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2 Effective Date: July 1, 2009

Approval Date:

Table of Contents

Section 1. General Description and Purpose of the State Child Health Plans and State Child Health Plan Requirements (Section 2101) ................................................................ 5 1.1 The State will use funds provided under Title XXI primarily for (Check appropriate box) (42 CFR 457.70): .................................................................................................... 5 1.2 .................................................................................................................................. 6 1.3 .................................................................................................................................. 6 1.4 .................................................................................................................................. 6 Section 2. General Background and Description of State Approach to Child Health Coverage and Coordination (Section 2102 (a)(1)-(3)) and (Section 2105)(c)(7)(A)-(B)) .... 9 2.1. ................................................................................................................................. 9 2.2. ................................................................................................................................. 9 2.3. ............................................................................................................................... 12 Section 3. Methods of Delivery and Utilization Controls (Section 2102)(a)(4)) ......... 14 3.1. ............................................................................................................................... 14 3.2. ............................................................................................................................... 18 Section 4. Eligibility Standards and Methodology (Section 2102(b)) ............................. 20 4.1. ............................................................................................................................... 20 4.2. ............................................................................................................................... 23 4.3. ............................................................................................................................... 23 4.4. ............................................................................................................................... 25 Section 5. Outreach (Section 2102(c) ............................................................................ 30 Section 6. Coverage Requirements for Children’s Health Insurance (Section 2103) .... 32 6.1. ............................................................................................................................... 32 Indian Health Clinics ......................................................................................................... 6.2. ............................................................................................................................... 35 6.3 ................................................................................................................................ 37 6.4. ............................................................................................................................... 38