Feds call for changes in kids insurance plan

Friday, June 26, 1998 | 11:31 a.m.

CARSON CITY -- The start of the much-heralded "Check Up" program to insure children of low-income families is being delayed again as state officials make major changes.

The federal Health Care Financing Administration has refused to approve the state's proposal saying it conflicts with a congressional law.

Chris Thompson, administrator of the state Division of Health Care Financing and Policy, said he hopes to get a start-up date in October. The initial estimate now is for 7,500 children, rather than the original number of 40,000.

The program was originally slated to begin in April and then was delayed until July 1.

"It's a setback," said Sen. Ray Rawson, R-Las Vegas. "It slows us down but it hasn't stopped us."

The federal government will kick in $30.6 million this year for the program and the state will add $16.6 million. Nevada hoped to have a simplified program with little paperwork for those who apply with a basic health plan.

Under the original plan, a family of four earning $28,000 to $32,000 annually would pay a $50 enrollment fee and $50 per quarter for a maximum of $200 per year to cover both children. This would provide medical coverage and there would be an additional $5 fee for each drug prescription and $5 charge per visit to the dentist.

Under the new plan, which will be similar to Medicaid, benefits will be expanded and the co-payments will be eliminated. There will still be a sign-up fee, but there will be more red tape to qualify, which Rawson said will discourage some people from applying.

The federal agency, in refusing to approve the Nevada plan on June 19, said the process for enrolling the children did not comply with federal law. A key objection by the agency was the screening process. It said that a child should not be enrolled in the state's plan unless there was a full determination that showed the child was not eligible for Medicaid.

"The feds want us to expand Medicaid. The president wanted a simplified plan. But HCFA (Health Care Financing Administration) didn't buy that," Rawson said.

Thompson said Nevada's plan will be rewritten and submitted for approval. He told the committee the application required by the government is similar to Medicaid which requires a full examination of a family's assets.

"This is not the program we started with," Thompson said. "I wish I could say it was. I wish I could say it was as good. It's not. But I still believe that with two-thirds of the money coming from the federal government, it's still a better program than if we had to fund it ourselves."