New Data Collection and Reporting Requirements Under CHIP

 

 

CHIPRA 2009 contained several provisions to expand and improve data collection and reporting by both the states and the federal government with respect to CHIP and, for some initiatives, also for Medicaid. For example, the new law directs the Secretary of HHS to develop child health quality measures, a standardized format for reporting such information, and procedures to encourage states to voluntarily report on the quality of pediatric care under both chip health insurance pa and Medicaid.

In addition, several reporting requirements were added to states' annual CHIP reports including, for example, data on eligibility criteria, access to primary and specialty care, and data on premium assistance for employer-sponsored coverage. GAO is to conduct a study of children's access to primary and specialty care under Medicaid and CHIP.

CHIPRA also established a new federal commission, called the Medicaid and CHIP Payment and Access Commission, or MACPAC. This commission will review policies under both programs affecting children's access to benefits including, for example, payment policies and their impact on access and quality of care. Regular, on-going reports to Congress are to detail these findings and are to include recommendations for improving access and quality of care for children under Medicaid and CHIP.

CHIPRA also required the Secretary of HHS to conduct a new, independent federal evaluation of 10 states with approved CHIP plans that meet certain criteria (e.g., represent different geographic regions, utilize diverse approaches to CHIP coverage, and have significant portions of uninsured children). This evaluation will be modeled after the first such federal evaluation undertaken in the early 2000s. 

As with the first federal evaluation, the new evaluation will examine, for example, effectiveness of outreach and enrollment strategies, the effects of cost-sharing on utilization, and factors related to disenrollment and retention of children.