EE17
Incarcerated individuals
CMS-required outcome
Incarcerated individuals receive timely access to inpatient services and receive a timely and accurate eligibility determination upon release.
Default metrics
- Number/Percentage of individuals whose eligibility status was suspended due to incarceration, if applicable.
- Number/Percentage of claims for inpatient services for incarcerated individuals.
- Number/Percentage of claims paid for services other than inpatient services for incarcerated individuals.
Regulatory sources
- For states, District of Columbia, Northern Mariana Islands, and American Samoa:
- - 42 CFR 435.1009
- For Guam, Puerto Rico, and the Virgin Islands:
- - 42 CFR 436.1005