Massachusetts Executive Office of Health and Human Services
The Children’s Medical Security Plan Legislative Report
FY 2023– THIRD QUARTER
Reporting Period January 1, 2023 – March 31, 2023
The Children’s Medical Security Plan provides access to primary and preventive health care
services to certain children and adolescents. Children from birth to age 18 are eligible for CMSP
provided they are not eligible for other MassHealth benefits (except MassHealth Limited) and
provided that they are not otherwise insured. Effective November 1, 2005, enrollee premiums
were set at zero for those enrollees whose income is less than 200% of the Federal Poverty Level
(FPL), and premiums are set via a sliding scale for enrollees with incomes of 200% of the FPL
and above.
Enrollment Demographics
At the end of the third quarter of FY 2023 (March 31, 2023), there were 71,036 children eligible
for CMSP. CMSP eligibility does not indicate that an eligible member is using CMSP services,
additional information on CMSP utilization can be found below.
Month Month-End Eligibility
January 2023 69,357
February 2023 69,680
March 2023 71,036
The following is a breakdown of spending for CMSP for the third quarter of FY 2023.
Fiscal Year 2023 – Third Quarter – CMSP Spending by Type of Service
Medical Claims Member
Amt Paid # Claims Count
January 2023 $1,930,966 9,297 27,925
February 2023 $1,951,666 9,513 26,958
March 2023 $2,117,210 10,197 28,791
TOTAL $5,999,842 29,007 83,674
Dental Claims Member
Amt Paid # Claims Count
January 2023 $707,599 3,324 14,282
February 2023 $633,988 3,029 12,848
March 2023 $647,690 3,193 13,323
TOTAL $1,989,277 9,546 40,453
 Pharmacy Claims Member
Amt Paid # Claims Count
January 2023 $59,586 2,275 3,448
February 2023 $58,177 2,176 3,298
March 2023 $63,818 2,638 4,048
TOTAL $181,581 7,089 10,794
Total Expenditures
The number of claims filed for CMSP for the third quarter of Fiscal Year FY 2023 totaled
134,921. There were 83,674 medical claims, 40,453 dental claims, and 10,794 pharmacy claims
filed during the third quarter of the fiscal year. Total expenditures for the third quarter of the
Fiscal Year 2023 were $8,170,699. Based on year-to-date expenditures, annual spending for
CMSP is estimated at $17,017,088 million.