1. CMS Update/Issues Discussion Cheryl Camillo Supporting Families After Welfare Reform Breakthrough Series Collaborative Learning Session #3 Charleston, SC April 22-24, 2003

2. Update

3. 2004 Budget Proposals (http:/www.hhs.gov/budget/04budget/fy2004bib.pdf) Medicaid reform  Builds on HIFA waivers New Freedom Initiative  3 new demonstration projects  Provides eligiblity to spouses of disabled workers who are entering the workforce  Provides presumptive eligibility for institutionally qualified individuals discharged from the hospital into the community Expiring SCHIP funds  Extends availability of expiring funds through FY 2004

4. 2004 Budget Proposals (http:/www.hhs.gov/budget/04budget/fy2004bib.pdf) QI  Extends for 5 years TMA  Extends for 5 years  Provides option of 12 months continuous eligibility  Provides option to waive reporting requirements  Is optional for states that have extended eligibility to families with incomes of 185% of the FPL  Provides option to provide health coupons instead of traditional Medicaid in second six-month period

5. Section 1925 TMA Was extended through June 30, 2003 by the omnibus appropriations bill enacted in February. The TANF Reauthorization bill passed by the House (H.R. 4) would extend it through FY 2004. However, it contains an offset of administrative costs. The Senate Finance Committee has yet to mark-up the bill.

6. DEHPG Priorities Implementing the New Freedom Initiative (http//www.cms.hhs.gov/newfreedom) Working with states to develop creative solutions to state budget crises.

7. SCHIP Priorities Reminding states to factor in the Title XXI maintenance of effort requirement as they consider rolling back eligibility for children. CMS recently approved two state plan amendments (Michigan and Rhode Island) to provide prenatal care to unborn children. Provided interim strategy via State Medicaid Director letter (http://cms.hhs.gov/states/letters/smd032703.pdf) for redistributing unspent FY 2000 SCHIP funds.http://cms.hhs.gov/states/letters/smd032703.pdf

8. HIPAA/Privacy We hope to issue guidance to states soon.

9. Issues

10. School-Based Services Federal requirements are described in detail in “Medicaid and School Health – A Technical Assistance Guide,” which can be found on our web site at: http://www.cms.hhs.gov/medicaid/schools/scbintro.asp Costs related to services are billed at the services/FMAP rate.  May 21, 1999 State Medicaid Director letter (http://cms.hhs.gov/states/letters/smd52199.asp)http://cms.hhs.gov/states/letters/smd52199.asp clarified reimbursement policy.

11. School-Based Services Medicaid may also reimburse at the 50% rate for administrative activities.  We hope to publish the final version of the administrative claiming guide this month. For questions:  General: Linda Tavener @ (410) 786-3838  Administrative claiming: Richard Strauss @ (410) 786-2019

12. Implementing Eligibility Reductions Submit an approvable state plan amendment (SPA), if appropriate. Provide proper notice to recipients per 42 CFR 431, Subpart E. Provide appropriate training to staff.

13. MEQC Procedures September 12, 2000 State Medicaid Director letter (http://cms.hhs.gov/states/letters/smd91200.asp) provides details re: MEQC pilots and alternative negative case action reviews.http://cms.hhs.gov/states/letters/smd91200.asp For questions, call Janet Reichert at (410) 786-4580.

14. Renewals Must be done at least once every 12 months with respect to circumstances that may change. States must have procedures for timely and accurate reporting of changes. States must conduct ex parte reviews.

15. Renewals There is no signature requirement. Only a change in citizenship status must be verified. There is no interview requirement.

16. Renewals Ex parte renewals Telephone renewals Passive renewals Using info from other programs