United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2000-04-14 monographic deposited born digital 38 p. GA 1.13:HEHS-00-86 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-00-86 P0b002ee180397d81 f:he00086 DGPO 2010-08-12 2011-03-24 GAOREPORTS-HEHS-00-86 machine generated eng fdlp REPORT GAOREPORTS-HEHS-00-86 HEHS-00-86 Health insurance Health care programs Disadvantaged persons Comparative analysis Children Federal/state relations State-administered programs Eligibility determinations Public assistance programs Medicaid Program State Children's Health Insurance Program Alabama Arkansas California Colorado Florida Kansas North Carolina New York Pennsylvania Utah Letter Report HEHS

Pursuant to a congressional request, GAO reviewed the Medicaid program and State Children's Health Insurance Program (SCHIP), focusing on the differences between both programs with regard to outreach, application and eligibility determination, screening and enrollment, and benefits.<p/>GAO noted that: (1) across GAO's sample of 10 states, Medicaid and SCHIP programs are similar in terms of their outreach mechanisms, but have differences in the way they enroll children and the scope of benefits they offer; (2) certain information that is federally required for Medicaid eligibility determination is not required for SCHIP; (3) however, half of the states GAO surveyed required more documentation for Medicaid than for SCHIP, and states often required more documentation for Medicaid than was federally required; (4) states do have the flexibility under federal law to streamline requirements for Medicaid and SCHIP; (5) while all of the states in GAO's sample reported policies and procedures to ensure that eligible children were appropriately enrolled in Medicaid rather than SCHIP, the ease with which Medicaid-eligible children were enrolled varied; (6) in some cases, persons applying for Medicaid for their children were required to fill out additional forms or appear in person in order to determine eligibility and obtain coverage; and (7) GAO's review of five optional benefits (dental, hearing, mental health, prescription drugs, and vision) shows that while states' SCHIP programs offer many of the same benefits as Medicaid, SCHIP imposes more limits on these benefits. https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-00-86/html/GAOREPORTS-HEHS-00-86.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-00-86/pdf/GAOREPORTS-HEHS-00-86.pdf GAO/HEHS-00-86 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-00-86 Letter Report GAO/HEHS-00-86; Medicaid and SCHIP: Comparisons of Outreach, Enrollment; Health insurance Health care programs Disadvantaged persons Comparative analysis Children Federal/state relations State-administered programs Eligibility determinations Public assistance programs Medicaid Program State Children's Health Insurance Program Alabama Arkansas California Colorado Florida Kansas North Carolina New York Pennsylvania Utah Title 42 Section 1396a(a)(10)(A) Title 42 Section 1396a(a)(10)(C) 42 U.S.C. 1396a(a)(10)(A) 42 U.S.C. 1396a(a)(10)(C) Title 42 Part 435.965 42 CFR Part 435.965