The CMS August 2007 Directive: Implementation Issues and Implications for State SCHIP Programs

This State Health Policy Briefing discusses the August 17, 2007 letter from the Centers for Medicare and Medicaid Services (CMS), which has major implications for the State Children’s Health Insurance Program (SCHIP) and children’s health coverage. Among states and advocates alike, there is concern that aspects of the directive work against achieving the goals of SCHIP and the broader purpose of assuring that children have health coverage and access to quality care.


This paper examines the four requirements within the directive that are of greatest concern to states. It also provides details and context on CMS’s directive requirements, background on current state policy and practice related to each requirement, along with a discussion of the issues and implications for states in assessing the feasibility and implications of responding to the new requirements.

shpbriefing_cmsdirective.pdf 225.1 KB


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