Department of Health

Eligibility of Children Enrolled in Child Health Plus B

In New York State’s Child Health Plus B Program, which is administered by the Department of Health, free or low-cost health insurance is provided to low-income children who are not eligible for Medicaid. We examined whether ineligible children were enrolled in the Child Health Plus B Program and identified more than 20,000 ineligible enrollments. The enrollments were ineligible because the children were either simultaneously enrolled in Medicaid, covered by other health insurance, or eligible for coverage under the State’s public employee health benefits plan. We determined that, during the six-month period covered by our analysis, the premiums paid by the State on behalf of these ineligible enrollments exceeded $2.6 million. We recommended the Department investigate the ineligible enrollments, recover all overpayments, and improve its controls to prevent such enrollments in the future.

For a complete copy of Report 2005-S-58 click here.
For a copy of the associated follow-up report click here.