What Are SCHIP Requirements Regarding Medicaid Substitution

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SCHIP Requirements Regarding Medicaid Substitution

In addition to concerns regarding substitution of SCHIP for private coverage, there is also a concern that States may favor enrollment of children in SCHIP rather than Medicaid because of the enhanced matching rate available to States for children covered under SCHIP. Therefore, Title XXI contains three provisions to prevent substitution of SCHIP for current Medicaid coverage:

State plans must include assurances that the State will coordinate its SCHIP program with other public and private programs, including Medicaid.

States choosing to create a non-Medicaid SCHIP program must maintain Medicaid eligibility efforts, and, more specifically, the State cannot adopt more restrictive income and resource methodologies for Medicaid eligibility.

Children who apply for SCHIP must be screened for Medicaid eligibility and, if found eligible, enrolled in Medicaid.

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Give me an overall context

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What Is the Regulatory Guidance Regarding Crowd-Out Under SCHIP?

Where else is HCFA guidance discussed?

SCHIP Guidance - HCFA Guidance

Who presented this material?

Lisa Dubay

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