NY Health Access About Us   |   Contact Us Empire Justice Center Legal Aid Society NYLAG WNYLC

Child Health Plus in New York: A Program Primer

print  Print
share  Share
Views: 16046
Posted: 14 Oct, 2009
by --
Updated: 08 Sep, 2015
by Amanda Gallipeau (Empire Justice Center)

New York State’s Child Health Plus (CHP) program has undergone dramatic expansion in the past few years and is of increasing importance to low-income families with income above Medicaid levels.  Our clients often struggle with medical bills incurred during gaps in CHP coverage. Understanding eligibility and enrollment processes for CHP, and how the program differs from Medicaid, can help advocates make arguments about the timing of enrollment or dis-enrollment and the obligations plans may have had to extend coverage.

Advocates looking for official guidelines from the New York State Department of Health (NYSDOH) on CHP can look to the Model Contract for the CHP program.   Another good source for an official explanation of health plan obligations and responsiblities is the CHP Plan Manual .  General rules regarding eligibility for CHP also exist in statute.  See N.Y. Public Health Law §2511.   However, SDOH does not issue administrative directives to govern administration of the CHP program in anywhere near the volume it does for Medicaid and Family Health Plus, because local districts play a much smaller role in running the program.  Instead, NYSDOH contracts with health plans to process applications and make eligibility decisions..  

As of October 14, 2009, the 2008-2012 CHP contract is the most recent available.  However, advocates should be aware that SDOH is in the process of revising the contract.  The updated contract will be posted here as soon as it is available.

This article was authored by the Empire Justice Center.

Empire Justice Center

Attached files
item PLAN MANUAL for associations with attachments_sections (3-2008).doc (780 kb) Download
item 2008-2012 CONTRACT with expansion FINAL august.pdf (1.16 mb) Download

Also read
item Child Health Plus Overview
item Sources of Legal Authority for Health Care Advocates

Prev     Next
Public Health Insurance Programs in New York State       Temporary Protected Status (TPS) and Public Health Insurance

This site provides general information only. This is not legal advice. You can only obtain legal advice from a lawyer. In addition, your use of this site does not create an attorney-client relationship. To contact a lawyer, visit http://lawhelpny.org. We make every effort to keep these materials and links up-to-date and in accordance with New York City, New York state and federal law. However, we do not guarantee the accuracy of this information. To report a dead link or other website-related problem, please e-mail us.