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Provider Networks: Comparison of Child-Focused Network Adequacy Standards between CHIP and Private Health Plans
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Katherine M. Iritani (au)
Federal funding for the joint federal-state State Childrenäó»s Health Insurance Program (CHIP) expires at the end of FY 2017. Any state with insufficient federal CHIP funding is required to have procedures to enroll eligible children in qualified health plans (QHPs) certified by the Department of Health and Human Services (HHS) as comparable to CHIP, if any such QHPs are available. This report examines (1) federal and selected state CHIP and QHP network adequacy standards; (2) the extent to which selected issuers of CHIP plans and QHPs include childrenäó»s hospitals and otherwise help ensure access to pediatric specialists; and (3) how CMS and selected states monitor CHIP plan and QHP compliance with adequacy standards. Tables and figure. This is a print on demand report.
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