PUBLICATION OF PROPOSED REGULATION ENSURING

PATIENT PROTECTIONS IN THE CHILDREN'S
HEALTH INSURANCE PROGRAM

HHS Secretary Donna E. Shalala announced a proposed regulation today that will extend patient protections to all children enrolled in the Children's Health Insurance Program (CHIP), a federal-state partnership that provides health insurance for America's uninsured children.

The proposed rule, on display today at the Federal Register, includes protections such as access to health care specialists, access to emergency services when and where the need arises, an assurance that doctor and patients can openly discuss treatment options, and access to a fair, unbiased and timely appeals process. This proposed regulation is consistent with President Clinton's 1998 Executive Order that all federal health plans -- collectively covering more than 85 million Americans -- should come into compliance with the Patients' Bill of Rights.

"The CHIP program is one of the proudest achievements of the Clinton administration," said Secretary Shalala. "Not since the creation of Medicaid has the nation taken such an affirmative action to assure the health of its most vulnerable children. This proposed regulation is the next step in improving access to health care for millions of America's children."

Since CHIP was launched two years ago, more than 1.3 million children have been enrolled. In a unique federal-state partnership, each state has designed a CHIP program best suited to reach its own uninsured children. The states have created innovative CHIP outreach campaigns such as Georgia partnering with K-Mart to distribute CHIP flyers as parents take their children shopping for school clothes and New Jersey creating a CHIP check-off box on the back of the Free and Reduced Cost Lunch application.

All 50 states, five U.S. territories, and the District of Columbia have had their CHIP plans approved. Additionally, 28 amendments to CHIP plans have been approved to enroll even more children. HHS continues to provide technical assistance to the states in drafting their plans and amendments to streamline the states' CHIP plan approval process as well as sending federal teams to work with states to eliminate possible barriers to enrollment.

Additionally, this new regulation codifies current CHIP policies and practices that the federal government developed in partnership with the states. These policies include:

• enrolling all eligible children in the CHIP program;
• ensuring that Medicaid eligible children are enrolled when appropriate ;
• ensuring a nominal level of family cost-sharing; and,
• requiring a meaningful benefits package when a state opts to create a separate state CHIP plan.

Signed into law two years ago by President Clinton, CHIP allocates $24 billion in federal funds over its first five years to enable the states to find, enroll, and insure eligible children across the nation. CHIP provides health care insurance to children who are mostly from working families with incomes too high to qualify for regular Medicaid but too low to afford private health insurance. With continued outreach efforts, the states and U.S. territories estimate that they will enroll 2.6 million children by September 2000.

"It is heartwarming to see how states are embracing this program," said Michael Hash, deputy administrator of the Health Care Financing Administration (HCFA). "This rule is the culmination of two years of working with states to develop policies that will continue CHIP's success. It is a trustworthy blueprint for the states as they continue strengthening and expanding their CHIP plans."

"The publication of this proposed regulation is a critical step in implementing this historic program," said Earl Fox, administrator of the Health Resources and Services Administration that works together with HCFA to administer the CHIP program. "Providing health coverage to America's uninsured children will help get them the medical care they need to begin healthy, happy, and productive lives."

The proposed CHIP regulation will have a 60-day public comment period. After comments have been evaluated and incorporated, the final regulation will be published.

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