
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document not affected by Public Laws enacted between
  January 23, 2000 and December 4, 2001]
[CITE: 42USC1397hh]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                       CHAPTER 7--SOCIAL SECURITY
 
        SUBCHAPTER XXI--STATE CHILDREN'S HEALTH INSURANCE PROGRAM
 
Sec. 1397hh. Annual reports; evaluations


(a) Annual report

    The State shall--
        (1) assess the operation of the State plan under this subchapter 
    in each fiscal year, including the progress made in reducing the 
    number of uncovered low-income children; and
        (2) report to the Secretary, by January 1 following the end of 
    the fiscal year, on the result of the assessment.

(b) State evaluations

                           (1) In general

        By March 31, 2000, each State that has a State child health plan 
    shall submit to the Secretary an evaluation that includes each of 
    the following:
            (A) An assessment of the effectiveness of the State plan in 
        increasing the number of children with creditable health 
        coverage.
            (B) A description and analysis of the effectiveness of 
        elements of the State plan, including--
                (i) the characteristics of the children and families 
            assisted under the State plan including age of the children, 
            family income, and the assisted child's access to or 
            coverage by other health insurance prior to the State plan 
            and after eligibility for the State plan ends,
                (ii) the quality of health coverage provided including 
            the types of benefits provided,
                (iii) the amount and level (including payment of part or 
            all of any premium) of assistance provided by the State,
                (iv) the service area of the State plan,
                (v) the time limits for coverage of a child under the 
            State plan,
                (vi) the State's choice of health benefits coverage and 
            other methods used for providing child health assistance, 
            and
                (vii) the sources of non-Federal funding used in the 
            State plan.

            (C) An assessment of the effectiveness of other public and 
        private programs in the State in increasing the availability of 
        affordable quality individual and family health insurance for 
        children.
            (D) A review and assessment of State activities to 
        coordinate the plan under this subchapter with other public and 
        private programs providing health care and health care 
        financing, including medicaid and maternal and child health 
        services.
            (E) An analysis of changes and trends in the State that 
        affect the provision of accessible, affordable, quality health 
        insurance and health care to children.
            (F) A description of any plans the State has for improving 
        the availability of health insurance and health care for 
        children.
            (G) Recommendations for improving the program under this 
        subchapter.
            (H) Any other matters the State and the Secretary consider 
        appropriate.

                     (2) Report of the Secretary

        The Secretary shall submit to Congress and make available to the 
    public by December 31, 2001, a report based on the evaluations 
    submitted by States under paragraph (1), containing any conclusions 
    and recommendations the Secretary considers appropriate.

(c) Federal evaluation

                           (1) In general

        The Secretary, directly or through contracts or interagency 
    agreements, shall conduct an independent evaluation of 10 States 
    with approved child health plans.

                       (2) Selection of States

        In selecting States for the evaluation conducted under this 
    subsection, the Secretary shall choose 10 States that utilize 
    diverse approaches to providing child health assistance, represent 
    various geographic areas (including a mix of rural and urban areas), 
    and contain a significant portion of uncovered children.

                        (3) Matters included

        In addition to the elements described in subsection (b)(1) of 
    this section, the evaluation conducted under this subsection shall 
    include each of the following:
            (A) Surveys of the target population (enrollees, 
        disenrollees, and individuals eligible for but not enrolled in 
        the program under this subchapter).
            (B) Evaluation of effective and ineffective outreach and 
        enrollment practices with respect to children (for both the 
        program under this subchapter and the medicaid program under 
        subchapter XIX of this chapter), and identification of 
        enrollment barriers and key elements of effective outreach and 
        enrollment practices, including practices that have successfully 
        enrolled hard-to-reach populations such as children who are 
        eligible for medical assistance under subchapter XIX of this 
        chapter but have not been enrolled previously in the medicaid 
        program under that subchapter.
            (C) Evaluation of the extent to which State medicaid 
        eligibility practices and procedures under the medicaid program 
        under subchapter XIX of this chapter are a barrier to the 
        enrollment of children under that program, and the extent to 
        which coordination (or lack of coordination) between that 
        program and the program under this subchapter affects the 
        enrollment of children under both programs.
            (D) An assessment of the effect of cost-sharing on 
        utilization, enrollment, and coverage retention.
            (E) Evaluation of disenrollment or other retention issues, 
        such as switching to private coverage, failure to pay premiums, 
        or barriers in the recertification process.

                     (4) Submission to Congress

        Not later than December 31, 2001, the Secretary shall submit to 
    Congress the results of the evaluation conducted under this 
    subsection.

                             (5) Funding

        Out of any money in the Treasury of the United States not 
    otherwise appropriated, there are appropriated $10,000,000 for 
    fiscal year 2000 for the purpose of conducting the evaluation 
    authorized under this subsection. Amounts appropriated under this 
    paragraph shall remain available for expenditure through fiscal year 
    2002.

(d) Inspector General audit and GAO report

                              (1) Audit

        Beginning with fiscal year 2000, and every third fiscal year 
    thereafter, the Secretary, through the Inspector General of the 
    Department of Health and Human Services, shall audit a sample from 
    among the States described in paragraph (2) in order to--
            (A) determine the number, if any, of enrollees under the 
        plan under this subchapter who are eligible for medical 
        assistance under subchapter XIX of this chapter (other than as 
        optional targeted low-income children under section 
        1396a(a)(10)(A)(ii)(XIV) of this title); and
            (B) assess the progress made in reducing the number of 
        uncovered low-income children, including the progress made to 
        achieve the strategic objectives and performance goals included 
        in the State child health plan under section 1397gg(a) of this 
        title.

                         (2) State described

        A State described in this paragraph is a State with an approved 
    State child health plan under this subchapter that does not, as part 
    of such plan, provide health benefits coverage under the State's 
    medicaid program under subchapter XIX of this chapter.

                 (3) Monitoring and report from GAO

        The Comptroller General of the United States shall monitor the 
    audits conducted under this subsection and, not later than March 1 
    of each fiscal year after a fiscal year in which an audit is 
    conducted under this subsection, shall submit a report to Congress 
    on the results of the audit conducted during the prior fiscal year.

(Aug. 14, 1935, ch. 531, title XXI, Sec. 2108, as added Pub. L. 105-33, 
title IV, Sec. 4901(a), Aug. 5, 1997, 111 Stat. 566; amended Pub. L. 
106-113, div. B, Sec. 1000(a)(6) [title VII, Sec. 703(b), (c)], Nov. 29, 
1999, 113 Stat. 1536, 1501A-401.)


                               Amendments

    1999--Subsecs. (c), (d). Pub. L. 106-113 added subsecs. (c) and (d).

                  Section Referred to in Other Sections

    This section is referred to in section 1397gg of this title.
