GenIC #2 - CHIP State Plan Eligibility

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

#2 - IG_CS26 - Ending Dates of Eligibility_R1_Final_11-30-12

GenIC #2 - CHIP State Plan Eligibility

OMB: 0938-1188

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Template CS26 – General Eligibility - Ending Dates of Eligibility

Statute:

Regulation:


INTRODUCTION


To be completed by States with separate child health assistance programs.


In template CS26, States provide information as to the methodology used in determining the ending date of eligibility.


BACKGROUND


As with the beginning dates of eligibility, in determining the State’s methodology for the effective date or eligibility termination, States should take into consideration the coordinated transition of children between CHIP and other insurance affordability programs to avoid gaps in coverage.


TECHNICAL GUIDANCE


This template is broken down into the following sections:


Assurance

Ending Date of Eligibility

Rules for Pregnant Women, if applicable


Assurance

Template CS26 begins with the State being asked to provide an assurance that it determines the end date of eligibility in accordance with the provisions that follow.


The State provides this affirmative assurance by checking the box next to the assurance statement. If the State does not check this box, the system will not accept this template for review and approval


Ending Date of Eligibility

The State must select from the 5 options listed. Only one option may be selected.


If the State selects ‘Other‘, it must provide a description in the text box provided. The description must include an explanation of the date (e.g. 15th of the month, any time during the month), other factors considered (e.g. effective date new coverage) and rationale (e.g. avoid gaps in coverage).


Review Criteria

The description should be sufficiently clear, detailed and complete to permit the reviewer to determine that the State’s election meets applicable federal statutory, regulatory and policy requirements.


Rules for Pregnant Women


This section displays only for States that offer coverage to targeted low-income pregnant women.


This section consists of two policy statements and no entries are required by the State.

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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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