Medicaid program: claims processing assessment system (CPAS)--HCFA. Final rule.

Abstract

These final regulations provide that existing Medicaid quality control claims processing requirements are replaced by a claims processing assessment system (referred to as CPAS). CPAS is required both for States with an approved Medicaid management Information System (MMIS) and for those without such a system. For States without an approved MMIS, CPAS is a State plan requirement. For States with an approved MMIS, CPAS is a part of MMIS. This also provides final notice of the CPAS requirements that are included as an additional condition for approval and annual reapproval of MMIS. These changes are intended to increase State flexibility in claims processing oversight and reduce the burden on States with demonstrated good performance.