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Implementation Guide:
Medicaid State Plan Eligibility
Eligibility Groups – Mandatory Coverage
Children with Title IV-E Adoption Assistance, Foster
Care or Guardianship Care
Contents
POLICY CITATION....................................................................................................... 2
BACKGROUND ............................................................................................................. 2
Overview ..................................................................................................................... 2 Income Eligibility ........................................................................................................ 3 Requirements ............................................................................................................... 3 INSTRUCTIONS ............................................................................................................ 4 A. Characteristics .................................................................................................. 4 B. Additional Information (optional) .................................................................... 4 REVIEW CRITERIA ...................................................................................................... 4
Children with Title IV-E Adoption Assistance, Foster Care or
Guardianship Care
POLICY CITATION
Statute: 473(b), 1902(a)(10)(A)(i)(I) Regulation: 42 CFR 435.
BACKGROUND
Overview
This reviewable unit (RU) describes the eligibility group for children with adoption assistance, foster care or guardianship care under title IV-E of the Act, as described in 42 C.F.R. §435.145. It provides the criteria under which such “IV-E individuals” must be covered under this group.
Section 473(b)(1) of the Social Security Act (the Act) requires that IV-E individuals be considered to be receiving cash assistance (aid to families with dependent children, or AFDC, as it was in effect on July 16, 1996). In turn, section 1902(a)(10)(A)(i)(I) of the Act makes those cash assistance recipients eligible for Medicaid.
Title IV-E of the Act provides for federal payments to states for foster care and kinship guardianship care maintenance and for adoption assistance on behalf of children who meet the program’s eligibility requirements. The title IV-E agency in the state determines children’s eligibility under its IV-E plan, which may include evaluation of whether the child would have met AFDC criteria, the circumstances of removal from the home, citizenship and residency requirements, or special needs criteria for adoption. Based on the IV-E agency’s determination of eligibility, the Medicaid agency must provide Medicaid to the IV-E individual.
Consistent with the requirements described at 42 C.F.R. §435.145, the eligibility group for children with title IV-E adoption assistance, foster care or guardianship care is a mandatory eligibility group that covers individuals for whom: A title IV-E adoption assistance agreement with a state or Tribe is in effect; Title IV-E foster care maintenance payments are being made by a state or Tribe; or Title IV-E kinship guardianship assistance maintenance payments are being made by a state or Tribe.
Adoption Assistance: For the purpose of Medicaid eligibility, an individual with a IV-E adoption assistance agreement is eligible under this group regardless of whether adoption assistance payments or services are being received, or whether a judicial decree of adoption has actually been issued.
administratively with no action needed by the child or the child’s representative. A IV-E renewal consists of confirming: Continued state residency; and That the adoption assistance agreement remains in effect, or the foster care or guardianship assistance maintenance payments continue to be made.
INSTRUCTIONS
A. Characteristics There are three statements ( A.1. through A.3. ) describing the characteristics of this eligibility group.
B. Additional Information (optional) Except in limited circumstances, this field remains blank. Please consult with CMS before adding any additional information concerning this RU.
REVIEW CRITERIA
No specific review criteria are needed.
