H-4855.1 _______________________________________________
SUBSTITUTE HOUSE BILL 3026
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State of Washington 55th Legislature 1998 Regular Session
By House Committee on Health Care (originally sponsored by Representatives Dyer and Cooke)
Read first time 02/03/98. Referred to Committee on .
AN ACT Relating to creating the children's health initiative program; and adding a new section to chapter 74.09 RCW.
NEW SECTION. Sec. 1. A new section is added to chapter 74.09 RCW to read as follows:
(1) It is the intent of the legislature to create the children's health insurance program, the benefits of which are not an entitlement, to provide health care to children who do not have access to medical assistance and are not insured at the time of enrollment. However, if Washington state is not permitted, by January 1, 1999, to expend funds authorized by the state children's health insurance program, P.L. 105-33, Subtitle J, Title XXI of the federal social security act for medicaid coverage of optionally categorically needy children with household income less than two hundred percent of the federal poverty level not presently enrolled in medical assistance, the children's health insurance program shall be terminated on January 1, 1999, and children's medicaid coverage shall be limited to needy children with household income less than two hundred percent of the federal poverty level as currently provided pursuant to this chapter.
(2) "Children's health insurance program" means the program established in compliance with P.L. 105-33, Subtitle J, the state children's health insurance program under Title XXI of the federal social security act for health care coverage of children: (a) Who are under the age of nineteen; (b) who are not insured; (c) whose gross family income at the time of enrollment exceeds two hundred percent, but does not exceed two hundred fifty percent, of the federal poverty level as adjusted for family size and determined annually by the federal department of health and human services; and (d) who chooses to obtain basic health care coverage in return for periodic payments.
(3) The department shall design the children's health insurance program with benefit structures that comply with P.L. 105-33, Subtitle J, the state children's health insurance program under Title XXI of the federal social security act. The primary mechanism for financing and delivery of health care through the program shall be through contracts with managed health care systems as provided in RCW 74.09.522.
(4) The department shall: Accept applications from individuals, on behalf of their dependent children, for enrollment in the children's health insurance program; establish appropriate minimum-enrollment periods, as may be necessary; and determine, upon application and on a reasonable schedule defined by the department, or at the request of any enrollee, eligibility due to current gross family income. No assistance may be paid with respect to any children's health insurance enrollee whose current gross family income is less than two hundred percent or greater than two hundred fifty percent of the federal poverty level or, subject to this chapter, who is a recipient of medical assistance under this chapter. If, as a result of an eligibility review, the department determines that a children's health insurance enrollee's gross family income is greater than two hundred fifty percent of the federal poverty level and that the enrollee knowingly failed to inform the plan of such increase in income, the department may bill the enrollee for the assistance paid on the enrollee's behalf during the period of time that the enrollee's gross family income was greater than two hundred fifty percent of the federal poverty level.
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