on a finding from an Express Lane agency not-
withstanding sections 1902(a)(46)(B), 1903(x), 
and 1137(d) and any differences in budget unit, 
disregard, deeming or other methodology, if the 
following requirements are met: 
‘‘(I) PROHIBITION
ON
DETERMINING 
CHILDREN INELIGIBLE FOR COVERAGE.—If 
a finding from an Express Lane agency 
would result in a determination that a 
child does not satisfy an eligibility require-
ment for medical assistance under this title 
and for child health assistance under title 
XXI, the State shall determine eligibility for 
assistance using its regular procedures. 
‘‘(II) 
NOTICE
REQUIREMENT.—For 
any child who is found eligible for medical 
assistance under the State plan under this 
title or child health assistance under title 
XXI and who is subject to premiums based 
on an Express Lane agency’s finding of 
such child’s income level, the State shall 
provide notice that the child may qualify 
for lower premium payments if evaluated 
by the State using its regular policies and 
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of the procedures for requesting such an 
evaluation. 
‘‘(III) COMPLIANCE WITH SCREEN AND 
ENROLL
REQUIREMENT.—The State shall 
satisfy the requirements under (A) and (B) 
of section 2102(b)(3) (relating to screen and 
enroll) before enrolling a child in child 
health assistance under title XXI. At its op-
tion, the State may fulfill such requirements 
in accordance with either option provided 
under subparagraph (C) of this paragraph. 
‘‘(ii) OPTION TO APPLY TO RENEWALS AND 
REDETERMINATIONS.—The State may apply the 
provisions of this paragraph when conducting 
initial determinations of eligibility, redetermina-
tions of eligibility, or both, as described in the 
State plan. 
‘‘(B) RULES
OF
CONSTRUCTION.—Nothing in 
this paragraph shall be construed— 
‘‘(i) to limit or prohibit a State from taking 
any actions otherwise permitted under this title 
or title XXI in determining eligibility for or en-
rolling children into medical assistance under 
this title or child health assistance under title 
XXI; or 
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‘‘(ii) to modify the limitations in section 
1902(a)(5) concerning the agencies that may 
make a determination of eligibility for medical 
assistance under this title. 
‘‘(C) OPTIONS FOR SATISFYING THE SCREEN AND 
ENROLL REQUIREMENT.— 
‘‘(i) IN GENERAL.—With respect to a child 
whose eligibility for medical assistance under 
this title or for child health assistance under title 
XXI has been evaluated by a State agency using 
an income finding from an Express Lane agen-
cy, a State may carry out its duties under sub-
paragraphs (A) and (B) of section 2102(b)(3) 
(relating to screen and enroll) in accordance 
with either clause (ii) or clause (iii). 
‘‘(ii) ESTABLISHING A SCREENING THRESH-
OLD.— 
‘‘(I) IN GENERAL.—Under this clause, 
the State establishes a screening threshold 
set as a percentage of the Federal poverty 
level that exceeds the highest income thresh-
old applicable under this title to the child 
by a minimum of 30 percentage points or, 
at State option, a higher number of percent-
age points that reflects the value (as deter-
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mined by the State and described in the 
State plan) of any differences between in-
come methodologies used by the program ad-
ministered by the Express Lane agency and 
the methodologies used by the State in deter-
mining eligibility for medical assistance 
under this title. 
‘‘(II) CHILDREN
WITH
INCOME
NOT 
ABOVE
THRESHOLD.—If the income of a 
child does not exceed the screening threshold, 
the child is deemed to satisfy the income eli-
gibility criteria for medical assistance 
under this title regardless of whether such 
child would otherwise satisfy such criteria. 
‘‘(III) CHILDREN WITH INCOME ABOVE 
THRESHOLD.—If the income of a child ex-
ceeds the screening threshold, the child shall 
be considered to have an income above the 
Medicaid applicable income level described 
in section 2110(b)(4) and to satisfy the re-
quirement under section 2110(b)(1)(C) (re-
lating to the requirement that CHIP match-
ing funds be used only for children not eli-
gible for Medicaid). If such a child is en-
rolled in child health assistance under title 
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XXI, the State shall provide the parent, 
guardian, or custodial relative with the fol-
lowing: 
‘‘(aa) Notice that the child may be 
eligible to receive medical assistance 
under the State plan under this title if 
evaluated for such assistance under the 
State’s regular procedures and notice 
of the process through which a parent, 
guardian, or custodial relative can re-
quest that the State evaluate the child’s 
eligibility for medical assistance under 
this title using such regular procedures. 
‘‘(bb) A description of differences 
between the medical assistance pro-
vided under this title and child health 
assistance under title XXI, including 
differences in cost-sharing requirements 
and covered benefits. 
‘‘(iii) TEMPORARY
ENROLLMENT
IN
CHIP 
PENDING SCREEN AND ENROLL.— 
‘‘(I) IN GENERAL.—Under this clause, 
a State enrolls a child in child health as-
sistance under title XXI for a temporary 
period if the child appears eligible for such 
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