|
|
CMS Issues New Guidance on August 17,
2007
SCHIP "Crowd Out" Directive
|
On
Wednesday, May 7, the Centers for Medicare and
Medicaid Services (CMS) issued a new
letter to state health officials providing
further guidance on the
August 17, 2007 CMS SCHIP "crowd out" directive.
This May 7 CMS guidance intends to clarify
components of the August 17 CMS directive, and
address some of the concerns that have been
raised about its negative impact on states'
abilities to cover children in SCHIP, especially
those above 250% of the federal poverty level
(FPL).
The
May 7 CMS guidance clarifies that:
*
Changes made to state crowd-out procedures
because of the August 17 directive need not
apply to existing enrollees in SCHIP;
*
Crowd-out procedures - particularly the 12-month
uninsurance period requirement and the
cost-sharing requirement - need not apply to
enrollees under 250% FPL; and
*
States will have flexibility in ensuring they
meet the requirement that at least 95% of
children in the state below 200% FPL eligible
for Medicaid or SCHIP have coverage.
The
CMS guidance indicates CMS will work with states
individually to ensure that the 95% coverage
requirement is met, including efforts to use
data from sources other than the Current
Population Survey (CPS). The guidance also
suggests that CMS will review alternate
proposals by states to document crowd-out
prevention on a case-by-case basis. A
Wall Street Journal
article today provides further insight into
the guidance.
While the May 7 CMS guidance is a step towards
ensuring children do not lose existing SCHIP
coverage, how the CMS guidance affects states'
abilities to cover additional uninsured children
remains to be determined. The Academy will
continue to advocate that the August 17, 2007
CMS directive be rescinded, and we will provide
further information on this issue as it becomes
available.
If
you have questions or need additional federal
information, please contact Bob Hall in the
Department of Federal Affairs at 202/347-8600
ext 3309, or
rhall@aap.org. For additional
state-level questions or information, please
contact Dan Walter in the Division of State
Government Affairs at 800/433-9016 ext. 4086, or
dwalter@aap.org.
The Division of State Government Affairs sends
this update to the Academy's Executive
Committee, Board of Directors, District
Vice-Chairs, Chapter Presidents, Chapter Vice
Presidents, Chapter Legislative Contacts,
Committee on State Government Affairs, Committee
on Federal Government Affairs, Chapter Executive
Directors, and other interested AAP members and
staff.
For additional state legislative information,
strategy suggestions, in-depth resources on
issues of pediatric interest, and past editions
of this update, log onto the
AAP
Member Center and see the State Government
Affairs area at
http://www.aap.org/moc/statelegislation.
|
AAP
Division of State Government Affairs
- May 8, 2008