MES Certification Navigator
TPL11

MCO TPL Recovery

CMS-required outcome

As determined by the state policies, system(s) enables the state to manage and oversee TPL recoveries made by its MCOs.

Default metrics
  • Number of dollars recovered due to MCO TPL recovery.
  • Percentage of recovered reimbursement attributed to MCOs.
  • Response time for MCOs to respond to SME regarding TPL recovery.
Regulatory sources
  • COB/TPL Training and Handbook- 2020 (pg. 53-55)

Other Third Party Liability outcomes