EPS3
CMS-Required Outcome
CMS-required outcome
The state includes submission requirements (timeliness, re-submissions, etc.), definitions, data specifications and standards, and consequences for non-compliance in its managed care contracts. The state enforces consequences for non-compliance.
Default metrics
- This is a state specific requirement, for the most part, states have encounters submission/re-submission processes based on 30/60/90/180 days and 365 days.
Regulatory sources
- 42 CFR Part 438.3