Department of Health

Management of Child Health Plus Program

In New York State's Child Health Plus program, which is administered by the Department of Health, fully or partly subsidized health insurance coverage is provided to low-income children who are not eligible for Medicaid. Beginning in 1998, the program is eligible to receive federal funds, which could total about $257 million a year. However, we found that if certain changes are not made in program rules and administration, it is unlikely that the Department will be able to obtain all available federal funds. For example, Department officials intend to make use of the additional funding by increasing program enrollment from 37 percent of the targeted population in 1997 to 85 percent of the targeted population by the year 2000. However, we question whether such a large increase can be achieved in so short a time. Therefore, to make use of the additional funding, we recommend that program coverage be expanded. After our field work was completed, the Governor proposed changes in program coverage that are consistent with our recommendation.

We also found that, contrary to federal regulations, many Medicaid eligible children appear to be enrolled in the Child Health Plus program instead of in Medicaid. If such children continue to be enrolled in the program, we estimate that New York could lose $35 million a year in federal funds. Since the Department is also responsible for administering New York's Medicaid program, we recommend the Department develop a process for enrolling children in the correct program.

For a complete copy of Report 97-S-10 click here.
For a copy of the 90-day response click here.