DEPARTMENT OF HEALTH & HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, Maryland   21244-1850 
 
Center for Medicaid, CHIP and Survey & Certification 
 
SHO# 11-001 
CHIPRA# 20 
 
February 14, 2011 
 
Re: CHIPRA Quality Measures 
 
Dear State Health Official:  
 
Part of creating an effective and efficient health system is the ability to measure access to 
services; the quality of the services provided; and most importantly, the individuals experiences 
with those services.  Most States already collect and report heath care quality measures and have 
done so for years.  However, differences in States resources, data collection systems and 
capabilities, measures used, and quality improvement priorities limit comprehensive national 
comparisons on the quality of childrens health care across a set of standardized, evidence-based 
measures. 
 
This letter provides guidance to States regarding implementation of provisions of the Childrens 
Health Insurance Program Reauthorization Act of 2009 (CHIPRA) (Pub. L. 111-3), enacted on 
February 4, 2009.  CHIPRA includes a broad range of provisions to improve the quality of health 
care provided to children.  Specifically, section 401 of CHIPRA adds section 1139A to the 
Social Security Act (the Act) to develop, improve, and promote child health care quality 
measures.  Section 1139A(a) requires the Secretary of the Department of Health and Human 
Services to identify an initial core set of recommended pediatric quality measures for voluntary 
use by State Medicaid and Childrens Health Insurance Program (CHIP) programs.  Section 
1139A(b) requires the Secretary to create a Pediatric Quality Measures Program (PQMP) and 
regularly update the child health care quality measures established in section 1139A(a).  This 
letter also provides guidance about section 402 of CHIPRA, which is designed to improve the 
availability of public information regarding the enrollment of children in CHIP and Medicaid. 
 
The Centers for Medicare & Medicaid Services (CMS), in collaboration with States, health care 
providers, health care quality experts, and families, seeks to improve care for children enrolled in 
Medicaid and CHIP, as well as improve how this care is measured.  While reporting on the initial 
core set of childrens quality measures is voluntary for States, the core measures set represents a 
major step toward developing a quality-driven, evidence-based, national system for measuring 
the quality of childrens health care.  This guidance highlights five components that will help 
build the foundation of this national quality measurement system, including additional 
information on the initial core set of childrens quality measures previously published by the 
Secretary. 
    Page 2 - State Health Official 
 
Components of CHIPRAs Child Health Care Quality Performance Measures System 
 
I.  Establishment of an initial core set of child health care quality performance 
measures for voluntary use by State programs  
Section 1139A(a)(1) of the Act requires the Secretary to identify and publish childrens health 
care quality measures.  In 2009, under delegated authority of the Secretary, CMS began 
collaborating with the Agency for Healthcare Research and Quality (AHRQ) to identify a set of 
child-focused health care quality measures.  In order to include a wide range of national expertise 
in identifying measurement priority areas and the initial core set of measures, AHRQ established 
a Subcommittee of its National Advisory Council (SNAC) on Quality Measures for Children's 
Healthcare in Medicaid and CHIP Programs.  The SNAC evaluated which measures were best 
suited for the core set based on their validity, feasibility of use by Medicaid and CHIP programs, 
and importance to improving health outcomes for children.  Specific details on the process and 
criteria used to identify the initial core set can be found at:  http://www.ahrq.gov/chipra/.  The 
SNAC recommended an initial core set of 25 measures which represents a wide spectrum of 
facets related to the quality of health care for children as required by CHIPRA.  When used with 
other measures States already collect, the core set is intended to provide a broader window with 
which to view, assess, and improve the quality of health care children receive. 
 
In September 2009, CMS held a listening session to provide State Medicaid and CHIP programs 
the opportunity to comment on the draft initial core set of quality measures recommended by the 
SNAC.  Additionally, a Federal Quality Work Group comprised of representatives from various 
Federal agencies reviewed the measures.  After CMS and AHRQ reviewed the feedback 
provided by States, the Federal Quality Work Group and the SNAC, the Secretary released a set 
of 24 measures for public comment on December 29, 2009 through a Federal Register notice.  
States, providers, and health plans will likely have some degree of familiarity with over half (15) 
of the initial core set measures, as they are National Committee for Quality Assurance (NCQA) 
Healthcare Effectiveness Data and Information Set (HEDIS) measures.  The list of measures is 
provided in Enclosure A. 
 
