EE16
Eligibility Category
CMS-required outcome
The system uses automated business rules to assign accurate eligibility categories for all the mandatory and relevant optional eligibility groups at initial application and renewal. Example business rules include: · Correct identification of individuals age 19-64 at or below 133 percent FPL (VIII group) · Correct alignment of eligibility categories to FMAP rate
Default metrics
- Most recent PERM results
Regulatory sources
- For states, District of Columbia, Northern Mariana Islands, and American Samoa:
- - 42 CFR 435.404
- For Guam, Puerto Rico, and the Virgin Islands:
- - 42 CFR 436.404