NR = not reported   NA = not applicable      -- = the state was not required to complete this section of the state plan             template and did not volunteer the information.

Identifiers				The following information was provided by the state officials reviewing the database.This information is not contained in the state plan or any other official correspondence between HCFA and the state.Because the database was intended to reflect what is on record with HCFA, we have not corrected the state plan or amendments to show this information, but we present it here so that the information can be accessible to all users of the database
State	Program	Phase or Component	Amend.#	Other Information Provided by State Officials
AK	AK Denali KidCare		NA	Alaska does not use presumptive eligibility. To establish and continue enrollment, the state conducts random spot checks for quality assurance and redeterminations ever 6 months; applicants do not select PCP/HMO at the time of application. The state has no other insurance subsidy programs and does not check the enrollee list against a database of private insurance holders. Each tribal program has a designated Denali KidCare outreach staff person who works with state outreach workers to identify and enroll children. Outreach staff visit places where families visit -- Medicaid offices, day care, schools, Head Start, and WIC. Applications and information are available from these places and others. Applications are available on a web site and the state uses radio, TV, and print media to advertise. The state does not have an enrollment broker and does not use a joint application for the Medicaid and SCHIP programs. The state has not requested a waiver for cost-effective alternatives or for the purchase of family coverage.
AL	AL SCHIP	Phase 1
AL	AL SCHIP	Phase 1	NA	At time of application, files are NOT cross-referenced to identify other public and private health insurance programs under which a child may be covered. cross-referenced to identify other public and private health insurance programs under
AL	AL SCHIP	All Kids (Phase 2)
AL	AL SCHIP	All Kids (Phase 2)	1	The state does not use an enrollment broker. There are limits on the amount of inpatient and outpatient substance abuse benefits. The state plan includes care coordination but not enabling services.
AL	AL SCHIP	All Kids (Phase 2)	2
AL	AL SCHIP	Plus (Phase 3)
AL	AL SCHIP	Plus (Phase 3)	2	To be eligible for the Plus program, the child cannot have other health insurance coverage. Applicants may not mail or fax applications. The state does not check Plus enrollment against a database of private insurance holders. No premiums are required for the Plus program. The state does not use an enrollment broker or a joint application for the Plus program and Medicaid. HMOs are not used to deliver services. Program benefits include enabling services, case management and care coordination. An enrollee survey is not conduced for quality assurance for the Plus program.
AR	AR SCHIP	Phase I - ARKids A
AR	AR SCHIP	Phase I - ARKids A	NA
AR	AR SCHIP	Phase II - ARKids B
AR	AR SCHIP	Phase II - ARKids B	1
AS	AS SCHIP		NA
AZ	KidsCare		NA
AZ	KidsCare		1
AZ	KidsCare		2
AZ	KidsCare		3
AZ	KidsCare		4
CA	Healthy Families	Medi-Cal Expansion
CA	Healthy Families	Medi-Cal Expansion	NA
CA	Healthy Families	Medi-Cal Expansion	1
CA	Healthy Families	Medi-Cal Expansion	2
CA	Healthy Families	Health Insurance Plan (MRMIB)
CA	Healthy Families	Health Insurance Plan (MRMIB)	NA
CA	Healthy Families	Health Insurance Plan (MRMIB)	2
CA	Healthy Families	Health Insurance Plan (MRMIB)	3
CA	Healthy Families	Health Insurance Plan (MRMIB)	4
CA	Healthy Families	Health Insurance Plan (MRMIB)	5
CA	Healthy Families	Access for Infants and Mothers (AIM)
CA	Healthy Families	Access for Infants and Mothers (AIM)	NA
CA	Healthy Families	Access for Infants and Mothers (AIM)	2
CA	Healthy Families	Access for Infants and Mothers (AIM)	3
CA	Healthy Families	Access for Infants and Mothers (AIM)	4
CA	Healthy Families	Access for Infants and Mothers (AIM)	5
