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Effective Date:

Approval Date:

Updated and amended effective August 24, 2001

25

(see Appendix A).

D. Fiscal year 1996 state expenditures for CHIP are as follows: CHIP expenditures in fiscal year 1996 totaled $31,611,373, including an expenditure of $30,685,814 for its Free Program, and $915,559 for its Subsidized Program.

6.1.4.

Secretary-Approved Coverage. (Section 2103(a)(4)) (42 CFR 457.450)

6.1.4.1. Coverage the same as Medicaid State plan

6.1.4.2. Comprehensive coverage for children under a Medicaid Section 1115 demonstration project

6.1.4.3. Coverage that either includes the full EPSDT benefit or that the state has extended to the entire Medicaid population

6.1.4.4. Coverage that includes benchmark coverage plus additional coverage

6.1.4.5. Coverage that is the same as defined by existing comprehensive state-based coverage

6.1.4.6. Coverage under a group health plan that is substantially equivalent to or greater than benchmark coverage through a benefit by benefit comparison (Please provide a sample of how the comparison will be done)

6.1.4.7. Other (Describe)