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similar fees prior to disenrollment. (42 CFR 457.570(a))
The disenrollment process affords the enrollee an opportunity to show that the enrollee’s family income has declined prior to disenrollment for non payment of cost-sharing charges. (42 CFR 457.570(b))
In the instance mentioned above, that the state will facilitate enrolling the child in Medicaid or adjust the child’s cost-sharing category as appropriate. (42 CFR 457.570(b))
The state provides the enrollee with an opportunity for an impartial review to address disenrollment from the program. (42 CFR 457.570(c))
8.8 The state assures that it has made the following findings with respect to the payment aspects of its plan: (Section 2103(e))
8.8.1
No Federal funds will be used toward state matching requirements. (Section 2105(c)(4)) (42 CFR 457.220) 8.8.2
No cost-sharing (including premiums, deductibles, copays, coinsurance and all other types) will be used toward state matching requirements. (Section 2105(c)(5) (42 CFR 457.224) (Previously 8.4.5) 8.8.3
No funds under this title will be used for coverage if a private insurer would have been obligated to provide such assistance except for a provision limiting this obligation because the child is eligible under the this title. (Section 2105(c)(6)(A)) (42 CFR 457.626(a)(1)) 8.8.4
Income and resource standards and methodologies for determining Medicaid eligibility are not more restrictive than those applied as of June 1, 1997. (Section 2105(d)(1)) (42 CFR 457.622(b)(5))
WISCONSIN
Effective Date:
Approval Date: 44