The “Inmate Exception” and Its Impact on Health Care Services for Children in Out-of-Home Care in California

This paper was commissioned by The California Endowment. Youth Law Center was asked to explore the payment exclusions for “inmates of a public institution” in federal Medicaid law and their impact on access to care for children in public systems in California. The paper presents federal statutes, regulations and guidance, and their counterparts in Medi-Cal, California;’s Medicaid program. The paper also discusses barriers to coverage of eliglble children and the need for clarification in certain areas. It discusses ways to maximize Medicaid reimbursement under then existing law, and includes recommendations for future work.