Medicaid Final Rule on Former Foster Kids

The Centers for Medicare & Medicaid Services has published a final rule regarding Medicaid and children who have been in foster care. The new regulations address some of the provisions in January’s proposed rule, but one of the most pressing issues, whether former foster youth retain coverage when moving across state lines, remains outstanding.

Under the proposed rule, states would have the option to provide coverage to youth who were in care in a different state, but they would not be required to do so. Limiting coverage to the placement state could have the unfortunate result of restricting a youth’s ability to pursue education, other opportunities, or even relationships. Without federal intervention, cross-state issues often create unnecessary barriers to implementation of policies that help kids and families.

The final rule did finalize the following issues:

Presumptive Eligibility. Former foster youth is a population that can be determined presumptively eligible. Children currently in care have always been presumptively eligible. Hospitals must be allowed to make presumptive eligibility determinations based on income for all groups of presumptively eligible individuals, including former foster youth.

Exemption from Alternative Benefits Plan (ABP). Former foster youth under age 26 are exempt from mandatory enrollment in ABPs.

Early and Periodic Screening Diagnosis and Treatment (EPSDT). The rule clarifies that former foster youth are eligible for EPSDT services until age 21. Advocates, as well as the U.S. Department of Health and Human Services, have encouraged optimizing the use of the EPSDT benefit on behalf of children. EPSDT services must be made available to all children under 21, even if enrolled in an ABP.

Cost Sharing and Premiums Exemption. The final rule does not exempt former foster youth from cost sharing and premiums.

Post new comment

Refresh Type the characters you see in this picture.
Type the characters you see in the picture; if you can't read them, submit the form and a new image will be generated. Not case sensitive.  Switch to audio verification.
To prevent automated spam submissions leave this field empty.
©2015 Alliance for Strong Families and Communities. All Rights Reserved