EE11
Enrollment
CMS-required outcome
Following an eligibility determination, the system promptly sends the beneficiary information to MMIS to complete enrollment into the appropriate delivery system (e.g., FFS, managed care).
Default metrics
- Percentage of automated transmissions to the MMIS.
- Percentage of transmissions to MMIS that require manual intervention or exceptions.
Regulatory sources
- For states, District of Columbia, Northern Mariana Islands, and American Samoa:
- - 42 CFR 435.914
- For Guam, Puerto Rico, and the Virgin Islands:
- - 42 CFR 436.901