Is there a simplified Payment Error Rate Measurement (PERM)/Medicaid Eligibility Quality Control (MEQC) timeline with milestone dates/cycles that can be provided to states (all cycles)?
| PERM Cycle* | PERM Review Period | MEQC Planning Document Due to CMS | MEQC Review Period | MEQC Case-Level Report on Findings and CAP Due to CMS |
|---|---|---|---|---|
| Cycle 1 | July 1, 2017 – June 30, 2018 | November 1, 2018 | January 1 – December 1, 2019 | August 1, 2020 |
| Cycle 2 | July 1, 2018 – June 30, 2019 | November 1, 2019 | January 1 – December 1, 2020
What is the Precertification Pilot?The Precertification Pilot was an experiment conducted from October 2017-March 2018 designed to streamline certification and attract new vendors. Unfortunately, the pilot was found to be unscalable across Medicaid. However, key learnings from the pilot will be incorporated into current processes and future experiments around vendor engagement, certification, scalability, and sustainability. How can I find a provider that accepts Medicaid or CHIP?Each state Medicaid and CHIP program has its own provider network. Contact your state for a list of providers.
How do I replace my Medicaid card?Contact your state Medicaid agency. They can help you get replacement cards and answer your questions about what services are covered, providers to use, and how to renew your eligibility. GU-20-0002CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to Increase payment rates for Inpatient and Outpatient Hospital Services, Physician Services, Home Health Services, Clinic Services for Physicians Services and Other Practitioner’s Services during the Public Health Emergency Period.
MD-20-0001CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to suspend certain premium payments required under Maryland’s Medicaid state plan.
Please clarify that state flexibility to reimburse in the aggregate extends to reimbursement rates forThe new AAC requirements were designed to more accurately reflect the pharmacy providers' actual prices paid to acquire drugs and the professional services required to fill a prescription. We agree that each state is able to establish rates that satisfy (or are consistent with) AAC and may be based on a variety of data sources, which may include FSS prices, and other pricing benchmarks. Does Medicaid cover pregnancies, mental health, dental, nursing home, or long term care?States are required to cover certain benefits and others are optional. To learn what your state covers, contact your state Medicaid agency.
Are Eligibility and Enrollment (E&E) systems now going to be certified the way MMIS systems are certified?No, E&E systems are not subject to certification. Though the Medicaid Eligibility and Enrollment Toolkit (MEET) was based on the MMIS toolkit, the MEET was created as a way to align how CMS reviews Medicaid enterprise systems and is a means for CMS to provide technical assistance to the states. Why are there Standards and Conditions (S&C) and Access and Delivery (A&D) criteria in the Information Architecture checklist?When streamlining the core checklists (IA, TA and S&C checklists), we found that some criteria fit better in other checklists, so they were moved. To keep traceability simple for the states, we chose to keep the original identifiers for any criteria that were moved. The same holds true for criteria moved to the programmatic tab of the IV&V progress report template. |