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4 Coverage), and 503 (Prospective Payments for Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs).
Children Covered Under Program
• The state reported that 35,894 children were ever enrolled in the program as of September 30, 2010
Health Care Delivery System
• The Department’s Medicaid Purchasing Administration (MPA) in coordination with the Department of Social and Health Services and other state agencies, including the Department of Health, the Governor’s Office, and the Health Care Authority, administers Washington CHIP.
• The program utilizes the State's Medicaid managed care delivery system and employs the Medicaid income eligibility criteria. The managed care system consists of contracts with health carriers for medical care coverage, contracts with Regional Support Networks (RSN) for mental health care, and fee for service (FFS) for primary care case management (PCCM) clinics.
• Families are not required to select a managed care plan for their child at the time of application. An automatic assignment will be made when a family does not make a selection at the time of application and there are two or more plans in that community.
Benefit Package
• Washington provides the same coverage to CHIP children that are provided to enrollees covered under the Medicaid State Plan.
Cost Sharing
• Washington charges a premium of $20 per month per child enrolled in CHIP with a family maximum of $40 per month for children above 200 percent of the FPL up to and including 250 percent of the FPL. For children from 251 percent of the FPL up to and including 300 percent of the FPL, premiums are $30 per month per child with a family maximum of $60 per month.
Crowd-Out Strategy
• In order to avoid crowd out, eligible children must be uninsured for 4 months prior to application in cases where the applicant had employer-sponsored dependent coverage. The State allows for certain exceptions to the 4-month waiting period.
• The CHIP application requests information regarding other insurance coverage for each