EE19
Retroactive Eligibility
CMS-required outcome
Individuals receive timely and accurate determinations of eligibility for the three months prior to the date of application if the individual would have been eligible and received Medicaid covered services.
Default metrics
- Percentage of individuals who received retroactive coverage up to 3 months prior to the date of application.
Regulatory sources
- For states, District of Columbia, Northern Mariana Islands, and American Samoa:
- - 42 CFR 435.915
- For Guam, Puerto Rico, and the Virgin Islands:
- - 42 CFR 436.901