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• On April 12, 2007, New York submitted its tenth amendment seeking to increase the financial eligibility standard for its separate CHIP from the current family income eligibility level at or below 250 percent of the FPL to family income at or below 400 percent of the FPL. The amendment also proposed to implement a 6-month waiting period of prior uninsurance for children with family incomes above 250 percent of the FPL, with certain listed exceptions. This amendment was disapproved.

• On May 14, 2007, New York submitted its eleventh amendment to eliminate temporary enrollment in CHIP of children who appear to be Medicaid eligible at the time of initial application, while their Medicaid eligibility is being determined for up to a 2-month period. The amendment also allows children to remain enrolled in CHIP at the annual re- determination when they appear to be Medicaid eligible until the Medicaid eligibility determination is completed and the child is enrolled in Medicaid. For a child enrolled in Medicaid, expenditures made after the CHIP redetermination and during the Medicaid retroactive eligibility period will be claimed under the Medicaid program (and no payment will be made for duplicative payments). This provision ensures continuity of care for children during the transition between programs and fiscal integrity for the CHIP program.

• New York submitted its twelfth amendment on March 18, 2009, as the replacement for its tenth amendment. This amendment increases the effective financial eligibility standard for New York’s separate CHIP from the current family income level at or below 250 percent of the FPL to the family income level at or below 400 percent of the FPL. The amendment also implements a 6-month waiting period of prior uninsurance for children with family incomes above 250 percent of the FPL, allows ten exceptions to this waiting period, and imposes premiums for children in this income range.

• On June 30, 2009, New York submitted its thirteenth amendment to implement the new provision permitted by section 214 of the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), which gives States the option to provide coverage with Federal funds under Medicaid and CHIP to certain non-citizen children who are lawfully residing in the United States.

• On July 6, 2009, New York submitted its fourteenth amendment to implement premium increases for children with gross family incomes between 251 and 400 percent of the FPL, as approved by its State legislature as part of the 2009-2010 State budget.

• New York submitted its fifteenth amendment on March 29, 2010, to demonstrate compliance with CHIPRA provisions regarding the premium grace period, mental health parity, and reimbursement of federally qualified health centers (FQHCs) and rural health clinics (RHCs) using a prospective payment system (PPS). The amendment also makes minor programmatic updates regarding the application form and outreach activities.

Children Covered Under the Program

• The State reported that 532,635 children were ever enrolled in its program during FFY 2009.