GenIC #2 - CHIP State Plan Eligibility

Medicaid and CHIP Program (MACPro) (CMS-10434)

#2 - IG_CS16 - Spenddown_R1_Final_11-30-12

GenIC #2 - CHIP State Plan Eligibility

OMB: 0938-1188

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Template CS16 – Spenddown(s)

Statute: Section 2102(b) of the SSA

Regulation: 42 CFR 457.320(a)(5)


INTRODUCTION


In this template States indicate whether they apply spenddown and if so, provide information as to their application of spenddown.


BACKGROUND


States have the option of applying spenddowns with respect to determining financial eligibility for CHIP.


TECHNICAL GUIDANCE


This template includes a Y/N question for State to indicate if the State applies a Spenddown process for any of the covered population groups whose household income exceeds the CHIP qualifying income limit.


If the answer is yes, a text box displays for the State to provide a description of the types of spenddowns used in CHIP and how they are applied.


Review Criteria

The description should be sufficiently clear, detailed and complete to permit the reviewer to understand what expenses are allowed as spenddowns and how the state treats them in the income calculation for determining eligibility.


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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorRoy Trudel
File Modified0000-00-00
File Created2021-01-22

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