Application Procedures, Eligibility Requirements Impact CHIP, Medicaid Enrollment, GAO Study Finds
Medicaid and CHIP program eligibility and application requirements can impact the ability of beneficiaries to "obtain and keep coverage," a study by the General Accounting Office found. The study, "Medicaid and SCHIP: State's Enrollment and Payment Policies Can Affect Children's Access to Care," examined the processes for applicants to "obtain, maintain, and renew" enrollment in Medicaid and CHIP in 10 states -- Alabama, California, Colorado, Florida, Kansas, Michigan, New York, North Carolina, Pennsylvania and Utah. The study also analyzed payment information in four states by comparing fee-for-service Medicaid and CHIP programs with those that use capitation payment systems. While eight of the 10 states used joint applications for their Medicaid and CHIP programs, the study found that the "extent of coordination" between the two programs affected applicants' ability to enroll, as forms are often transferred between offices, which may cause delays. The study also found that differences in the health plans and providers that participate in Medicaid and CHIP programs have implications for beneficiaries' access to care. However, GAO found that having a choice of managed care health plans or of primary care case managers did "not necessarily give beneficiaries greater access to providers" because plan choices may be limited or exclude plans with larger networks ("Medicaid and SCHIP: States' Enrollment and Payment Policies Can Affect Children's Access To Care, Sept. 2001). The full study is available online.
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