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The purpose of this General Information System (GIS) message is to alert local social services districts to a new notification requirement regarding low birth weight babies. This pertains to all Medicaid eligible newborns, including those on Temporary Assistance cases. General Managed Care policy dictates that a child born to a mother enrolled in Medicaid Managed Care or Family Health Plus will be automatically enrolled in that plan if the plan does business in that local district.
Managed Care policy further states that newborns with either an SSI/SSI-Related designation or who appear to meet the criteria for the SSI and SSI-Related category (SSI look alike) are excluded from managed care enrollment from age 0 to 6 months. This includes babies born weighing less than 1200 grams at birth. There is a Newborn Daily Update Report sent to districts that will show this designation as "Infant Less 1200 Grams". The upstate version is WMS Report WINR5228, and in New York City, it is WINRO796.
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