Crosswalk (CMS-64 Summary)

Crosswalk for CMS-21 and CMS-64 (version 2).docx

Quarterly Medicaid and CHIP Budget and Expenditure Reporting for the Medical Assistance Program, Administration and CHIP (CMS-10529)

Crosswalk (CMS-64 Summary)

OMB: 0938-1265

Document [docx]
Download: docx | pdf

Crosswalk for the implementation of the Medicaid Eligibility Quality Control (MEQC) Regulation for CFR 42 SECTION 431.800 MEDICAID ELIGIBILITY QUALITY CONTROL PROGRAM on the current CMS-64 and CMS-21, starting Quarter beginning 4/1/2019


Quarter Beginning 4/1/2019 Type of Change Rationale for the Change

CMS 64 Series Form: CMS is adding lines to capture MEQC “Medicaid Eligibility Quality Control (MEQC)” Collections and Overpayments to various MBES worksheets. CMS Regional MBES contacts will support states in properly reporting the MEQC Collection and Overpayment Amounts.

The forms contain Medicaid Eligibility Quality Control Collections and Overpayments.

To comply with CFR 42 Sect 431.810 – 431.820, related to MEQC Collection and Overpayment reporting beginning April 1, 2019.

As a result of these new lines beginning with the 4/1/2019 Submission, 2 new Medical Eligibility Quality Control lines (MEQC) were added to the CMS 64 Summary form, Line 9G- - MEQC Collections.

It is a Line Item added to the CMS 64 Summary form for Medicaid Eligibility Quality Control Collections. On Line 9G of the CMS 64 Summary, Column (a) is the Total Computable amount of MEQC Collections and Column (e) will allow entry of the MEQC Federal Share associated with the Total Computable entered in Column (a).

To comply with CFR 42 Sect 431.810 – 431.820, related to MEQC Collection and Overpayment reporting beginning April 1, 2019. T

Line 10G- Adjustments Decreasing Prior Qtrs - MEQC Overpayment Adjustments

It is a Line Item added to CMS 64 Summary form for Medicaid Eligibility Quality Control Overpayments. The line will pre-fill Line 10G Column (a) of the CMS 64 Summary form with the Line 5 Total Overpayments, Total Computable Column (a) It will also pre-fill Line 10G Column (6) of the CMS 64 Summary form with the Total Overpayment Total Federal Share column (e) from the CMS 64.9OMEQC entry. .

To comply with CFR 42 Sect 431.810 – 431.820, related to MEQC Collection and Overpayment reporting beginning April 1, 2019.

Beginning with the 4/1/2019 Submission a new Medicaid screen (CMS 64.9OMEQC).

It is a new form that allow for the entry of Medicaid Eligibility Quality Control (MEQC) collection and overpayment recoveries.

To comply with CFR 42 Sect 431.810 – 431.820, related to MEQC Collection and Overpayment reporting beginning April 1, 2019.




Crosswalk for the implementation of the Demonstration Programs to Improve Community Mental Health Services and additional Revisions for the Certification (CMS-21 Summary and 21.O MEQC) MBES/CBES Started on 4/1/2019


Line #s on Current CMS-21 (Starting Submission on 4/1/2019

Type of Change

Rational for Change

Beginning with the 4/1/2019 Submission, 2 new Medical Eligibility Quality Control lines (MEQC) were added to the CMS 21 Summary form.


Line 4a- Adjustments Decreasing Clams - MEQC Collections and 6a - Adjustments Decreasing Claims - MEQC Overpayments.

It is a Line Item added to the CMS 21 Summary form for Medicaid Eligibility Quality Control Collections. On Line 4a of the CMS 21 Summary, Column (a) is the Total Computable amount of MEQC Collections and Column (b) will allow entry of the MEQC Federal Share associated with the Total Computable entered in Column (a).

To comply with CFR 42 Sect 431.810 – 431.820, related to MEQC Collection and Overpayment reporting beginning April 1, 2019.

Line 6a- Adjustments Decreasing Claims - MEQC Overpayments

It is a Line Item added to CMS 21 Summary form for Medicaid Eligibility Quality Control Overpayments. The line will pre-fill Line 6a Column (a) of the CMS 21 Summary form with the Line 5 Total Overpayments; Total Computable Column (a) It will also pre-fill Line 6a Column (b) of the CMS 21 Summary form with the Total Overpayment Total Federal Share column (e) from the CMS 21.OMEQC entry.

To comply with CFR 42 Sect 431.810 – 431.820, related to MEQC Collection and Overpayment reporting beginning April 1, 2019.

Beginning with the 4/1/2019 Submission a new Medicaid Eligibility Quality Control Overpayment screen (CMS 21.OMEQC) will be available for entry.

It is a new form that allow for the entry of Medicaid Eligibility Quality Control (MEQC) Overpayment amounts. On the CMS 21.OMEQC.The Total Computable, amount Column (a) and the Total Federal Share amount Column (e) from Line 5 Total Overpayment will pre-fill Line 6a Total Computable Column (a) and Line 6a Column (b) on the CMS-21 Summary form.

To comply with CFR 42 Sect 431.810 – 431.820, related to MEQC Collection and Overpayment reporting beginning April 1, 2019.


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File Modified0000-00-00
File Created0000-00-00

© 2024 OMB.report | Privacy Policy