CMS encourages States to collect measures from the initial core set, in addition to their existing 
State-specific measures.  The more States that collect and report the initial core set of measures, 
the greater the potential for States and others to benefit from this information.  CMS is 
developing data information systems to standardize reporting and make access to quality data 
more available to States for comparison purposes.  By having access to these data, States will 
have the opportunity to integrate quality data in designing and implementing their quality 
improvement initiatives. 
 
II.   Reporting the initial core set of measures to CMS 
CMS recognizes that State Medicaid and CHIP programs are enhancing information systems to 
address opportunities and requirements under CHIPRA, the Health Information Technology for 
Economic and Clinical Health Act (HITECH) enacted as part of the American Recovery and 
Reinvestment Act of 2009, and the Affordable Care Act.  CMS is also conducting similar 
enhancements to meet the data exchange needs of evolving State systems.  While these system 
transitions are in development, CMS has designated the CHIP Annual Reporting Template 
System (CARTS), a web-based data submission tool currently used by Title XXI Programs, as 
the vehicle which all States choosing to report the initial core measures (or a subset thereof) 
    Page 3 - State Health Official 
 
should use.  Since most CHIP programs are experienced users of CARTS, CMS has provided 
them with updated instructions for annual reporting.  State Medicaid programs will receive 
access to the CARTS system through a designated entry screen for voluntary reporting on the 
child health care quality measures. 
 
As required by CHIPRA, CMS released guidance, reporting procedures, and technical 
specifications for the initial core set of measures on February 3, 2011.  The CHIPRA Initial Core 
Set Technical Specification Manual can be found at:   
http://www.cms.gov/MedicaidCHIPQualPrac/Downloads/CHIPRACoreSetTechManual.pdf  
 
III.  Requirement for State CHIP Programs to annually report on the quality of health 
care and consumer satisfaction measures included in the CAHPS Medicaid survey 
The ability to measure patient experience is critical to understanding how to improve the quality 
of health care children receive.  As required by CHIPRA section 402(a)(2), which amends 
reporting requirements in section 2108 of the Act, Title XXI programs are required to report 
results from AHRQs Consumer Assessment of Healthcare Providers and Systems (CAHPS) 
Child Medicaid Survey.  Currently, States voluntarily report Medicaid data to the CAHPS 
database either annually or biannually.  According to AHRQs National CAHPS Benchmarking 
Database, a total of 17 States submitted data in 2008 and 12 States submitted Medicaid data in 
2009.  In 2009, the CAHPS database included information on about 70,000 children.  States that 
currently report CAHPS through AHRQ can continue to do so.  Other States have the option to 
submit results of their CAHPS data to AHRQ or to CMS through CARTS.   
 
CHIPRA section 402 specifically addresses reporting requirements for CHIP programs for 
collecting data on AHRQs CAHPS and provides up to three reporting periods for States that 
need time to make operational and infrastructure changes (e.g., implement legislative changes, 
update data collection processes, modify contracts with health plans).  With CARTS as the 
reporting vehicle, we are deeming that the three transition periods outlined in CHIPRA become 
the CARTS reporting periods: December 31, 2010; December 31, 2011; and December 31, 2012.  
We expect States to vary in how long they will need to implement collection and reporting 
efforts related to the core measures with all Title XXI programs submitting measurement data to 
CARTS by December 31, 2013.  CMS is currently undergoing a review of its multiple reporting 
systems.  As this effort evolves CMS may identify other reporting vehicles for the quality 
measures.  
 
The CAHPS Medicaid survey is also part of the 24 initial core set of childrens health care 
quality measures.  Title XIX programs can choose to voluntarily report the CAHPS survey.   
 
IV.  Creation of a Pediatric Quality Measures Program to enhance the initial core set of 
measures and to develop additional health care quality measures 
While the initial core set of measures covers a range of quality areas, it does not 
comprehensively reflect all the dimensions of childrens health care.  As required by section 
1139A(b)(1) of the Act, the Secretary will create a Pediatric Quality Measures Program (PQMP) 
that will: (1) test and refine the initial core set of measures to make them more broadly 
applicable to Medicaid, CHIP, and other programs; and (2) develop additional quality measures 
that address dimensions of care where standardized measures do not currently exist. 
    Page 4 - State Health Official 
 
