Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
600 Washington Street
Boston, MA  02111
www.mass.gov/masshealth


		MassHealth
		Eligibility Letter 152
		September 1, 2006


TO:	MassHealth Staff

FROM:	Beth Waldman, Medicaid Director

RE:	Revisions to Children’s Medical Security Plan Regulations
	

This letter transmits a change to the Children’s Medical Security Plan (CMSP) 
regulations.  These regulations were originally filed as an emergency, effective July 1, 
2006.  These final changes are being made after public notice.

The regulations at 130 CMR 522.004(C)(4) have been revised to clarify the eligibility 
requirement that he member must be “uninsured.”

These regulations are effective July 2, 2006.



	MANUAL UPKEEP

Insert	Remove	Trans. By

522.003	522.003	E.L. 149






130 CMR:  DIVISION OF MEDICAL ASSISTANCE




Rev. 07/02/06

	MASSHEALTH
	OTHER DIVISION PROGRAMS
	Trans. by E.L. 152


Chapter 522
Page 522.003


522.003:	Adoption Assistance and Foster Care Maintenance

    Any child placed in subsidized adoption or foster care under Title IV-E of the Social Security 
Act is automatically eligible for medical assistance provided by the state where the child resides.

(A)  Children receiving state-subsidized adoption payments from a state that is a member of the 
Interstate Compact on Adoption and Medical Assistance (ICAMA) will be eligible for medical 
assistance provided by the state where the child resides if that state is a member of ICAMA.

(B)  Children receiving state-subsidized adoption payments from a state that is not a member of 
ICAMA, or any child receiving state-subsidized foster-care payments will only be eligible for 
medical assistance provided by his or her state of origin.

522.004:	Children’s Medical Security Plan (CMSP)

(A)  Regulatory Authority.  The Children’s Medical Security Plan (CMSP) is administered 
pursuant to M.G.L. c. 118E, §10F.

(B)  Overview.  CMSP provides coverage to uninsured children under age 19 who do not qualify 
for any other MassHealth coverage type, other than MassHealth Limited, and who do not have 
physician and hospital health-care coverage.  To apply for these benefits, an applicant must 
submit a Medical Benefit Request (MBR) as described in 130 CMR 502.001 and 502.002.

(C)  Eligibility Requirements.  Children are eligible for CMSP if they are:

(1)	a resident of Massachusetts, as defined in 130 CMR 503.002;
	
(2)	under age 19; 
	
(3)  not otherwise eligible for any other MassHealth coverage type, other than MassHealth 
Limited.  Children who are in a waiting period as described at 130 CMR 505.005(H) are 
considered not eligible for any other MassHealth coverage type.  However, children who are 
otherwise eligible and who are not receiving MassHealth coverage as a result of not 
complying with administrative requirements of MassHealth are not eligible for CMSP.  
Children who lose eligibility for MassHealth Family Assistance as a result of nonpayment of 
premiums or as a result of not enrolling in employer-sponsored health insurance through 
Premium Assistance are not eligible for CMSP; and

(4)  uninsured.  An applicant or member is uninsured if he or she:
	(a)  does not have insurance that provides physician and hospital health-care coverage;
	(b)  has insurance that is in an exclusion period; or
	(c)  had insurance that has expired or has been terminated.