Administrative Rule Review Report  #AR07-051

Legislative Service Office

24-Sep-07

AGENCY: Department of Health.

DATE SUBMITTED: September 12, 2007.

SUBJECT: Chapter 1, Kid Care CHIP (Children's Health Insurance Program).

NATURE OF RULES:                     Legislative and procedural.

STATUTORY AUTHORITY:         W.S. 35-25-108

DETERMINATION OF PROCEDURAL COMPLIANCE BASED UPON INFORMATION SUBMITTED BY THE AGENCY TO LSO:              Apparently complete to date.

SUMMARY OF RULES:          W.S. 35-25-101 through 35-25-111 creates the Child Health Insurance Program ("CHIP"), as authorized by Title XXI of the Social Security Act (42 U.S.C. 1397aa through 1397jj).  W.S. 35-25-105 creates a health benefit plan committee which is charged with reviewing and recommending changes to the schedule of health benefits offered under CHIP.

This rule amends the existing CHIP rules to reflect dental, vision and mental health benefit changes recommended by the committee to become effective July 1, 2007.  The benefit changes include:

· An additional nine days of inpatient hospital services (totaling 30 days/year);

· An additional 20 days of outpatient mental health services (totaling 40 days/year);

· Contact lenses become a covered benefit (but only as an alternative to glasses), up to $100/year;

· Preventive and diagnostic dental services are excluded from the $1,000/year dental benefit maximum.

The rule also corrects statutory and regulatory citations and repeals an obsolete provision.

FINDINGS:   The rules appear to be within the scope of statutory authority and legislative intent.

STAFF RECOMMENDATION:        That the rules be placed on the Consent List and be approved by the Council as submitted by the Agency.

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Gerald W. Laska

Staff Attorney

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David K. Gruver

Assistant Director

GWL/