|
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. ME = Medicaid expansion SSP = Separate state program Numbers in boxes: Place the on-screen arrow over the numbers in black or white boxes to view the program names. Click on the numbers in white boxes to view additional program information. Asterisks: Click on the asterisks to view footnotes. |
| Identifiers | Quality Assurance | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| State | # of Programs | Name | # of Amendments | External Audit/ In-depth Review | Credentialing of Plans | Credentialing of Providers | Plans Must Submit Claims/ Encounter Data | Plans Must Report Summary Data | Enrollee Survey | Enrollment Monitoring | Grievance/Complaint Process |
| AK | 1 | AK Denali KidCare | NA | -- | -- | -- | -- | -- | -- | -- | -- |
| AL | 3 | AL SCHIP | 2 | No or NR | No or NR | No or NR | Yes | Yes | Yes | No or NR | No or NR |
| AR | 2 | AR SCHIP | 1 | Yes | No or NR | No or NR | Yes | Yes | Yes | No or NR | Yes |
| AS | 1 | AS SCHIP | NA | -- | -- | -- | -- | -- | -- | -- | -- |
| AZ | 1 | KidsCare | 4 | Yes | No or NR | No or NR | Yes | Yes | Yes | Yes | No or NR |
| CA | 6 | Healthy Families | 5 | Yes | Yes | Yes | No or NR | Yes | Yes | Yes | Yes |
| CO | 1 | CHP+ | 2 | Yes | Yes | Yes | Yes | Yes | Yes | No or NR | Yes |
| CT | 4 | HUSKY Program | 1 | Yes | Yes | Yes | No or NR | Yes | Yes | No or NR | Yes |
| DC | 1 | DC Healthy Kids | NA | Yes | -- | -- | Yes | Yes | -- | Yes | -- |
| DE | 1 | Delaware Healthy Children`s Program | 1 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| FL | 4 | FL KidCare | 4 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| GA | 1 | Peach Care for Kids | 1 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| GU | 1 | Guam SCHIP | NA | -- | -- | -- | Yes | Yes | -- | Yes | -- |
| HI | 1 | HI SCHIP | 1 | -- | -- | -- | -- | Yes | -- | -- | -- |
| IA | 2 | Hawk-I | 4 | No or NR | No or NR | No or NR | Yes | No or NR | No or NR | No or NR | No or NR |
| ID | 1 | ID SCHIP | 2 | -- | -- | -- | -- | -- | -- | -- | -- |
| IL | 2 | Kidcare | 1 | Yes | No or NR | No or NR | No or NR | Yes | Yes | Yes | Yes |
| IN | 2 | Hoosier Healthwise | 2 | No or NR | Yes | No or NR | No or NR | Yes | Yes | No or NR | Yes |
| KS | 1 | HealthWave | 1 | Yes | Yes | No or NR | Yes | Yes | Yes | Yes | Yes |
| KY | 2 | KCHIP | 2 | No or NR | No or NR | No or NR | Yes | Yes | Yes | No or NR | Yes |
| LA | 1 | LaCHIP | 1 | -- | -- | -- | Yes | -- | -- | -- | -- |
| MA | 4 | MassHealth | NA | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| MD | 3 | Maryland Children`s Health Program | 2 | Yes | No or NR | No or NR | Yes | No or NR | Yes | No or NR | No or NR |
| ME | 2 | Cubcare | 1 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| MI | 2 | MI SCHIP | 2 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| MN | 1 | Minnesota Medical Assistance Program | NA | -- | -- | -- | -- | -- | -- | -- | -- |
| MO | 1 | MC+ for Kids | 1 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| MP | 1 | CNMI SCHIP | NA | -- | -- | -- | -- | -- | Yes | -- | -- |
