State Medicaid Eligibility Quality Control Sample Selection Lists and Supporting Regulations

Forms and Documents

Document	Type	Status	Availability
CMS 319 - Supporting Statement Part A 30df.pdf	Supporting Statement A	Uploaded 2026-02-06	Repair queued
Attachment B MEQC case level template 01212021.xlsm	Supplementary Document	Uploaded 2021-01-28	Available
MEQC updated Phase 1 guidance 081720.pdf	Supplementary Document	Uploaded 2021-01-28	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
43652	State Medicaid Eligibility Quality Control Sample Selection Lists and Supporting Regulations at 42 CFR 431.800 - 431.865		Modified

ICR Details

OMB Control No: 0938-0147	ICR Reference No: 202602-0938-007
Status: Received in OIRA	Previous ICR Reference No: 202010-0938-008
Agency/Subagency: HHS/CMS	Agency Tracking No: CPI - 319
Title: State Medicaid Eligibility Quality Control Sample Selection Lists and Supporting Regulations
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 02/09/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	665	0
Time Burden (Hours)	9,840	0
Cost Burden (Dollars)	0	0

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Abstract: 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.

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Authorizing Statute(s): US Code: 42 USC 1396b Name of Law: Payment to States
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 97619	12/09/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 2534	01/21/2026
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 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

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ICR Summary of Burden

	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

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: 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.

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Annual Cost to Federal Government: $393,690

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 02/09/2026

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