Title XXI Outreach and Enrollment
Regulations: Legislation and HCFA (now CMS) Suggested Approaches
In addition, the President’s fiscal year 1999
budget included proposed legislation for enhanced matching for children’s outreach
efforts that allowed a 90 percent matching rate for outreach activities for all
uninsured children, not just those who were eligible for welfare (as covered
by the welfare reform bill’s Medicaid Fund ). Originally, matching
funds were provided only for outreach activities to Medicaid eligible children.
In the January
23, 1998, letter to State officials (this letter and other HCFA (now CMS) guidance can be found at http://www.cms.hhs.gov/home/schip.asp  ), the Health Care Financing Administration (HCFA), now the Centers for Medicare and Medicaid Services (CMS), made the
following two suggestions for expanding enrollment of children into SCHIP:
- Allow Immediate Coverage by Means of Presumptive
Eligibility. The presumptive eligibility option allows a qualified entity or its
employees to presume temporary eligibility for Medicaid if the child’s family income
does not exceed the State’s applicable income eligibility level. States could also
use this option in eligibility determination for a SCHIP separate State program.
- Outstation Eligibility Workers in Communities.
Outstationing involves locating eligibility workers in places other than welfare offices
to assist with the initial processing of applications. States can receive Federal matching
funds for outstationing eligibility workers. HCFA (now CMS) is encouraging States to consider
outstationing eligibility workers at sites such as schools, child care centers, churches,
Head Start centers, Job Corps sites, and GED programs.
According to HCFA (now CMS), the key to successfully enrolling
children at a wide range of sites is a simple application and enrollment process.
Suggested methods for simplifying enrollment include the following:
- Shortened and reduce the complexity of the
application form.
- Utilize less restrictive eligibility methodology.
- Reduce the “excessive” verification
requirements.
- Utilize a single application for Medicaid and SCHIP.
- Granting 12-month continuous eligibility.
The HCFA (now CMS) January
23, 1998, letter to State officials (this letter and other HCFA (now CMS) guidance can be found at http://www.cms.hhs.gov/home/schip.asp ), also provides examples of simplified Medicaid
application forms, a model joint application for SCHIP-Medicaid, a list of States
that have simplified the Medicaid application process, and a discussion of specific
outreach strategies currently being practiced or considered that States may use to
increase enrollment of eligible children into Medicaid.
Related
Questions
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Where else is HCFA (now CMS) guidance discussed?
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material?
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Outreach/Enrollment 
