CHIP Administration & Eligibility

Template CS30 – General Eligibility - List of Qualified Entities

Statute: Section 1920A

Regulation: 42CFR457.301

INTRODUCTION

This template applies only to States with separate child health assistance programs.

This template is not accessed directly. It is used in conjunction with templates CS28 (P.E for children) or CS29 (P.E. for pregnant women) and is displayed for States to identify the types of organizations it uses as qualified entities.

BACKGROUND

42 CFR457.301 defines Qualified Entities and identifies certain types of entities which may be used for the purpose of making determinations of presumptive eligibility. Agencies must meet the requirements specified in the Regulation.

TECHNICAL GUIDANCE

PREREQUISITE: States must have completed either template CS28 or CS29 through the Qualified Entities section within which this template gets displayed.

In template CS30, States select one or more of the options listed as to the types of entities used by the State to determine presumptive eligibility for children, if displayed within template CS28 and for pregnant women if displayed within template CS29.

If the State selects ‘Any other entity the State so deems, as approved by the Secretary’, it must enter the name and description of the entity in the text boxes provided. If there is more than one other entity, the State can reselect this option until all the additional entities have been entered.

Review Criteria

The description should be sufficiently clear, detailed and complete to permit the reviewer to determine that the State’s election meets applicable federal statutory, regulatory and policy requirements.

After the entities have been selected, the CHIP Agency must provide assurance that it has communicated the requirements for qualified entities at 1920A(b)(3) of the Act, and provided adequate training to the entities and organizations involved.

The State provides this affirmative assurance by checking the box next to the assurance statement. If the State does not check this box, the system will not accept this template for review and approval.

The State must then upload a copy of the training materials via the upload function.

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