Medicaid Managed Care Quality including Supporting Regulations in §§438.310, 438.330, 438.332, 438.334, and 438.340 (CMS-10553)

The May 6, 2016, final rule (RIN 0938-AS25, CMS-2390-F) contains new and revised quality and quality strategy requirements that apply to states that contract with MCOs, PIHPs, PAHPs and certain PCCM entities to deliver Medicaid services. The burden for elements previously captured in the CMS-10108 package (0938-0920), related to quality strategy and quality assessment and performance improvement (QAPI) programs have been moved into this PRA package, as the final rule has re-codified non-EQR portions of the quality regulations from Section 438 Subpart D into Subpart E. This PRA package now includes the Medicaid Quality Assessment and Performance Improvement Programs, State Review of Accreditation Status, Medicaid Managed Care Quality Rating System, and Quality Strategy (QS).

The latest form for Medicaid Managed Care Quality including Supporting Regulations in §§438.310, 438.330, 438.332, 438.334, and 438.340 (CMS-10553) expires 2022-09-30 and can be found here.

State Governments

Federal Enterprise Architecture: Health - Health Care Services