Kansas Family Medical Assistance
Manual (KFMAM)
Eligibility Policy - 11/21/2024
02000 >>> 02320
02310
02320 Continuous Eligibility Medicaid Newborns - A child born to a woman who is eligible for and will receive medical benefits under one of the following categories is automatically eligible for Medicaid coverage and is continuously eligible through the month the child turns age 1 provided the requirements below are met. This includes children born to Medicaid eligible incarcerated individuals as well as children born to women who are only eligible for emergency services due to immigration status (SOBRA) but who are otherwise eligible for one of the named programs. (MKEESM 2691)
a. Foster Care (See 2320.01)
b. Adoption Support Medical
c. SSI Medical
d. Aged Out Foster Care
e. Breast and Cervical Cancer
f. Protected Medical Groups
g. Working Healthy
h. Caretaker Medical
i. Transitional Medical
j. Extended Medical
k. Poverty Level Title 19
The child's identifying information: name, date of birth, and gender must be known to provide continuous coverage. When this information has been provided by the last day of the month the child turns age 1, coverage will be provided beginning with the month of birth. When the birth has been reported, but identifying information is not known, only coverage for the month of birth is provided.
No other eligibility factors must be met except for the fact that the child must be a citizen and a resident of the state. Verification of citizenship and identity is not required for children born to a Medicaid recipient. A loss of contact per 7230 shall not affect ongoing eligibility. Cooperation regarding countable income is not a requirement since changes in income do not affect newborn eligibility.
Newborn eligibility shall be provided if eligibility for the mother is established for any of the months in the prior medical period. However, if there is a break in assistance of one or more months during the continuous eligibility period due to residency requirements or voluntary withdrawal, continuous eligibility shall end and the child would have to qualify under the poverty level program again or another medical program. In addition, if continuous eligibility is not established for the month following the month regular eligibility is lost, it cannot be provided and the child would once again have to qualify for poverty level coverage or another medical program, except as noted in 2230 regarding TransMed benefits.
2320.01 Providing Medicaid Coverage to Newborn Children of Mothers in Foster Care - Newborns of mothers currently receiving foster care medical benefits are eligible for medical benefits under the newborn provisions of 2320. Unless the newborn is also in foster care, it is the responsibility of eligibility staff to establish Medicaid coverage for the newborn child.
The newborn child is ALWAYS entitled to Medicaid in the month of birth. This is true even if the newborn does not physically reside with the mother in the month of birth or following months.
A new application is not required to be filed on behalf of the infant to provide either coverage in the month of birth or continuing coverage. Coverage may be verbally requested, or an application filed, by the mother or the mother's caretaker. If the coverage is requested verbally, sufficient information must be obtained to set up a new case. A new case must be opened with the foster care/minor mother as the Primary Applicant.
If the child is not living with the mother, the current caretaker of the newborn child must file an application for medical assistance to continue coverage for the newborn beyond the month of birth.
For children residing in a group home or residential care facility, the administrator of the facility (or designee) is viewed as a qualifying caretaker of the newborn child for medical assistance. The minor mother's foster parent is also viewed as a qualifying caretaker of the newborn child for medical assistance.
2320.02 Facility Birth Reporting Form for Medicaid Deemed Newborns - ES-4501 Facility Birth Reporting form for Medicaid Deemed Newborns, may be used by a medical facility to report the birth of an infant born to a Medicaid mother, if the child has been transferred to their medical facility due to a medical necessity after birth. The form will not be considered a valid request for coverage if all the fields are not filled out or the mother of the newborn did not receive Medicaid coverage in the month of birth. This form is not considered verification of Citizenship or Identity as it is not a birth confirmation letter.