Evaluation of Medicaid's Eligibility Determination Error Rate

Contractor: Maximus, Inc.

Agency Contract Number: M0419

Contract Period: 6/1/03 - 1/31/04

Brief Description of Goals of Contract:

• The specific objectives of the study are:

  • to estimate the percentage of applicants by group for whom Medicaid eligibility is inaccurately determined;
• to estimate the cost to the state of claims paid for ineligible beneficiaries in the four groups;
• to identify common errors associated with specific eligibility groups, including the reason for the error, differentiating between errors caused by the state and errors
• resulting from inaccurate information received from the beneficiary; and
• to devise strategies for reducing errors in determining eligibility.

Summary of Significant Amendments:

Deliverables:

Agency Contact: Cliff Schmidt

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