CA	Healthy Families	Child Health and Disability Prevention Program
CA	Healthy Families	Child Health and Disability Prevention Program	NA
CA	Healthy Families	Child Health and Disability Prevention Program	2
CA	Healthy Families	Child Health and Disability Prevention Program	3
CA	Healthy Families	California Children`s Services
CA	Healthy Families	California Children`s Services	NA
CA	Healthy Families	California Children`s Services	2
CA	Healthy Families	County Mental Health Program
CA	Healthy Families	County Mental Health Program	NA
CA	Healthy Families	County Mental Health Program	2
CO	CHP+		NA	The state does not use income disregards or asset tests. The state conducts random spot checks for eligibility and the applicant selects a PCP and/or HMO at the time of the application. The state plans to implement a fully-integrated CHP+/Medicaid eligibility system by July 2003. The state does not have other insurance subsidy programs and it does not check the CHP+ enrollment against a database of private insurance holders. The state conducts joint outreach, has a joint application, and a referral system with other low income insurance programs for low-income children. The state does not use an enrollment broker, but does use community-based organizations to help with outreach. The service delivery model for CHP+ may include PCCMs, HMOs, and Medicaid providers; it does not include FFS. Additional program benefits include family planning, limited outpatient substance abuse, physical therapy, occupational therapy, and speech therapy; dental care is not included. Copayment amounts vary between $0, $2, and $5.
CO	CHP+		1
CO	CHP+		2
CT	HUSKY Program	Part A
CT	HUSKY Program	Part A	NA	Plans must submit claims/encounter data to the state for quality assurance. The state also uses CAHPS for quality assurance.
CT	HUSKY Program	Part A	0
CT	HUSKY Program	Part A	1
CT	HUSKY Program	Part B
CT	HUSKY Program	Part B	NA
CT	HUSKY Program	Part B	1
CT	HUSKY Program	HUSKY Plus Plan for Children with Special Physical Health Needs	NA	The state claims that the eligibility provisions are not applicable -- the child must only meet the disability requirement and be enrolled in Husky B. The sections on methods of establishing and continuing enrollment, how Medicaid eligibles are enrolled in Medicaid, how programs does not substitute for private coverage, how assistance is provided to Indians, and performance measures are not applicable for the HUSKY Plus program for children with special needs. The state conducts joint outreach with other insurance programs for low-income children. Benefits include outpatient, clinic/other ambulatory, prescription drugs, lab/radiology, durable medical equipment, disposable medical equipment, home/community based care, nursing care, dental, case management, care coordination, PT (with limits), OT (with limits), ST (with limits), medical transportation and enabling services. The plan does not include inpatient, inpatient mental health, outpatient mental health, abortion, routine dental, inpatient or outpatient substance abuse, or premiums for private coverage. To measure performance, the state will use a HUSKY Plus medical record audit tool.
CT	HUSKY Program	HUSKY Plus Plan for Children with Special Physical Health Needs	1
CT	HUSKY Program	HUSKY Plus Behavioral Health Plan	NA	The state claims that the eligibility provisions are not applicable; those enrolled in HUSKY Plus Behavioral Health Plan must be eligible and enrolled in HUSKY B with income at or below 300%. The sections on methods of establishing and continuing enrollment, how Medicaid eligibles are enrolled in Medicaid, how programs does not substitute for private coverage, how assistance is provided to Indians, and performance measures is not applicable. The state conducts joint outreach with other insurance programs for low-income people. The program contracts with traditional Medicaid providers of Children's FFS behavioral health services. The state contracts with the program as an administratrof of the program paid on a quarterly basis.
