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Restructure Medicare & Medicaid: Examples of Medicaid’s Mandatory Beneficiaries & Services Examples of Mandatory Beneficiaries Examples of Mandatory Services e Children under age 6 with family annual e Physician services income below $20,841 Laboratory & x-ray services Children age 6 or older with family annual income below $15,670 Inpatient hospital services Outpatient hospital services Pregnant women with annual income below $12,382 Rural health clinic services Elderly and disabled with annual Certified pediatric and family nurse income between below $6,768 (for an practitioner services individual) e Early & periodic screening, diagnostic, and treatment (EPSDT) services for individuals under 21 Note: Supplementary Security Income and Federal Poverty Levels are 2005 levels. Source: Kaiser Family Foundation, 2005. www.kpcb.com USA Inc. | What Might a Turnaround Expert Consider? 321 Restructure Medicare & Medicaid: Examples of Medicaid’s Optional Beneficiaries & Services Examples of Optional Beneficiaries Examples of Optional Services e Disabled and elderly with annual e Prescription drugs income between $7,082 (Supplementary Security Income, or SSI) and $9,310 (Federal Poverty e Rehabilitation and other therapies Level, or FPL) e Dental services Prosthetic devices, eyeglasses, e Nursing home residents with annual durable medical equipment income between $7,082 (SSI) and e Hospice services $21,000 (3x SSI) Inpatient psychiatric hospital Pregnant women with annual income services for individuals under age 21 above $12,382 (>133% of FPL) e Other specialist medical or remedial e Children under 6 with annual family dare income above $20,841 Note: Supplementary Security Income and Federal Poverty Levels are 2005 levels. Source: Kaiser Family Foundation, 2005. www.kpcb.com USA Inc. | What Might a Turnaround Expert Consider? 322 HOUSE_OVERSIGHT_021002