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State Pilots to Measure Medicaid Eligibility Determination Accuracy

State pilot programs to begin Jan. 1, 2014, will measure how accurately states determine Medicaid eligibility. The Centers for Medicare & Medicaid Services (CMS) will use these pilot programs for fiscal years 2014-2016. They will replace the payment error rate measurement (PERM) reviews and the Medicaid eligibility quality control (MEQC) program, which are currently used to measure how accurately states determine Medicaid eligibility. The pilot programs are being developed because the way in which states determine Medicaid eligibility will change in 2014, making it necessary to replace PERM reviews and MEQC programs. CMS will use results from the pilot programs in rulemaking for the PERM eligibility measurement component in fiscal year 2017. More information is available in August 15 CMS guidance.


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