Affordable Care Act (ACA) Changes to Move Segment of Children From CHIP to Medicaid

Under federal law, the Patient Protection and Affordable Care Act (PPACA) implements mandatory changes regarding eligibility guidelines for the Children’s Health Insurance Program (CHIP) and Medicaid.
Effective Jan. 1, 2014, a new methodology based on Modified Adjusted Gross Income (MAGI) will be used for determining CHIP eligibility. As a result of a conversion to MAGI, children in households with income limits up to 133 percent of the federal poverty level will be transitioning from CHIP to traditional Medicaid.

CHIP children in households with income limits up to 133 percent of the federal poverty level will need to ensure their CHIP provider is also enrolled in Medicaid. If the provider does not accept Medicaid they will need to locate a new provider.

To maintain patient caseloads, ensure uninterrupted compensation for services and assure continuity of care for this segment of children, the Division of Medicaid encourages affected providers to enroll in Medicaid.

Specially designated staff in the Bureau of Provider Beneficiary Relations are standing by to expedite the enrollment application process for these providers. We appreciate your patience during this change and would be happy to offer assistance to facilitate a smooth transition. For more information contact the Division of Medicaid by calling toll-free at (800) 421-2408 or (601) 359-6050.

Reference
Federal authority for the change in the Medicaid limit that affects CHIP: Section 2001 (a)(5)(B) of the Affordable Care Act implemented through federal regulations for the Medicaid program at 42 CFR § 435.118.