The CMS-21B Forms (PDF 220.52 KB) are used by states to report quarterly budget related statistical information required for implementation of the Children's Health Insurance Program (CHIP), Title XXI of the Social Security Act (the Act) , established by the Balanced Budget Act of 1997 (BBA).
The information provided by these forms is used by CMS to prepare the grant awards to states for the Medicaid and CHIP programs, to ensure that the appropriate level of Federal payments for State expenditures under the Medicaid program and the CHIP are made in accordance with the CHIP related BBA legislation provisions, and to track, monitor and evaluate the numbers of related children being served by the Medicaid and CHIP programs.