PaymentAccuracy.gov

An Official Website of the United States Government

Children's Health Insurance Program (CHIP)

Department of Health and Human Services

Children’s Health Insurance Program (CHIP) is a joint federal/state program, administered by the states that provides health insurance for qualifying children.

Agency Accountable Official: Ellen Murray , Assistant Secretary for Financial Resources

Program Accountable Official: Tim Love, Chief Operating Officer, Centers for Medicare & Medicaid Services

Current

$8.6B

Total Payments (Outlays)more info

$0.7B

Improper Paymentsmore info

8.2%

Improper Payment Ratemore info

2013

Not Reported Improper Payment Rate Target more info

All amounts are in billions of dollars

Tabular view for Projected improper payments Tabular View   

 

Note: HHS calculated and is reporting a national error rate based on the 34 states measured in Fiscal Years (FYs) 2012-2013. The baseline measurement for CHIP, based on the measurement of 50 States and the District of Columbia over a three-year period (FYs 2012 – 2014), will be published in the FY 2014 Agency Financial Report (AFR). Once all states have been measured for CHIP under PERM and a three-year baseline rate is established, HHS will publish out-year targets for CHIP.

Program Comments

The Children's Health Insurance Program (CHIP) is a state and federal partnership that provides low-cost health insurance coverage for children in families who earn too much income to qualify for Medicaid but cannot afford to purchase private health insurance coverage. States have considerable flexibility to establish income eligibility rules for the program, but children enrolling must be otherwise uninsured. Within federal guidelines, each state determines the design of its individual program, including eligibility parameters, benefit packages, payment levels for coverage, and administrative procedures. States have flexibility in designing the benefit package, but states are required to cover routine check-ups, immunizations, dental, inpatient and outpatient hospital care, and laboratory and x-ray services. Preventive care must be provided at no cost to the family; but premiums and other cost-sharing may be required for other services, within certain limits. The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) prohibited the Department of Health and Human Services (HHS) from calculating or publishing error rates for the program until six months after a final rule was published. The Department of Health and Human Services published a final rule in the summer of 2010 and reported an improper payment estimate in FY 2012 for the first time since FY 2008. Read More...