CMS-10398 #17 Eligibility - Deemed Newborns

OMB Control Number 0938-1148

Separate Child Health Insurance Program
Eligibility – Deemed Newborns

CS13

Section 2112(e) of the SSA and 42 CFR 457.360

Deemed Newborns – Children born to targeted low-income pregnant women are deemed to have applied for and be eligible for CHIP
or Medicaid until the child turns one.
The state operates this covered group in accordance with the following provisions:
The child was born to an eligible targeted low-income pregnant woman under section 2112 of the SSA
The child is deemed to have applied for and been found eligible for CHIP or Medicaid, as appropriate, as of the date of the
child’s birth, and remains eligible without regard to changes in circumstances until the child’s first birthday.
The state elects the following option(s):
The state elects to cover as a deemed newborn a child born to a mother who is covered as a targeted low-income child under
the state’s separate CHIP on the date of the newborn’s birth.
The state elects to recognize a child’s deemed newborn status from another state and provides benefits in accordance with the
requirements of section 2112(e) of the SSA.
The state elects to cover as a deemed newborn a child born to a mother who is covered under Medicaid or CHIP through the
Authority of the state’s section 1115 demonstration on the date of the newborn’s birth.

PRA Disclosure Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a
valid OMB control number. The valid OMB control number for this information collection is 0938-1148 (CMS-10398 #17). The time
required to complete this information collection is estimated to average 50 hours per response, including the time to review instructions,
search existing data resources, gather the data needed, and complete and review the information collection. If you have comments
concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard,
Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.

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