Medicaid Eligibility Quality Improvement Plan (MEQIP)

The Medicaid Eligibility Quality Improvement Plan (MEQIP) was established as the framework to communicate the Department of Health Care Policy and Financing vision, objectives and strategies to improve the Medicaid and Child Health Plan Plus (CHP+) eligibility determination process. An essential component of MEQIP is the Eligibility Quality Improvement Plan which is designed to provide a formal ongoing process by which eligibility sites monitor and evaluate the quality of administrative eligibility activities. Through this process supervisory case reviews must be completed to evaluate timely processing, data entry accuracy and supporting case file documentation.

Who needs to participate?

  • County Departments of Human Services
  • Medical Assistance Sites

What MEQIP objectives are measured?

  • Timely processing
  • Data entry
  • Case file documentation
  • Accurate authorization

What documentation must be maintained by the site?

  • A list of the cases reviewed by the site 
  • A review sheet for each case that was reviewed. The review sheet must address the three measured objectives (timely processing, data entry and case file documentation)
  • The site’s MEQIP quarterly reporting tool and report. This high level overview needs to be completed each quarter and submitted to the Department

How and when does a site submit the MEQIP quarterly report?
An MEQIP report must be submitted for each quarter to meqip@hcpf.state.co.us. The reporting period follows this schedule:

MEQIP Quarterly Report Reporting Period Due Date*
Quarter 1 Report July, August & September November 1st
Quarter 2 Report October, November & December February 1st
Revised Annual Plans July 1st - June 30th  March 31st
Quarter 3 Report January, February & March May 1st
Quarter 4 Report April, May & June August 1st

*Please note: if the due date falls on a non working day then submit the report the 1st working day after due date

For more information, please email: meqip@hcpf.state.co.us