CT	HUSKY Program	HUSKY Plus Behavioral Health Plan	1
DC	DC Healthy Kids		NA
DE	Delaware Healthy Children`s Program		NA
DE	Delaware Healthy Children`s Program		1
FL	FL KidCare	Medicaid expansion
FL	FL KidCare	Medicaid expansion	NA
FL	FL KidCare	Medicaid expansion	1
FL	FL KidCare	Healthy Kids
FL	FL KidCare	Healthy Kids	NA
FL	FL KidCare	Healthy Kids	1
FL	FL KidCare	Healthy Kids	3
FL	FL KidCare	Healthy Kids	4
FL	FL KidCare	Medi-Kids	1
FL	FL KidCare	Medi-Kids	4
FL	FL KidCare	CMS	1
FL	FL KidCare	CMS	4
GA	Peach Care for Kids		NA
GA	Peach Care for Kids		0
GA	Peach Care for Kids		1
GU	Guam SCHIP		NA
HI	HI SCHIP	Phase I	NA
HI	HI SCHIP	Phase I	1
IA	Hawk-I	Medicaid Expansion	NA
IA	Hawk-I	Medicaid Expansion	4
IA	Hawk-I	Separate State Program	1
IA	Hawk-I	Separate State Program	2
IA	Hawk-I	Separate State Program	3
IA	Hawk-I	Separate State Program	4
ID	ID SCHIP		NA
ID	ID SCHIP		1
ID	ID SCHIP		2
IL	Kidcare	Phase 1	NA
IL	Kidcare	Phase 2	1
IN	Hoosier Healthwise	Phase 1	NA
IN	Hoosier Healthwise	Phase 1	0	Applicants choose PCP/HMO at the time of application and applicants may fax or mail application to the state. The state checks Hoosier Healthwise enrollment against a database of private insurance holders. The state uses an enrollment broker. The state did not request waivers for cost-effective alternatives or the purchase of family coverage.
IN	Hoosier Healthwise	Phase 2	2
KS	HealthWave		NA	The state does not use presumptive eligibility. The state uses secretary-approved coverage as its benefits benchmark rather than the state employee plan. The state uses HEDIS for quality assurance, but it does not conduct an external adit/in-depth review or credential plans. There is a cap on the premium amount per child, but the state has not specified the cap.
KS	HealthWave		1
KY	KCHIP	Medicaid Expansion
KY	KCHIP	Medicaid Expansion	NA
KY	KCHIP	Medicaid Expansion	1
KY	KCHIP	Insurance Product
KY	KCHIP	Insurance Product	NA
KY	KCHIP	Insurance Product	1
KY	KCHIP	Insurance Product	2
LA	LaCHIP		NA
LA	LaCHIP		1
MA	MassHealth	Standard	NA
MA	MassHealth	Family Assistance Direct Coverage	NA
MA	MassHealth	Family Assistance Premium Assistance	NA
MA	MassHealth	Common Health	NA
MD	Maryland Children`s Health Program	Phase I	NA
MD	Maryland Children`s Health Program	Phase I	1
MD	Maryland Children`s Health Program	Phase II	2
MD	Maryland Children`s Health Program	Phase II- ESI	2
ME	ME CHIP Medicaid Expansion		NA
ME	Cubcare		NA
ME	Cubcare		1
MI	MI SCHIP	MI CHILD	NA
MI	MI SCHIP	MI CHILD	1
MI	MI SCHIP	MI CHILD	2
MI	MI SCHIP	Medicaid Expansion	1
MI	MI SCHIP	Medicaid Expansion	2
MN	Minnesota Medical Assistance Program		NA
MO	MC+ for Kids		NA
MO	MC+ for Kids		1
MP	CNMI SCHIP		NA
MS	MS SCHIP	Phase I
MS	MS SCHIP	Phase I	NA
MS	MS SCHIP	Phase II
MS	MS SCHIP	Phase II	1
MS	MS SCHIP	Phase II	2
MS	MS SCHIP	Phase II	3
MS	MS SCHIP	Employer-sponsored coverage	1
