Sec. 3. 12-month continuous enrollment
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Section 1902(e)(12) of the Social Security Act (42 U.S.C. 1396a(e)), is amended to read as follows: Notwithstanding any other provision of this title, a State plan approved under this title (or under any waiver of such plan approved pursuant to section 1115 or section 1915), shall provide that an individual who is determined to be eligible for benefits under such plan (or waiver) shall remain eligible and enrolled for such benefits through the end of the month in which the 12-month period (beginning on the date of determination of eligibility) ends.
The Secretary shall— identify methods that promote the retention of individuals who are enrolled under the State plan and who remain eligible for medical assistance beyond the 12-month period described in subparagraph (A); and actively promote the adoption of such enrollment retention methods by States, which should include but not be limited to issuing guidance and developing resources on State best practices. Not later than September 30, 2014, the Secretary shall publish the procedures that States are expected to use to provide annual enrollment and retention reports beginning September 30, 2015.
At a minimum, such reporting procedures shall include a description of State eligibility criteria and enrollment procedures under this title, and data regarding enrollment and retention using standardized reporting formats determined by the Secretary. The Secretary shall annually publish enrollment and retention performance results for all States beginning not later than June 30, 2016. Each such annual report shall include estimates of Medicaid enrollment continuity ratios for each State.
In this clause, the term enrollment continuity ratio means, for a given group, the ratio of the average monthly enrollment of that group in the fiscal year divided by the total unduplicated enrollment for that group in the fiscal year, expressed as a percentage. For purposes of such reports, the Secretary shall develop both overall ratios for all enrollees and separate ratios for the following categories: Children. Individuals whose eligibility category is related to being equal to or over the age of 65.
Individuals whose eligibility category is related to disability or blindness. Individuals whose eligibility category is related to their status as parents and caretaker relatives of children under 19 or who are otherwise not elderly, blind or disabled adults. . Section 2102(b) of the Social Security Act (42 U.S.C. 1397bb(b)) is amended by adding at the end the following new paragraph: Notwithstanding any other provision of this title, a State child health plan that provides child health assistance under this title through a means other than described in section 2101(a)(2), shall provide that an individual who is determined to be eligible for benefits under such plan shall remain eligible and enrolled for such benefits through the end of the month in which the 12-month period (beginning on the date of determination of eligibility) ends. .
Section 2105(a)(4)(A) of the Social Security Act (42 U.S.C. 1397ee(a)(4)(A)) is amended— by striking has elected the option of and inserting is in compliance with the requirement for ; and by striking applying such policy under its State child health plan under this title and inserting in compliance with section 2102(b) . Except as provided in paragraph
(2)or (3), the amendments made by subsections
(a)and
(b)shall apply to determinations (and redeterminations) of eligibility made on or after the date that is 18 months after the date of the enactment of this Act. In the case of a State plan under title XIX or State child health plan under title XXI of the Social Security Act ( 42 U.S.C. 1396 et seq. , 42 U.S.C. 1397aa et seq. ) which the Secretary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the respective plan to meet the additional requirement imposed by the amendment made by subsection
(a)or (b), respectively, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such applicable additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session is considered to be a separate regular session of the State legislature. A State may elect through a State plan amendment under title XIX or XXI of the Social Security Act ( 42 U.S.C. 1396 et seq. , 42 U.S.C. 1397aa et seq.) to apply the amendment made by subsection
(a)or (b), respectively, on any date prior to the 18-month date specified in paragraph (1), but not sooner than the date of the enactment of this Act.
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Sec. 3
12-month continuous enrollment
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