Crosswalk - Description of Dental Benefits Provided Under Medicaid and CHIP

Description of Dental Benefits Provided Under
Medicaid and the Chlidren's Health Insurance
Program (CHIP) - the previous form was paperbased.

Rev

Description of Dental Benefits Provided Under
Medicaid and the Chlidren's Health Insurance
Program (CHIP) - the paper form offers four
check-box choices for states to choose from: (1)
Medicaid; (2) CHIP Medicaid Expansion Program
ONLY; (3) CHIP Stand-Alone/Separate Program
ONLY: (4) CHIP Medicaid Expansion and StandAlone Program. For each of the four choices the
form offers a brief description. Option (3) offers
three sub-options: (a) Dental Services Provided
through a State-defined benefit package; (b)
Benchmark program; (c) Optional Supplemental
Dental Coverage for CHIP eligible children with
private or group insurance. For options 1, 2, and
3 there is a space to write in the state program
name. For option 3(b) there is a space to write in
the name of the benchmark plan.

Description of Dental Benefits Provided Under
Rev
Medicaid and the Chlidren's Health Insurance
Program (CHIP) - the electronic form offers five
check-box choices for states to choose from, with
an instruction to check all that apply: (1)
Medicaid; (2) Title XXI funded Medicaid
expansion; (3) Separate CHIP program that uses
a Medicaid benefit package; (4) separate CHIP
program that has a unique benefit package; and
(5) optional supplemental coverage for CHIP
eligible children with private or group coverage.
For options 1, 2, 3 and 4 there is a space to type
in the relevant state program name.

Burden Change

Reason for Change

Type of Change

2013 (new version)

2011 (old version)
Description of Dental Benefits Provided Under
Medicaid and the Chlidren's Health Insurance
Program (CHIP) - paper form

CMS created an electronic form for states to use. Yes. The electronic form
The electronic form is more convenient for states, streamlines the data
and enhances accuracy and tracking.
collection. It also
eliminates the need for a
separate email
communication to CMS.
Estimate: 1 hour
savings.

CMS revised the choices to more accurately
No.
reflect the way states implement their CHIP dental
programs. The revised form collects only the
information essential to creating a Summary of
Benefits that is accurate and comprehensible by
the public.

Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.