![]() ![]() Health and Human Services Secretary-approved coverage is health benefits coverage that the Secretary determines provides appropriate coverage for the population of targeted low-income children covered under the program.Your entire office will be able to use your search subscription. There may be additional coverage requirements depending on the specific benchmark package used by the state. ![]() Physicians' surgical and medical services.Inpatient and outpatient hospital services.In addition to the mandatory coverage for all types of CHIP coverage, benchmark-equivalent health benefits coverage must include coverage for the following categories of services: Health Maintenance Organization (HMO) Plan. A health insurance coverage plan that is offered through an HMO, as defined in the Public Health Service Act, and has the largest insured commercial, non-Medicaid enrollment in the state.īenchmark-equivalent coverage has an aggregate actuarial value that is at least actuarially equivalent to the coverage under one of the benchmark packages.State Employee Plan. A health benefits plan that is offered and generally available to state employees in the state.Federal Employees Health Benefit Plan. The standard Blue Cross/Blue Shield preferred provider option service benefit plan offered to federal employees.In a separate CHIP, states can choose to provide benchmark coverage, benchmark-equivalent coverage, or Secretary-approved coverage.īenchmark coverage is health benefits coverage that is substantially equal to the health benefits coverage in one of the following benefit plans: The EPSDT benefit is designed to assure that children receive early detection and care, so that health problems are averted or diagnosed and treated as early as possible. EPSDT provides a comprehensive array of prevention, diagnostic, and treatment services for low-income infants, children, and adolescents under age 21, as specified in section 1905(r) of the Social Security Act. States with a Medicaid Expansion CHIP must provide the Medicaid benefit for children and adolescents known as Early and Periodic Screening, Diagnostic and Treatment services, or the EPSDT benefit. Medicaid Expansion CHIP programs provide the same Medicaid benefit package as provided for children under each state’s Medicaid state plan and/or section 1115 demonstration program. States may choose between a Medicaid expansion program, a separate CHIP, or a combination of both types of programs. States have flexibility to design their own program within federal guidelines, so benefits vary by state and by the type of CHIP program. The Children's Health Insurance Program (CHIP) provides comprehensive benefits to children. Medicaid MAGI & CHIP Application Processing Time.Testing Experience & Functional Tools demonstration.Alternatives to Psychiatric Residential Treatment Facilities Demonstration.Balancing Long Term Services & Supports.Person-Centered Hospital Discharge Model.Vision and Hearing Screening Services for Children and Adolescents.Early and Periodic Screening, Diagnostic, and Treatment.State Planning Grants for Qualifying Community-Based Mobile Crisis Intervention Services.SUPPORT Act Provider Capacity Demonstration.SUPPORT Act Innovative State Initiatives and Strategies.Medicaid Eligibility & Enrollment Toolkit.Medicaid Enterprise Certification Toolkit.Medicaid Information Technology Architecture.Section 223 Demonstration Program to Improve Community Mental Health Services.Actuarial Report on the Financial Outlook for Medicaid.CMS-64 FFCRA Increased FMAP Expenditure Data. ![]() State Budget & Expenditure Reporting for Medicaid and CHIP.Medicaid Eligibility Quality Control Program.Medicaid Third Party Liability & Coordination of Benefits.Seniors & Medicare and Medicaid Enrollees.Coronavirus Disease 2019 (COVID-19): Section 1115 Demonstrations.1115 Substance Use Disorder Demonstrations.1115 Demonstration Monitoring & Evaluation.Medicaid & CHIP Marketplace Interactions.Performance Indicator Technical Assistance.Medicaid Enrollment Data Collected Through MBES.March 2023 Medicaid & CHIP Enrollment Data Highlights.Home & Community Based Services Authorities.Lawfully Residing Immigrant Children & Pregnant Individuals.Medicaid and CHIP Quality Resource Library.Affordable Care Act Program Integrity Provisions.Medicaid and CHIP Eligibility & Enrollment Webinars.Unwinding and Returning to Regular Operations after COVID-19.Home & Community-Based Services in Public Health Emergencies.Using Section 1115 Demonstrations for Disaster Response.Medicaid Data Collection Tool (MDCT) Portal.Eligibility & Administration SPA Implementation Guides.Health Home Information Resource Center.Promoting Community Integration Through Long-Term Services and Supports.Improving Care for Medicaid Beneficiaries with Complex Care Needs and High Costs. ![]()
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