Title XXI Cost-Sharing Regulations for Medicaid Expansion Programs

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Title XXI Cost-Sharing Regulations for Medicaid Expansion Programs

In a February 1998 letter to State officials (this letter and other HCFA guidance can be found at http://cms.hhs.gov/schip/), the Health Care Financing Administration (HCFA) set out basic rules regarding cost-sharing in SCHIP.

For States implementing Medicaid expansion programs, the following rules apply:

Enrollment fees, premiums, or similar charges on children are permitted under certain circumstances.

Deductibles, coinsurance, copayments, or similar charges are prohibited.

State cost-sharing obligations imposed by Medicaid must be followed.

Cost-sharing must be "nominal."

Services may not be denied even if a cost-sharing charge cannot be paid.

Related Questions:

Give me an overall context

Give me an example

What's the Effect of Copayments and Premium Cost-Sharing on Access and Utilization in State Expansion Programs?

What other issues are talked about in this section?

Title XXI Cost-Sharing Regulations for Non-Medicaid Expansion Programs

Where else is HCFA Guidance discussed?

SCHIP Guidance - HCFA Guidance

Who presented this material?

Judith Arnold, Leighton Ku, Ph.D., M.P.H., and Rose M. Naff addressed the issue of cost-sharing at SCHIP seminar held in Sanibel Island, Florida, June 29-July 1, 1998. At the SCHIP seminar held later in Portland, Oregon, September 14-16, 1998, Rose Naff again addressed this issue.

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