House of Representatives

SB 1087

children's health insurance; covered services

Sponsors: Senators Nichols, Hartley, Solomon, et al.

 

DP

Committee on Health

DP

Committee on Financial Institutions & Insurance

DPA/SE

Committee on Appropriations

 

DPA

Caucus and COW

 

X

As Transmitted To The Governor

 

 

SB 1087 allows school districts to perform outreach for the Children’s Health Insurance Program (CHIP) administered through the Arizona Health Care Cost Containment System (AHCCCS). 

The bill expands coverage for eye examinations, non-emergency transportation and mental health services.  SB 1087 decreases the six-month bare requirement to three months and requires that AHCCCS develop rules to grant hardship exemptions.

 

History

The Children’s Health Insurance Program was created in 1997 to provide health insurance coverage for uninsured low-income children under the age of nineteen. Primary funding for CHIP is provided through a federal grant and state-matching tobacco tax monies.  As of March 1, 2001, 103,618 children have been approved for health coverage through CHIP (47,015 for KidsCare and 56,603 for Medicaid.)

 

CHIP members pay premiums if they are at 150%-200% of the federal poverty level.  Children are terminated from the program if their premiums are not paid for two consecutive months.  AHCCCS estimates that 4,856 children were terminated last year from CHIP.

 

According to AHCCCS, an average of 117 children are denied enrollment each month due to the voluntary loss of insurance provision for eligibility.  The reason for this provision was to eliminate the incentive for parents to drop insurance coverage to enroll children into CHIP.

 

Provisions

·          Requires AHCCCS to adopt rules to prescribe circumstances for hardship exemptions to premium requirements.

·          Allows school districts to perform outreach for the CHIP program administered through AHCCCS.  The outreach activities shall not reduce or interfere with classroom instruction time and stipulates that outreach activities not be performed by a school district during regularly scheduled classroom hours.

·          Requires AHCCCS to adopt rules to allow them to waive part of or the entire premium if a child is chronically ill.

·          Changes the requirement that children have not voluntarily dropped insurance coverage from six months to three months as a provision for eligibility into CHIP.  This provision may be waived for any child who is seriously or chronically ill.  AHCCCS must establish rules to define conditions that constitute a serious or chronic illness.

·          Expands services to include multiple eye examinations and prescriptive lenses as needed. The program currently only provides one eye examination and one set of prescriptive lenses each year.

·          Adds medically necessary non-emergency transportation to the list of covered services.  Only medically necessary emergency transportation is covered under the current program.

·          Removes visitation limits for impatient and outpatient behavioral health services and stipulates that the services must be the same as the least restrictive health benefits coverage plan for behavioral health services as state employees.

 

 

 

 

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45th Legislature                       

First Regular Session    2          May 8, 2001

 

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