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Medicaid program; reduction in error rate tolerance beginning October 1, 1983; Medicaid quality control
Abstract:
This proposed rule would revise current Medicaid regulations and establish new regulations concerning the disallowance of Federal financial participation to States whose eligibility payment error rate for Medicaid, as measured by the Medicaid quality control system, exceeds the 3-percent national standard. Specifically, the proposed rule would provide that the current regulations regarding the 3-percent national standard apply only to the period April 1, 1983 through September 30, 1983. The proposed rule would also establish regulations that would apply to periods beginning October 1, 1983. These modifications to the regulations are based on and implement the provisions of section 133 of the Tax Equity and Fiscal Responsibility Act of 1982 (Pub. L. 97-248).
Insights
This rule revises Medicaid regulations on disallowing federal funds to states with Medicaid eligibility error rates above 3%. New rules apply from October 1, 1983, implementing the Tax Equity and Fiscal Responsibility Act.
Area of Science:
- Health Policy
- Public Administration
- Healthcare Regulation
Background:
- Current Medicaid regulations address federal financial participation based on state eligibility error rates.
- A 3-percent national standard for Medicaid eligibility payment error rates is currently in place.
- The Tax Equity and Fiscal Responsibility Act of 1982 mandates changes to these regulations.
Purpose of the Study:
- To propose revisions to existing Medicaid regulations.
- To establish new regulations regarding the disallowance of federal funds.
- To implement specific provisions of the Tax Equity and Fiscal Responsibility Act of 1982.
Main Methods:
- The proposed rule modifies the application period for the existing 3-percent standard.
- New regulations are established for periods commencing October 1, 1983.
- The rule directly implements Section 133 of the Tax Equity and Fiscal Responsibility Act (Pub. L. 97-248).
Main Results:
- Federal financial participation may be disallowed for states exceeding the Medicaid eligibility error rate standard.
- The existing 3-percent standard will apply retroactively only until September 30, 1983.
- New regulatory framework for error rate disallowance will be effective from October 1, 1983.
Conclusions:
- The proposed rule aims to enhance fiscal responsibility within the Medicaid program.
- Implementation of the Tax Equity and Fiscal Responsibility Act will refine error rate management.
- States must adhere to updated regulations to ensure continued federal financial participation.