Through the PQMP, AHRQ will issue grant awards to Centers of Excellence that will work to 
improve and enhance the initial core childrens measures and to develop new health care quality 
measures meaningful to State Medicaid and CHIP programs, and applicable to all payer systems.  
The Centers of Excellence approach will create a cohort of entities with expertise in health care 
quality measurement specific to the needs of children and their health care delivery system.  By 
April 2011, AHRQ will identify a CHIPRA Coordinating and Technical Assistance Center to 
facilitate common approaches, provide technical assistance, and ensure coordination of efforts 
across the Centers of Excellence.  The Coordinating Center will also assist in creating a 
transparent process to recommend improved core measures to the Secretary.  In December 2010, 
AHRQ released a Federal Register notice soliciting public comments on priority areas for 
measurement development and asking the public to identify additional priorities as needed.  As 
required by CHIPRA, the Secretary will then incorporate these improved measures into the 
childrens health care quality measures core set by January 1, 2013, and annually thereafter.  
Additional information on the Pediatric Quality Measures Program, the Centers of Excellence, 
and the CHIPRA Coordinating and Technical Assistance Center can be found at: 
http://www.ahrq.gov/chipra/#Core2 
 
V.  Technical assistance to States implementing the initial core set of measures 
In public comments received in response to the December 2009, Federal Register notice, States 
concerns about the initial core measures ranged from the burden of new quality reporting, current 
data collection and reporting systems constraints, challenges for partial-risk programs to report 
measures, to the need for technical assistance.  Section 1139A(a)(7) of the Act requires CMS to 
provide technical assistance to States for voluntary reporting on the initial core set.  CMS is 
committed to supporting State efforts, and will be establishing a specific plan for technical 
assistance to include webinars, learning networks, sharing of promising practices and lessons 
learned, and an annual CMS State Medicaid and CHIP quality conference. 
 
The national technical assistance program will support States in understanding how to collect, 
report, and analyze the core measures to target improvements in the quality of health care for 
children.  The overarching goals for providing technical assistance and analytic support are to 
increase the number of States consistently collecting and uniformly reporting the voluntary initial 
core measures set, and to help States understand how to use these data to improve the quality of 
health care for children.  As part of the technical assistance and analytic support program, CMS 
will gain an understanding of States abilities in reporting on the initial core measures.  
Subsequently, technical assistance will be largely tailored to States needs, and will be available 
through a variety of vehicles, including annual CMS State Medicaid and CHIP Quality 
Conferences starting in 2011, and continuing through 2015. 
 
CMS will provide technical assistance to States on all of the core measures through a variety of 
methods (e.g., webinars, one-on-one technical assistance, etc.).  However, based on public 
comments received from States, national health care quality experts, and other stakeholders in 
response to the Federal Register notice of December 29, 2009, CMS will focus initial outreach 
and technical assistance efforts on 12 of the 24 measures.  CMS selected this subset of measures 
for targeted technical assistance because they reflect existing and evolving State reporting 
efforts, including the alignment of childrens health care quality measure collection opportunities 
under CHIPRA and the Electronic Health Record (EHR) Incentive Program.  In subsequent 
years, CMS will offer technical assistance to States on the additional core measures. 
    Page 5 - State Health Official 
 
Table 1. Childrens Quality Measures Targeted for Technical Assistance in Year One 
 
Prevention and Health Promotion 
Measure  Measure Steward1  Used in other 
CMS 
Measurement 
Activities 
Childhood immunization status  NCQA/HEDIS  Meaningful Use 
 
Weight Assessment and Counseling for  NCQA/HEDIS  Meaningful Use 
Nutrition and Physical Activity for 
Children/Adolescents: Body Mass 
Index Assessment for 
Children/Adolescents 
Chlamydia screening   NCQA/HEDIS  Meaningful Use 
Well-child visits in the first 15 months  NCQA/HEDIS  Current CHIP 
of life  reporting element 
Well-child visits in the 3rd, 4th, 5th, and  NCQA/HEDIS  Current CHIP 
6th years of life  reporting element 
Total eligible children who received  CMS  CMS Form 416 
preventive dental services 
 
Management of Acute Conditions 
Measure  Measure Steward  Used in other 
CMS 
Measurement 
Activities 
Appropriate testing for children with  NCQA/HEDIS  Meaningful Use 
Pharyngitis 
Total eligible children who received  CMS   CMS Form 416 
dental treatment services 
Pediatric central-line associated blood  Centers for Disease  Reporting activity 
stream infections  Neonatal Intensive  Control and Prevention  related to health 
Care Unit and Pediatric Intensive Care  care acquired 
Unit  conditions 
 
