The Department of Health and Human Services is handing out end of the year bonuses. Unlike the big cash awards that investment firms give their best performers at year's end, these bonuses are meant to help the poor and disadvantaged.

HHS announced today that it will give $206 million to 15 states for making significant progress this year in enrolling uninsured children in Medicaid. 

HHS Secretary Kathleen Sebelius said that the awarding of the bonuses highlights the ongoing and committed efforts by states to improve access to health coverage programs and take the aggressive steps necessary to enroll eligible children.

The states' actions reflect President Obama's serious commitment to assuring that our country's children get the health care they need. These performance bonuses demonstrate our support for the effective strategies these states have undertaken, Sebelius said.

Funding for the bonuses was included in the Children's Health Insurance Program Reauthorization, or CHIPRA, which was signed into law by Obama in February 2009.

The CHIPRA established two sets of performance goals that states must meet to qualify for a bonus - taking specific steps to streamline their enrollment and renewal processes to make it easier for families with eligible children to gain coverage and documenting a significant increase in the number of children enrolled in Medicaid. 

States must have adopted at least five program features-like providing a guarantee of 12 months of continuous coverage, using a joint application for both Medicaid and CHIP and streamlining procedures for renewing a child's coverage-that are known to encourage enrollment and retention of eligible children.  States must also be able to document significant increases in Medicaid enrollment among children during the year that are above and beyond what would have been expected, even with the economic recession. States with increases of more than 10 percent above this baseline qualify for a higher award amount.

States receiving bonus awards today include: Alabama, Alaska, Colorado, Illinois, Iowa, Kansas, Louisiana, Maryland, Michigan, New Jersey, New Mexico, Ohio, Oregon, Washington state and Wisconsin.  Awards vary by state according to a formula set out in CHIPRA but total more than $206 million this fiscal year.

The largest award went to Alabama at $54.9 million. Wisconsin was second with $23 million.

Last year, $75 million in bonuses went out to 10 states.

The increase in both the number of states receiving awards and the amount distributed is particularly encouraging given the difficult economic times states are facing, said Cindy Mann, deputy administrator of the Centers for Medicare & Medicaid Services and director of the Center for Medicaid, CHIP and Survey & Certification.