Children in foster care or out-of-home placement
GA | MS | NE | NY "704. Exclusions from GBHC Participation
1. Recipients who meet any of the following conditions are excluded from participation in the GBHC plan: ...
c. Children in foster care..." Georgia Agreement, page VII-1."Medicaid clients in the above categories of Medicaid eligibility are excluded from participation in HealthMACS in the following circumstances: ...
6. Client is a foster child." Mississippi Contract, page 83."ARTICLE III...
3.2.5 Excluded Clients: The following clients shall be excluded from the NHC (based on the information known to the HHS eligibility system): .
(d) Clients who are residing out of state (i.e., children who are placed with relatives out of state, and who are designated as such by HHS personnel..." Nebraska Contract, page 23."5.1(b) Foster care children in the direct care of LDSS and homeless persons reading in homeless shelters who reside in the Service Area may be eligible for enrollment in a Medicaid managed care plan at the option of the LDSS as indicated by an x below. Determinations as to eligibility may be made by the LDSS for persons in these categories on a case by case basis.
(i) _____ Foster care children in the direct care of LDSS may be eligible for a managed care plan, as determined by the LDSS or a case by case basis.
_____ Foster care children in the direct care of LDSS are not eligible for enrollment in a managed care plan.
(ii) _____ Homeless persons residing in homeless shelters may be eligible for enrollment in a managed care plan, as determined by the LDSS or a case by case basis.
_____ Homeless persons residing in homeless shelters are not eligible for enrollment in a managed care plan...6.0 ENROLLMENT EXCLUSIONS
6.1 The following individuals shall be deemed ineligible for enrollment in the PCPCP."ENROLLMENT EXCLUSIONSSpend-down Medically Needy Otherwise eligible individuals with access to private health insurance, if cost is less than the cost to the State of enrolling that individual Foster Care children placed in voluntary agencies (not in the direct care of the LDSS.) Medicare/Medicaid Dually Eligibles unless and until program features and reimbursement rates are approved by the Commissioner of Health. Residents of State-operated psychiatric facilities and residential treatment facilities for children or youth Recipients of mental health family care services Residents of residential health care facilities at the time of enrollment Participants in capitated long term care demonstration projects Participants in the Long Term Home Health Care program Infants living with incarcerated mothers in state or local correctional facilities Certified blind or disabled children living or expected to be living separate and apart from the parent for 30 days or more Individuals expected to be MA eligible for less than six months Individuals receiving hospice services at the time of enrollment Individuals restricted under the Recipient Restriction Program." New York Contract, pages 16-17.
Persons in receipt of the following Medicaid services shall be deemed ineligible for enrollment in the Contractor's plan. If an enrolled member requires receipt of such service, he/she shall be disenrolled from the Contractor's plan, except as otherwise provided below:Voluntary Child Caring Agency Residential Treatment facility for Children or Youth... In foster care or a subsidized adoption program." New York Contract, Appendix L, page 8.