SCHIP

Since its establishment in 1997, State Children's Health Insurance Programs have become a popular way to ensure coverage for each state's uninsured, low income children. But given the finite SCHIP funds available to states, demand for the program often exceeds capacity and qualifying children are denied access.

HMS's eligibility identification services help SCHIP agencies identify enrolled children that already have other coverage, allowing other children access to SCHIP benefits. These same services can be used during the initial application process to identify insurance coverage before actual enrollment. Both of these activities help SCHIPs ensure that program benefits are truly serving those who meet program participation requirements. At the same time, states are able to demonstrate compliance with program rules, which can affect future federal funding allotments.

When we locate other third party coverage for SCHIP-enrolled children, we conduct reclamation activities to recoup payments that were the responsibility of another third party.