Medicaid program: claims processing assessment system--HCFA. Proposed rule.

Abstract

These rules propose to revise claims processing requirements for Medicaid Quality control (MQC) systems and to delete the requirement from current regulations that States perform Third Party Liability quality control reviews. The preamble discussion will also serve as notice of our proposal that revised claims processing elements of the MQC program will become a condition for Medicaid Management Information System (MMIS) approval and annual reapproval under section 1903(r)(5) of the Act. The revised system will be referred to as the claims processing assessment system (CPAS). These changes are intended to increase State flexibility in the area of reporting requirements and reduce the burden on States under the current MQC reporting system.