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Effective Date:

Approval Date:

Updated and amended effective August 24, 2001

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the Secretary requires. (Section 2107(b)(1)) (42CFR 457.720)

9.5.

The state assures it will comply with the annual assessment and evaluation required under Section 10. Briefly describe the state’s plan for these annual assessments and reports. (Section 2107(b)(2)) (42CFR 457.750)

CHIP requires the submission of annual reports containing information on enrollments, demographics, utilization of services, etc.

CHIP requires monitoring and evaluation of quality and access to health care services. The Department of Health contracts with an external review organization to conduct this evaluation.

9.6.

The state assures it will provide the Secretary with access to any records or information relating to the plan for purposes of review of audit. (Section 2107(b)(3)) (42CFR 457.720)

9.7.

The state assures that, in developing performance measures, it will modify those measures to meet national requirements when such requirements are developed. (42CFR 457.710(e))

Pennsylvania assumes the promulgation of such measures by the Secretary of the Department of Health and Human Services.

9.8. The state assures, to the extent they apply, that the following provisions of the Social Security Act will apply under Title XXI, to the same extent they apply to a state under Title XIX: (Section 2107(e)) (42CFR 457.135)

9.8.1.

Section 1902(a)(4)(C) (relating to conflict of interest standards)

9.8.2.

Paragraphs (2), (16) and (17) of Section 1903(i) (relating to limitations on payment)

9.8.3.

Section 1903(w) (relating to limitations on provider donations and taxes)

9.8.4.

Section 1132 (relating to periods within which claims must be filed)

9.9. Describe the process used by the state to accomplish involvement of the public in the design and implementation of the plan and the method for insuring ongoing public involvement. (Section 2107(c)) (42CFR 457.120(a) and (b))

The Commonwealth of Pennsylvania, in December of 1997, conducted public forum hearings across the state to provide a platform for advocacy and community-based groups, private citizens and