Management of Chronic Conditions 
Measure  Measure Steward  Used in other 
CMS 
Measurement 
Activities 
Annual number of asthma patients ages  Alabama Medicaid   
2 through 20 years old with 1 or more 
asthma-related emergency room visits 
Annual pediatric hemoglobin A1C  NCQA   
testing 
 
 
   
                                                 
1 A measurement steward is responsible for updating or retiring measures as the technical specifications are changed, new 
clinical evidence emerges, or the measures performance changes.   Page 6 - State Health Official 
 
Availability of Care 
Measure  Measure Steward1  Used in other 
CMS 
Measurement 
Activities 
Children and adolescent access to  NCQA/HEDIS  Current CHIP 
primary care practitioners  reporting element 
 
As illustrated in the table, 10 of the 12 measures selected for the initial phase of technical 
assistance align with current CMS measurement activities.  Four of the initial core set of child 
health measures are identified as meeting the meaningful use criteria for quality measures under 
the EHR Incentive Program.  Likewise, three core set measures are among the four measures 
previously reported by Title XXI programs (CHIP, Medicaid Expansions, and Combination 
CHIP and Medicaid).  We believe this list balances the benefits of quality measurement data 
collection and reporting with efforts to minimize the reporting burden on States who want to 
participate in multiple measurement-related initiatives. 
 
Conclusion 
 
CHIPRA establishes a process for States to participate in a national effort for assuring optimal 
health care quality, including the identification of a core set of health care quality measures for 
children.  The initial core set of childrens measures, along with the Pediatric Quality Measures 
Program and the creation of a national technical assistance program, are the first steps taken, 
after much consultation with States, in making quality measurement a priority for Medicaid and 
CHIP.  These efforts will promote a new focus and commitment to ensure our nations children 
receive the quality of care they deserve.  If you have questions or suggestions related to these 
initiatives, please contact our Chief Quality Officer, Marsha Lillie-Blanton at Marsha.Lillie-
Blanton@cms.hhs.gov. 
 
Sincerely, 
 
/s/ 
 
Cindy Mann 
Director 
 
 
Enclosures: 
A) CHIPRA Initial Core Measures 
B) Timeline of Quality Reporting Activities 
   
                                                 
1 A measurement steward is responsible for updating or retiring measures as the technical specifications are changed, new 
clinical evidence emerges, or the measures performance changes.   Page 7 - State Health Official 
 
cc: 
 
CMS Regional Administrators  
 
CMS Associate Regional Administrators  
Division of Medicaid and Childrens Health  
 
Andrew Allison  
President  
National Association of Medicaid Directors  
 
Alan R. Weil, J.D., M.P.P.  
Executive Director  
National Academy for State Health Policy  
 
Matt Salo  
Director of Health Legislation  
National Governors Association 
 
Rick Fenton  
Acting Director  
Health Services Division  
American Public Human Services Association  
 
Christine Evans, M.P.H.  
Director, Government Relations  
Association of State and Territorial Health Officials  
 
Debra Miller  
Director for Health Policy  
Council of State Governments  
 
Joy Wilson  
Director, Health Committee  
National Conference of State Legislatures 
 
    Enclosure A: Initial Core Set of Childrens Quality Measures for Voluntary Reporting 
 
Prevention and Health Promotion 
Measure  Measure Steward  Description 
Frequency of Ongoing Prenatal  NCQA/HEDIS  Percentage of Medicaid deliveries between 
Care  November 6 of the year prior to the 
measurement year and November 5 of the 
measurement year that received the 
following number of visits: 
< 21 percent of expected visits 
21 percent  40 percent of expected visits 
41 percent  60 percent of expected visits 
61 percent  80 percent of expected visits 
 81 percent of expected visits 
 
Prenatal and Postpartum Care:  NCQA/HEDIS  The percentage of deliveries of live births 
Timeliness of Prenatal Care  between November 6 of the year prior to the 
measurement year and November 5 of the 
measurement year that received a prenatal 
care visit in the first trimester or within 42 
days of enrollment in the organization. 
 
Percent of live births weighing  Centers for Disease  The measure assesses the number of resident 
less than 2,500 grams  Control and  live births less than 2,500 grams as a 
Prevention   percentage of the number of resident live 
births in the State reporting period. 
 
Cesarean rate for nulliparous  California Maternal  Percentage of women who had a cesarean 
singleton vertex   Quality Care  section among women with first live 
Collaborative  singleton births [also known as nulliparous 
term singleton vertex (NTSV) births] at 37 
weeks of gestation or later. 
 
