Page:United States Statutes at Large Volume 111 Part 1.djvu/596

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Ill STAT. 572 PUBLIC LAW 105-33 —AUG. 5, 1997 "PRESUMPTIVE ELIGIBILITY FOR CHILDREN 42 USC "SEC. 1920A. (a) A State plan approved under section 1902 I396r-la. may provide for making medical assistance with respect to health care items and services covered under the State plan available to a child during a presumptive eligibility period. "(b) For purposes of this section: "(1) The term 'child' means an individual under 19 years of age. "(2) The term 'presumptive eligibility period' means, with respect to a child, the period that— "(A) begins with the date on which a qualified entity determines, on the basis of preliminary information, that the family income of the child does not exceed the applicable income level of eligibility under the State plan, and "(B) ends with (and includes) the earlier of— "(i) the day on which a determination is made with respect to the eligibility of the child for medical assistance under the State plan, or "(ii) in the case of a child on whose behalf an application is not filed by the last day of the month following the month during which the entity makes the determination referred to in subparagraph (A), such last day. "(3)(A) Subject to subparagraph (B), the term 'qualified entity* means any entity that— "(i)(I) is eligible for payments under a State plan approved under this title and provides items and services described in subsection (a) or (II) is authorized to determine eligibility of a child to participate in a Head Start program under the Head Start Act (42 U.S.C. 9821 et seq.), eligibility of a child to receive child care services for which financial assistance is provided under the Child Care and Development Block Grant Act of 1990 (42 U.S.C. 9858 et seq.), eligibility of an infant or child to receive assistance under the special supplemental nutrition program for women, infants, and children (WIC) under section 17 of the Child Nutrition Act of 1966 (42 U.S.C. 1786); and "(ii) is determined by the State agency to be capable of making determinations of the t3T)e described in paragraph (1)(A). "(B) The Secretary may issue regulations further limiting those entities that may become qualified entities in order to prevent fraud and abuse and for other reasons. "(C) Nothing in this section shall be construed as preventing a State from limiting the classes of entities that may become qualified entities, consistent with any limitations imposed under subparagraph (B). "(c)(1) The State agency shall provide qualified entities with— "(A) such forms as are necessary for an application to be made on behalf of a child for medical assistance under the State plan, and "(B) information on how to assist parents, guardians, and other persons in completing and filing such forms.