State Medicaid Agency Weekly X 100% Review X Operating Agency Monthly Less than 100% Review Sub-State Entity Quarterly Representative Sample; Confidence Interval = Other Annually Specify: X Continuously and Stratified: Describe Ongoing Group: Other Specify: Other Specify: Data Source (Select one) (Several options are listed in the on-line application): If is selected, specify: ‘Other’ Responsible Party for Frequency of data Sampling Approach data collection/generation: (check each that collection/generation (check each that applies) (check each that applies) applies) State Medicaid Agency Weekly X 100% Review X Operating Agency Monthly Less than 100% Review Sub-State Entity Quarterly Representative Sample; Confidence Interval = Other Annually Specify: X Continuously and Stratified: Describe Ongoing Group: Other Specify: Other Specify: Data Aggregation and Analysis Responsible Party for Frequency of data data aggregation and aggregation and analysis analysis: (check each that (check each that applies applies State Medicaid Agency Weekly X Operating Agency Monthly Sub-State Entity Quarterly Other X Annually Specify: Continuously and
State Medicaid Agency Weekly X 100% Review X Operating Agency Monthly Less than 100% Review Sub-State Entity Quarterly Representative Sample; Confidence Interval = Other Specify: Annually X Continuously and Ongoing Stratified: Describe Group: Other Specify: Other Specify: Data Source (Select one) (Several options are listed in the on-line application): If ‘Other’ is selected, specify: Responsible Party for data collection/generation (check each that applies) Frequency of data collection/generation: (check each that applies) Sampling Approach (check each that applies) State Medicaid Agency Weekly X 100% Review X Operating Agency Monthly Less than 100% Review Sub-State Entity Quarterly Representative Sample; Confidence Interval = Other Specify: Annually X Continuously and Ongoing Stratified: Describe Group: Other Specify: Other Specify: Data Aggregation and Analysis Responsible Party for data aggregation and analysis (check each that applies Frequency of data aggregation and analysis: (check each that applies State Medicaid Agency Weekly X Operating Agency Monthly Sub-State Entity Quarterly Other Specify: X Annually Continuously and