Childhood Immunization Status  NC National  Percentage of patients who turned 2 years 
Committee for Quality  old during the measurement year who had 
Assurance (NCQA)  four DTaP/DT, three IPV, one MMR, three 
Healthcare  H influenza type B, three hepatitis B, one 
Effectiveness Data and 
chicken pox vaccine (VZV), four 
Information Set 
pneumococcal conjugate (PCV), two 
(HEDIS) 
hepatitis (HepA), two or three rotavirus 
QA/HEDIS 
(RV); and two influenza vaccines by the 
child's second birthday. The measure 
calculates a rate for each vaccine and nine 
separate combination rates. 
 
 
 
 
 
 
 
 
National Committee for Quality Assurance (NCQA) 
Healthcare Effectiveness Data and Information Set (HEDIS) 
 
 
   
Prevention and Health Promotion 
Measure  Measure Steward  Description 
Immunizations for Adolescents  NCQA/HEDIS  Percentage of patients who turned 13 years 
old during the measurement year who had 
one dose of meningococcal vaccine and one 
tetanus, diphtheria toxoids and a cellular 
pertussis vaccine (Tdap) or one tetanus, 
diphtheria toxoids vaccine (Td) by their 
thirteenth birthday; a second dose of MMR 
and three hepatitis B vaccinations; and one 
varicella vaccination by their thirteenth 
birthday. The measure calculates a rate for 
each vaccine and one combination rate. 
 
Weight Assessment and  NCQA/HEDIS  Percentage of children, 3 through 17 years of 
Counseling for Nutrition and  age, whose weight is classified based on 
Physical Activity for  body mass index percentile for age and 
Children/Adolescents: Body Mass  gender. 
Index Assessment for   
Children/Adolescents 
Developmental Screening in the  Child and  Assesses the extent to which children at 
First Three Years of Life   Adolescent Health  various ages from 0-36 months were 
Measurement  screened for social and emotional 
Initiative and NCQA   development with a standardized, 
documented tool or set of tools. 
Chlamydia Screening   NCQA/HEDIS  Percentage of women 16 through 20 who 
were identified as sexually active who had at 
least one test for Chlamydia during the 
measurement year. 
Well-Child Visits in the First 15  NCQA/HEDIS  Percentage of members who received zero, 
Months of Life  one, two, three, four, five, and six or more 
well-child visits with a primary care 
practitioner during their first 15 months of 
life. 
 
Well-Child Visits in the 3rd, 4th,  NCQA/HEDIS  Percentage of members ages 3 through 6 
5th, and 6th Years of Life  years old who received one or more well-
child visits with a primary care practitioner 
during the measurement year. 
 
Adolescent Well-Care Visit   NCQA/HEDIS  Percentage of members ages 12 through 21 
years who had at least one comprehensive 
well-care visit with a primary care 
practitioner or an OB/GYN practitioner 
during the measurement year. 
Total Eligibles Who Received  CMS   Total eligible children 1 through 20 years of 
Preventive Dental Services  age who received preventive dental services. 
 
 
 
 
 
 
National Committee for Quality Assurance (NCQA) 
Healthcare Effectiveness Data and Information Set (HEDIS 
    Management of Acute Conditions 
Measure  Measure Steward  Description 
Appropriate Testing for Children  NCQA/HEDIS  Percentage of patients who were diagnosed 
with Pharyngitis  with Pharyngitis, dispensed an antibiotic, 
and who received a group A streptococcus 
test for the episode. 
 
Otitis media with effusion (OME)  American Medical  Percentage of patients ages 2 months through 
 avoidance of inappropriate use  Association /PCPI1  12 years with a diagnosis of OME who were 
of systemic antimicrobials in  not prescribed systemic antimicrobials. 
children  ages 2 through 12 
 
Total Eligibles who Received  CMS   Total eligible children 1 through 20 years 
Dental Treatment Services  of age who received dental treatment 
  services. 
Ambulatory Care: Emergency  NCQA/HEDIS  The number of visits per member per year as 
Department Visits  a function of all child and adolescent 
members enrolled and eligible during the 
measurement year. 
 
Pediatric central-line associated  Centers for Disease  Rate of central line-associated blood stream 
blood stream infections   Control and  infections (CLABSI) identified during 
Neonatal Intensive Care Unit and  Prevention  periods selected for surveillance as a 
Pediatric Intensive Care Unit  function of the number of central line 
  catheter days selected for surveillance in 
pediatric and neonatal intensive care units. 
 
