For those interested, CSAC would like to share that the Centers
for Medicare and Medicaid Services (CMS) issued new
guidance in response to the Consolidated
Appropriations Act, 2023 (P.L.
117-328) (CAA). This guidance addresses statutory
requirements set forth in the CAA, impacting Medicaid and the
Children’s Health Insurance Program (CHIP) services and
eligibility for youth detained in public institutions, including
jails, prisons, and juvenile justice facilities. The required
coverage changes will take effect on January 1, 2025, and states
must submit Medicaid and CHIP state plan amendments by this
date.
Eligibility: Youth under 21 enrolled in
Medicaid before or during incarceration, including former
foster care children, are eligible. States can receive federal
funding for Medicaid services for eligible youth awaiting
trial.
Screenings and Diagnostic Services: States
must provide medical and dental screenings and diagnostic
services to eligible youth within 30 days before release and no
later than one week after release, following EPSDT standards.
Targeted Case Management: States must offer
targeted case management services, including referrals, as part
of the Medicaid state plan.
CHIP Services:
Screening, Diagnostic, and Case Management
Services: Similar to Medicaid, CHIP services must
include screenings, diagnostic services, and case management 30
days before the release of eligible youth.
Continuous Coverage: The CAA allows states to
suspend or continue CHIP coverage during a child’s
incarceration rather than terminate it. CHIP coverage cannot
end at the conclusion of a child’s continuous eligibility
period if they remain incarcerated. States must reassess CHIP
eligibility before a child’s release and may extend CHIP
coverage to youth awaiting trial.
