State Medicaid Eligibility Quality Control Sample Selection Lists and Supporting Regulations

ICR 202602-0938-007

OMB: 0938-0147

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0938-0147 202602-0938-007
Received in OIRA 202010-0938-008
HHS/CMS CPI - 319
State Medicaid Eligibility Quality Control Sample Selection Lists and Supporting Regulations
Reinstatement without change of a previously approved collection   No
Regular 02/09/2026
  Requested Previously Approved
36 Months From Approved
665 0
9,840 0
0 0

The Medicaid Eligibility Quality Control (MEQC) program provides states and the District of Columbia (hereinafter, “states”) a unique opportunity to improve the quality and accuracy of their Medicaid and Children’s Health Insurance Program (CHIP) eligibility determinations. The MEQC program is intended to complement the Payment Error Rate Measurement (PERM) program by ensuring state operations make accurate and timely eligibility determinations so that Medicaid and CHIP services are appropriately provided to eligible individuals.

US Code: 42 USC 1396b Name of Law: Payment to States
  
None

Not associated with rulemaking

  89 FR 97619 12/09/2024
91 FR 2534 01/21/2026
No

1
IC Title Form No. Form Name
State Medicaid Eligibility Quality Control Sample Selection Lists and Supporting Regulations at 42 CFR 431.800 - 431.865

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 665 0 0 0 19 646
Annual Time Burden (Hours) 9,840 0 0 0 -54,760 64,600
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
All 50 states, the District of Columbia and Commonwealth of Puerto Rico will conduct the MEQC pilot during their off-cycle PERM years. At any given point in time, 34 or 35 states will be working on MEQC pilot planning documents and MEQC case level review and reporting tasks. Based on CMS analysis of data from a sample of states who are MEQC State Advisory Committee members, the cumulative burden of conducting MEQC reviews and preparing case level reports and CAPs is now estimated at 9840 hours. Previous burden estimates for the MEQC pilot planning and MEQC case level review and reporting tasks were based on extrapolated data of workload estimates. The 9840 estimate is a more accurate reflection of the first-time states have pulled 400 active cases and 400 negative cases since the finalized July 2017 regulation. The new single package under CMS-319/OMB control number: 0938-0147 will include the MEQC Pilot Planning Document, Case Review and Reports of Findings. CMS-317/OMB control number: 0938-0146 will no longer be maintained as a separate package. Therefore, burden hours have increased to include MEQC pilot planning estimated state burden of 150 hours.

$393,690
No
    No
    No
No
No
No
No
Jamaa Hill 301 492-4190

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
02/09/2026

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