SNAC-recommended Initial Core Set, September 18, 2009
Title IV (Section 401(a)) of the Children's Health Insurance Program Reauthorization Act (CHIPRA; Public Law 111-3; February 3, 2009) amended Section 1139 of Title XI (42 U.S.C. 1301 et seq.) by adding a new section 1139A on Child Health Quality Measures. Section 1139A called for the Secretary of the U.S. Department of Health and Human Services (HHS) to "identify and publish for general comment an initial, recommended core set of child health quality measures for use by State programs administered under titles XIX and XXI, health insurance issuers and managed care entities that enter into contracts with such programs, and providers of items and services under such programs."
The legislation called for identification of "existing quality of care measures for children that are in use under public and privately sponsored health care coverage arrangements, or that are part of reporting systems that measure both the presence and duration of health insurance coverage over time."
Further, measures were asked to be identified for the following topics, although others could be included: duration of enrollment and coverage; preventive and health promotion services; treatment and management for acute and chronic conditions in children; family experiences of care, most integrated health care settings; and availability of services. CHIPRA also calls for evidence-based measures and measures that can identify disparities in health care quality by race and ethnicity, socioeconomic status, and special health care need. The measures are to be published no later than January 1, 2010.
In response to this legislative directive, the Agency for Healthcare Research and Quality (AHRQ) and Centers for Medicare and Medicaid Services (CMS) signed a Memorandum of Understanding in April 2009 giving AHRQ leadership responsibilities for identifying the initial core set, working in very close partnership with CMS. CMS has the authority for implementation of all CHIPRA provisions.