All babies born in the United States whose deliveries are covered by Medicaid may remain eligible under certain circumstances for Medicaid for up to a year after their birth, announced Leslie V. Norwalk, Acting Administrator of the Centers for Medicare & Medicaid Services.
The Medicaid statute provides that a child born to a mother receiving Medicaid will automatically be eligible for Medicaid for one full year, if certain conditions are met.
Typically, newborn eligibility for Medicaid is "deemed" as long as the mother remains Medicaid eligible, and the child is a member of the mother's household. Under this "deemed" status, the States do not make a new eligibility determination for the infant at the time of birth; rather, eligibility is continued under the mother's status for the first year. After one year, the child's own eligibility must be established pursuant to previously announced criteria.
Certain non-citizens, who ordinarily can not be eligible for Medicaid, can be eligible for emergency Medicaid services, including the labor and delivery of a child. Statements made by CMS in a July 2006 interim final rule stated that in these circumstances this "deeming" process would not extend to those infants born to mothers receiving such emergency Medicaid services.
CMS will modify this policy in an interim final rule that will be issued shortly. Any newborn whose mother files an application and is determined eligible for emergency Medicaid for the delivery could be deemed eligible for their first year of life. Documentation of eligibility would be required at redetermination in the same manner as for all deemed newborns.
"Health care benefits are critical to the healthy development of newborn babies," said Ms. Norwalk. "We have heard the concerns raised and are taking action to ensure that newborns in similar circumstances are treated the same under Medicaid eligibility rules," she said.
Norwalk concluded, "We intend to modify the documentation requirements to put all babies born in the United States whose deliveries are covered by Medicaid on an equal footing."
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