PERM & MEQC Eligibility Measurements

This page contains documents and guidance associated with the PERM eligibility component and Medicaid Eligibility Quality Control (MEQC) measurements. 

 The PERM eligibility component is used in order to comply with the Improper Payments Elimination and Recovery Act of 2010 (IPERA).  It measures improper payments in Medicaid and the Children's Health Insurance Program (CHIP) based on reviews of States' eligibility determinations of applicants and recipients. 

 The MEQC program is a statutory requirement under Section 1903(u) of the Social Security Act.  It requires States to annually provide an estimate of improper payments in Medicaid based on eligibility reviews of States' recipients.  MEQC is directed at improving the quality of State eligibility determinations.  States have three options when administering MEQC.  The first option is “Traditional” MEQC— Operating MEQC in accordance with the 42 CFR Part 431 Subpart P.  The second option is an MEQC Pilot— Operating MEQC under a  CMS-approved waiver of the requirements of 42 CFR Part 431 Subpart P and conducting a special study or focused review.  The third and final option entails the utilization of a Demonstration Waiver— Operating MEQC as part of a CMS-approved Section 1115 demonstration waiver.