| MS | 3 | MS SCHIP | 3 | No or NR | No or NR | Yes | Yes | No or NR | Yes | No or NR | No or NR |
| MT | 1 | MT SCHIP | 1 | No or NR | No or NR | No or NR | Yes | No or NR | No or NR | No or NR | Yes |
| NC | 1 | NC SCHIP | 5 | No or NR | No or NR | No or NR | Yes | No or NR | Yes | No or NR | No or NR |
| ND | 2 | Healthy Steps | 1 | Yes | Yes | No or NR | No or NR | Yes | Yes | No or NR | Yes |
| NE | 1 | Kid`s Connection | 1 | -- | -- | -- | -- | -- | -- | -- | -- |
| NH | 2 | Healthy Kids | 1 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| NJ | 5 | KidCare | 4 | Yes | No or NR | No or NR | Yes | Yes | Yes | No or NR | Yes |
| NM | 2 | NM SCHIP | 2 | No or NR | No or NR | No or NR | No or NR | No or NR | No or NR | No or NR | No or NR |
| NV | 1 | Nevada Check-Up | 1 | Yes | Yes | No or NR | Yes | Yes | Yes | No or NR | Yes |
| NY | 2 | NY SCHIP | 2 | No or NR | No or NR | Yes | Yes | Yes | Yes | Yes | No or NR |
| OH | 1 | OH Child Health Plan | 1 | Yes | -- | -- | Yes | Yes | -- | -- | -- |
| OK | 1 | SoonerCare | 1 | -- | -- | -- | -- | -- | -- | -- | -- |
| OR | 1 | OR SCHIP | 3 | Yes | Yes | Yes | Yes | Yes | Yes | No or NR | Yes |
| PA | 1 | PA SCHIP | 4 | Yes | Yes | No or NR | Yes | Yes | Yes | Yes | Yes |
| PR | 1 | PR SCHIP | NA | -- | -- | -- | -- | -- | -- | -- | -- |
| RI | 2 | RIte Care | 1 | No or NR | No or NR | No or NR | No or NR | No or NR | No or NR | No or NR | No or NR |
| SC | 1 | Partners for Healthy Children | NA | -- | -- | -- | -- | -- | -- | -- | -- |
| SD | 2 | SD SCHIP | 3 | Yes | No or NR | No or NR | Yes | Yes | Yes | Yes | Yes |
| TN | 1 | Tennessee`s CHIP | NA | -- | -- | -- | -- | -- | -- | -- | -- |
| TX | 2 | Texas Healthy Steps | 1 | No or NR | No or NR | Yes | Yes | No or NR | Yes | Yes | Yes |
| UT | 1 | UT SCHIP | NA | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| VA | 2 | VA SCHIP | 1 | No or NR | Yes | Yes | No or NR | Yes | No or NR | No or NR | No or NR |
| VI | 1 | Virgin Island`s SCHIP | 1 | -- | -- | -- | -- | -- | -- | -- | -- |
| VT | 1 | VT SCHIP | 3 | No or NR | No or NR | No or NR | No or NR | No or NR | No or NR | No or NR | No or NR |
| WA | 1 | WA SCHIP | 1 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| WI | 3 | BadgerCare | 1 | No or NR | Yes | No or NR | Yes  | Yes | Yes | Yes | No or NR |
| WV | 2 | WV SCHIP | 3 | Yes | No or NR | No or NR | Yes | Yes | Yes | No or NR | Yes |
| WY | 1 | WY SCHIP | NA | No or NR | No or NR | No or NR | No or NR | No or NR | Yes | No or NR | Yes |
| U.S. | # of Programs Mean| Range | | # of Amendments Mean|Range | # of States That Conduct External Audit/ In-depth Review | # of States That Credential Plans | # of States That Credential Providers | # of States That Require Plans to Submit Claims/ Encounter Data | # of States That Require Plans to Report Summary Data | # of States That Conduct Enrollee Survey | # of States That Monitor Enrollment | # of States with Grievance/ Complaint Process |
| 56 | 1.8 | 1 - 6 | 1.5 | 0 - 5 | 27 | 21 | 18 | 34 | 34 | 35 | 21 | 28 | |