Federal Balance Budget Act of 1997: Excerpts
The Federal Balanced Budget Act of 1997, Public Law 105-33, increased the attention given to performance monitoring and quality assurance in both Medicaid and the newly created State Children's Health Insurance Program.
Title IV, which contains the Medicare, Medicaid, and Children's Health Provisions of the Act established several new requirements relating to performance measurement and quality, as described below:
Subtitle H: Medicaid - Chapter 1: Managed Care
Contains requirements in Sec. 4704 and 4705:
Sec. 4704 requires "annual external independent review of [Medicaid] managed care entity activities and other specified quality care assurance measures..."
Sec. 4705 requires "any State contracting with Medicaid managed care organizations to develop and implement a quality assessment and improvement strategy incorporating certain access standards, monitoring procedures, and other measures..."
Sec. 4705 also "directs the Secretary to study and report to such committees on safeguards that may be needed to ensure that the health care needs of individuals with special health care needs and chronic conditions who are enrolled with Medicaid managed care organizations are adequately met."
Subtitle J: State Children's Health Insurance Program - Chapter 1: State Children's Health Insurance Program
Requires that States "submit for the Secretary's approval a child health plan for the use of funds, containing strategic objectives, performance goals, and performance measures."