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Federal Reporting Requirements: Quality Provisions

States must describe methods to:

• Assure the quality and appropriateness of care, particularly with respect to well-baby care, well-child care, and immunizations.
• Assure access to covered services, including emergency services.

States must evaluate the effectiveness of their plans including "the quality of health coverage provided." To do so, HCFA (now CMS) indicates that specific information on the number of children covered by age, income, and type of delivery system is essential to assessment of the program.

HCFA (now CMS) has outlined standard data elements necessary to monitor and evaluate SCHIP while taking deliberate caution not to overburden States with new requirements, given that many States are using existing Medicaid data and reporting systems.

Information States are expected to provide to HCFA (now CMS) includes, but is not limited to:

• Baseline estimates of the number of uninsured children in their State.

• A description of the progress made in reducing the number of uninsured, low-income children in the State.

• An assessment of progress toward the State's identified strategic objectives, performance goals, and performance measures.

States are expected to report on a number of structural and process indicators collected through a variety of sources, such as:

• Administrative data.

• Enrollee mail or telephone surveys.

• Population surveys.

• Disenrollee surveys.

• Surveys of employers.

• Site visits to eligibility determination locations.

Related Questions

Take me to related sites

• December 4, 1998, Memo on Federal Reporting Requirements. This document, and other HCFA (now CMS) guidance can be found at http://www.cms.hhs.gov/home/schip.asp

What led to this?

• Link to Federal Reporting Guidance (HCFA (now CMS))

Where else is HCFA (now CMS) guidance discussed?

• SCHIP Guidance - HCFA (now CMS) Guidance

Who presented this material?

• This information was taken from the HCFA (now CMS) Web site