The amendment also updated other portions of the State plan effective April 1, 2004.

• New York submitted its eighth amendment on March 31, 2006, with a retroactive effective date of April 1, 2005. This amendment instituted 12 months of continuous eligibility without regard to changes in income, although families are required to report changes in residency and access to other health insurance coverage. The amendment allowed for termination of the continuous eligibility period once the child reaches the age of 19, becomes enrolled in Medicaid, or for non-payment of the applicable premium.

• New York submitted its ninth amendment on April 4, 2007, to implement changes in the purchasing and distribution of immunizations to CHIP children. New York will be distributing State purchased vaccines to participating program providers for all CHIP enrollees. Prior to this change, health plans were responsible for obtaining and providing all required immunizations to CHIP enrollees, and vaccine costs were included in the capitated payments made to the health plans. Additionally, this amendment verifies completion of the phase-out of the CHIP Medicaid expansion during Federal fiscal year (FFY) 2006.