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OCR Page 1 of 16wefaleat
ce: Devarch
Edush
CENTER ON BUDGET
Marcy
AND POLICY PRIORITIES
from: Andrea
In case jav didnt see
Revised June 12, 2000
then f:
Issues for Consideration As States Reinstate Families That
Health-
Were Improperly Terminated from Medicaid Under Welfare Reform
Medicard
efters
by Liz Schott
4/2000
On April 7, 2000, the Health Care Financing Administration issued a letter to State
Medicaid Directors expressing concerns that families have lost Medicaid coverage when they
stopped receiving benefits under the state's Temporary Assistance for Needy Families program.¹
The letter notes that states have expanded eligibility for and simplified access to Medicaid for
low-income working families in many respects, but at the same time many families may have
improperly lost access to Medicaid when leaving welfare. Building upon federal and state efforts
to improve the ability of eligible, low-income families that left TANF to enroll and remain
enrolled in Medicaid, the HCFA letter specifically addressed three topics related to families
improperly losing Medicaid coverage under welfare reform.
The letter requires states to identify and reinstate families that, since the inception
of the state's TANF program, had Medicaid benefits improperly terminated when
their TANF case was closed or when Transitional Medical Assistance ended.
States must then review the reinstated families for ongoing Medicaid eligibility
prior to stopping the reinstated benefits.²
The letter clarifies longstanding federal requirements that states must review
ongoing Medicaid eligibility on an ex parte basis - that is, whenever possible,
without contacting the recipient - prior to stopping Medicaid, and addresses the
circumstances under which a state can ask a family to provide additional
information.
The letter also addresses state obligations to ensure that state computer systems
are not improperly denying or terminating persons from Medicaid.
1
The HCFA letter is available at http://hcfa.hhs.gov/medicaid/smd40700.htm. HCFA subsequently has posted
additional questions and answers on the April 7 letter on its website at http://hcfa.hhs.gov/medicaid/q&a40700.htm
2
The letter also requires states to identify and reinstate any children who lost eligibility for SSI due to the 1996
law change in the SSI disability standards and who were terminated from Medicaid when they lost SSI either
without adequate consideration of their potential Medicaid eligibility under Section 4913 of the Balanced Budget
Act (which provided a basis for ongoing Medicaid eligibility) or without a proper redetermination. The HCFA
letter directs states to compare the Social Security Administration list with their current Medicaid rolls and reinstate
any children not properly terminated or, if receiving Medicaid, not properly identified as a 4913 child. This
memorandum focuses on the reinstatements arising from TANF-related Medicaid terminations, which present a
different set of issues than the reinstatements of children who lost SSI.
F:\sfp\LIZ S\TANFMA conf\considerationsfinal.wpd
820 First Street, NE, Suite 510, Washington, DC 20002
Tel: 202-408-1080 Fax: 202-408-1056 [email protected] http://www.cbpp.org HN0026
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