Performance Improvement 2009. What Proportion of Eligible Low-Income Children Are Not Insured?


This Congressionally-mandated study sought to identify the percent of State Children’s Health Insurance Program (SCHIP) enrollees eligible for Medicaid.

Reviewers determined that 4 percent of children enrolled in separate SCHIPs were eligible for their States’ Medicaid program. These enrollment errors involved miscalculations of the families’ net income, clerical mistakes, and other unclassified errors. Projected to the population of all children enrolled in separate SCHIPs in 2006, the 4-percent error rate corresponded to about 105,000 children nationally. An additional 4.5 percent lacked sufficient documentation to make a determination regarding Medicaid eligibility, which leaves open the possibility that the number of children enrolled in separate SCHIPs who were eligible for Medicaid in 2006 could have been higher than our projection. The Centers for Medicare & Medicaid Services stated that it would continue to undertake a number of activities to prevent the types of errors identified.

Report Title: Separate State Children's Health Insurance Program Enrollees' Eligibility for Medicaid in 2006
Agency Sponsor: OS-OIG, Office of Inspector General
Federal Contact: Erin Lemire, 202-205-9523
Performer: Staff; Office of Inspector General
PIC ID: 9001

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"PerformanceImprovement2009.pdf" (pdf, 1.26Mb)

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