 
Management of Chronic Conditions 
Measure  Measure Steward  Description 
Annual number of asthma patients  Alabama Medicaid  Asthma emergency department utilization 
ages 2 through 20 years old with 1  for  for patients ages 2 through 20 years old  
or more asthma-related  diagnosed with asthma or treatment with at 
emergency room visits  least 2 short-acting beta adrenergic agents 
during the measurement year who also had 
one or more asthma-related emergency room 
visits. 
 
   
                                                 
1 Physician Consortium for Performance Improvement 
 
National Committee for Quality Assurance (NCQA) 
Healthcare Effectiveness Data and Information Set (HEDIS) 
  Management of Chronic Conditions 
Measure  Measure Steward  Description 
Follow-Up Care for Children  NCQA/HEDIS  Percentage of children ages 6 through 12 
Prescribed Attention Deficit  years of age with newly prescribed ADHD 
Hyperactivity Disorder (ADHD)  medication who had at least 3 follow-up care 
Medication  visits within a 10-month period, one of 
which was within 30 days from the time the 
first ADHD medication was dispensed. 
Follow-up after hospitalization for  NCQA/HEDIS  Percentage of discharges for members 6 
mental illness  years of age and older who were hospitalized 
for treatment of selected mental health 
disorders and who had an outpatient visit, an 
intensive outpatient encounter, or partial 
hospitalization with a mental health 
practitioner. 
Annual Pediatric hemoglobin  NCQA  Percentage of pediatric patients with 
A1C testing  diabetes who had a hemoglobin A1c test in a 
12-month measurement period. 
 
 
Family Experiences of Care 
Measure  Measure Steward  Description 
CAHPS 4.0 (child version  NCQA/HEDIS  Survey on an individuals experiences with 
including Medicaid and Children  health care.  
with chronic conditions 
supplemental items) 
 
 
Availability 
Measure  Measure Steward  Description 
Child and Adolescent Access to  NCQA/HEDIS  Percentage of enrollees 12 months through 
Primary Care Practitioners  19 years of age who had a visit with a 
primary care practitioner (PCP).  Four 
separate percentages are reported: 
 
  Children 12 months through 24 months 
and 25 months through 6 years who had 
a visit with a PCP during the 
measurement year. 
  Children 7 through 11 years and 
adolescents 12 through 19 years who 
had a visit with a PCP during the 
measurement year or the year prior to 
the measurement year. 
 
 
 
 
 
 
 
National Committee for Quality Assurance (NCQA) 
Healthcare Effectiveness Data and Information Set (HEDIS) 
    Enclosure B:  Timeline of CMS/CMCS CHIPRA Quality Measurement & Improvement Activities 
 
 
2010 
09/30/2010   Issue Secretarys 1st Annual Report on the Quality of Care for Children in 
Medicaid & CHIP (with State-specific quality data) 
 
12/31/2010  States can submit voluntary core quality measures to CMS using the CHIP 
Annual Report Template (CARTS) with updated instructions. 
 
 
2011 
02/03/2011  Issue written guidance (CMS Informational Bulletin) for voluntary reporting of 
CHIPRA core quality performance measures and reporting data through CARTS 
 
Summer 2011  Annual Quality Conference 
 
09/30/2011   Issue Secretarys 2nd Annual Report on the Quality of Care for Children in 
Medicaid & CHIP (with State-specific quality data) 
 
12/31/2011  Deadline for States to submit data on voluntary core quality measures [(including 
Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey] 
 
 
2012 
09/30/2012  Issue Secretarys 3rd Annual Report on the Quality of Care for Children in 
Medicaid & CHIP (with State-specific quality data) 
 
Summer 2012  Annual Quality Conference 
 
12/31/2012  Deadline for States to submit data on voluntary core quality measures (including 
CAHPS) 
 
 
2013 
01/01/2013  States begin data collection for required reporting of CAHPS 
 
01/01/2013   Publication of recommended changes to initial core quality measure set and new 
measures 
 
Summer 2013  Annual Quality Conference 
 
09/30/2013   Issue Secretarys 4th Annual Report on the Quality of Care for Children in 
Medicaid & CHIP (with State-specific quality data) 
 
12/31/2013   States begin required reporting of CAHPS survey along with voluntary core 
quality performance measures