This letter is one of a series that provides guidance on the implementation of the Children?s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), Public Law 111-3. CHIPRA includes several provisions that are designed to ensure immediate coverage for newborn babies born to mothers who are enrolled in Medicaid or the Children?s Health Insurance Program (CHIP). These new provisions can be found at sections 111, 113, and 211 of CHIPRA and are described in detail below. The effective date for these provisions was April 1, 2009. The Centers for Medicare & Medicaid Services (CMS) provided general information on the eligibility of such newborns in its May 11, 2009, letter to State Health Officials (SHO #09-006). This letter and enclosure provide further guidance on the eligibility of deemed newborns to help States effectively implement this provision.
Taken together, these new provisions, along with provisions in place prior to CHIPRA, are designed to assure that babies born to women covered by Medicaid or CHIP are automatically enrolled in Medicaid or CHIP for 1 year. The new provisions under CHIPRA:
- Extend deemed newborn eligibility under Medicaid or CHIP to children born to mothers receiving CHIP coverage.
- Eliminate the Medicaid requirement that, in order to receive coverage under Medicaid, newborns coming home from the hospital must live with the mother, remain a member of the mother?s household, and that the mother remain eligible for Medicaid (or would remain eligible if still pregnant).
- Amend the citizenship documentation requirements added by the Deficit Reduction Act of 2005 (DRA) to provide that children who were initially eligible for Medicaid or CHIP as deemed newborns shall be considered to have provided satisfactory documentation of citizenship and identity when their eligibility is renewed on their first birthday.
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