MT	MT SCHIP		NA
MT	MT SCHIP		1
NC	NC SCHIP		NA
NC	NC SCHIP		1
NC	NC SCHIP		2
NC	NC SCHIP		3
NC	NC SCHIP		4
NC	NC SCHIP		5
ND	Healthy Steps	Phase I
ND	Healthy Steps	Phase I	NA
ND	Healthy Steps	Phase II
ND	Healthy Steps	Phase II	1
NE	Kid`s Connection		NA
NE	Kid`s Connection		1
NH	Healthy Kids	Gold	NA
NH	Healthy Kids	Gold	1
NH	Healthy Kids	Silver	NA
NJ	KidCare	Plan A	NA
NJ	KidCare	Plan B	NA
NJ	KidCare	Plan B	1
NJ	KidCare	Plan B	3
NJ	KidCare	Plan B	4
NJ	KidCare	Plan C	NA
NJ	KidCare	Plan C	1
NJ	KidCare	Plan C	3
NJ	KidCare	Plan C	4
NJ	KidCare	Plan D	2
NJ	KidCare	Plan D	3
NJ	KidCare	Plan D	4
NJ	KidCare	1115 Demonstration	NA
NM	NM SCHIP		NA
NM	NM SCHIP		2
NM	NM SCHIP	1115 Demonstration	NA
NV	Nevada Check-Up		NA
NV	Nevada Check-Up		1
NY	NY SCHIP	CHPLUS
NY	NY SCHIP	CHPLUS
NY	NY SCHIP	CHPLUS	NA
NY	NY SCHIP	CHPLUS	2
NY	NY SCHIP	Medicaid Expansion	2
OH	OH Child Health Plan		NA
OH	OH Child Health Plan		1
OK	SoonerCare		NA
OK	SoonerCare		1
OR	OR SCHIP		NA
OR	OR SCHIP		2
OR	OR SCHIP		3
PA	PA SCHIP		NA
PA	PA SCHIP		1
PA	PA SCHIP		2
PA	PA SCHIP		3
PA	PA SCHIP		4
PR	PR SCHIP		NA
RI	RIte Care		NA	The state does use income diregards and has a mandatory period of no coverage of 4 months. Applicants may mail or fax applications to the state and there are annual redeterminations. Children in the Family Independence Program and medical assistance family programs are immediately eligible. The state does not use an enrollment broker.
RI	RIte Care		1
RI	RIte Care	1115 Demonstration	NA
SC	Partners for Healthy Children		NA
SD	SD SCHIP		NA
SD	SD SCHIP		1
SD	SD SCHIP		2
SD	SD SCHIP	CHIP NM	3
TN	Tennessee`s CHIP	Phase I	NA
TX	Texas Healthy Steps	Phase I
TX	Texas Healthy Steps	Phase I	NA
TX	Texas Healthy Steps	Phase II
TX	Texas Healthy Steps	Phase II	1
UT	UT SCHIP		NA
VA	VA SCHIP	Children's Medical Security Insurance Plan/Family Access to Medical Insurance Security Plan	NA	Some services are delivered FFS. For quality assurance the state requires credentialling of plans and providers. The state also uses HEDIS and CAHPS. Satisfaction is used as a performance measure.
VA	VA SCHIP	Children's Medical Security Insurance Plan/Family Access to Medical Insurance Security Plan	1
VA	VA SCHIP	Family Access to Medical Insurance Security Plan (FAMIS) - ESI	1
VI	Virgin Island`s SCHIP		NA
VI	Virgin Island`s SCHIP		1
VT	VT SCHIP		NA	The income threshold for premiums (cost sharing) is 225% FPL. Copayments for office visits were never implemented.
VT	VT SCHIP		1
VT	VT SCHIP		2
VT	VT SCHIP		3
WA	WA SCHIP		NA
WA	WA SCHIP		1
WI	BadgerCare	Medicaid expansion
WI	BadgerCare	Medicaid expansion	NA
WI	BadgerCare	Medicaid expansion	1
WI	BadgerCare	Employer-sponsored Coverage	1
WI	BadgerCare		NA
WV	WV SCHIP	Phase I	NA
WV	WV SCHIP	Phase I	2
WV	WV SCHIP	Phase II	1
WV	WV SCHIP	Phase II	2
WV	WV SCHIP	Phase II	3
WY	WY SCHIP	CHIP One	NA