These measures provide insight into how states and the federal government work together to administer Medicaid and the Children's Health Insurance Program (CHIP).
State Plan Amendment and 1915 Waiver Processing (State) | The following measures report approval times for Medicaid State Plan Amendments (SPAs) and 1915 waiver actions. |
Annual 372(S) Reporting: Timeliness of Report Submissions | This measure reports the percent of CMS 372(S) reports that were submitted within one month of the report’s due date. |
Medicaid MAGI and CHIP Application Processing Times | This measure reports the amount of time that it took state agencies to make Medicaid and CHIP MAGI eligibility determinations. |
Managed Care Capitation Rate Review: Timing of States’ Submissions | This measure reports the number of days between a state’s submission of a base capitation rate certification and the start of the managed care contract rating period. |
Managed Care Capitation Rate Review: Days Awaiting Information from States | This measure reports the number of days that states took to answer questions or provide requested additional information to CMS during the review of their managed care base capitation rates and capitation rate amendments. |
Managed Care Contract Review (State) | The following measures report the total number of days a managed care contract action was under CMS review and the average review time for CMS Time, State Time, and Shared Time. |
T-MSIS Data Quality: Number of Open Priority Items | This measure reports the number of open Transformed Medicaid Statistical Information System (T-MSIS) Priority Items (TPIs) for data quality in states’ T-MSIS data submissions. |
Initiation of Collaborative Investigations Between States and CMS’s Unified Program Integrity Contractors | This measure reports the states that have initiated collaborative investigations with CMS’s Unified Program Integrity Contractors. |
Healthcare Fraud Prevention Partnership Participation | This measure reports state participation in the Healthcare Fraud Prevention Partnership. |
Managed Care | Measure to be included in a future Scorecard. |