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Frequently Asked Questions

Frequently Asked Questions are used to provide additional information and/or statutory guidance not found in State Medicaid Director Letters, State Health Official Letters, or CMCS Informational Bulletins. The different sets of FAQs as originally released can be accessed below.

Showing 21 to 30 of 49 results

What is a validation error within a submission package?

A validation error occurs when additional information is required for certain fields on a page. This error will be indicated by red script on the page under the section that was required. In order to avoid a validation error, enter in all required information before attempting to validate data. For many screens this will occur upon selecting a button located towards the bottom of the page to validate your entries.

FAQ ID:92936

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What reports are available to State Users?

This table indicates what reports are available to State Users. These can be found under the "Reports" tab.

Report Name Description Available For
State Agency Profile Report Overview of a State's Medicaid Plan including the prior 12 months' submission package history State Point of Contact; State Director
Submission Detail Report View details on packages by date State Editor, State Point of Contact, State Director
Submission Statistics Detail Report View all Submission Packages currently in review State Editor, State Point of Contact, State Director
Submission Summary Report Overview of submitted packages by date State Editor, State Point of Contact, State Director

FAQ ID:92941

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Once a state submits a submission package to CMS, is the content locked?

Once a state submits a submission package to CMS, they may not edit it while it is in review. The state may withdraw the submission package, but once withdrawn, the package cannot be edited or resubmitted.

CMS may open the package for revisions informally via a clarification request. Clarification questions are entered into the Correspondence Log. The CPOC can compile questions from the Submission Review Team members by accessing the Analyst Notes. Please note, that the reviews of every RU does not have to be completed in order to send a request for Clarification to the State. During a Clarification, the State will have the opportunity to edit content. After the state has responded to Clarification, the CMS Point of Contact must assign Submission Review Team members to Reviewable Units again and review the submission package again.

After requesting Clarification, CMS (specifically the CPOC) has the option to prevent package submission. This is a way for CMS to pull the package back from the Clarification request. This may be necessary as the clock continues during the Clarification period. The CMS review team may not continue their review while the package is back with the State for Clarification, therefore the CPOC should exercise caution when to sending a Clarification, knowing that review will be temporarily suspended.

Another option is after CMS Point of Contact has reviewed the submission package, he/she has the option to Request Additional Information regarding the submission package. All Reviewable Units must appear in the complete status (represented by a checkmark) by having at least one Review Team member complete the review in order to initiate RAI. RAI stops the 90 Day Clock. In this option, the State will have the opportunity to edit content.

FAQ ID:92991

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How do I access previous reports for my state?

Select the "Records" tab in the upper tool bar. Click on the Quality Measure you are working with and then search for the report you would like to view by entering the report package ID.

FAQ ID:92996

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Is there a way to attach additional information or appendices to a report?

Yes, at the end of each report there is an "Upload Documents" section that allows you to upload any relevant documents.

FAQ ID:93011

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How does section 2001(a)(5)(B) of the Affordable Care Act impact states currently covering children 6-18 up to 133 percent of the FPL under a separate CHIP?

Section 2001(a)(5)(B) of the Affordable Care Act (implemented through regulations for the Medicaid program at section 435.118) increased the minimum income limit applicable to Medicaid eligibility for the mandatory group for poverty-level related children aged 6-18 from 100 to 133 percent of the FPL under section 1902(a)(10)(A)(i)(VII) of the Act. Therefore, if a state is currently covering uninsured children up to 133 percent of the FPL under a separate CHIP, these children must be transitioned to the Medicaid state plan under this children's group effective January 1, 2014. CMS is available to work with states individually on their transition plans for this population.

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FAQ ID:92606

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Are these children who are being transferred from CHIP to the Medicaid state plan considered optional targeted low-income children under section 1902(a)(10)(A)(ii)(XIV) of the Act?

No. For the purposes of eligibility, these children are considered a mandatory Medicaid group for poverty-level related children under section 1902(a)(10)(A)(i)(VII) of the Act. As described below, states will continue to receive the CHIP matching rate for this population.

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FAQ ID:92611

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Will new applicants/children ages 6-18 with incomes between 100 and 133 percent of the FPL with other health insurance qualify for coverage under the Medicaid state plan?

Yes. Under the Medicaid mandatory group for poverty-level related children under section 1902(a)(10)(A)(i)(VII) of the Act, insured children must be covered in addition to uninsured children (please also see applicable match rate questions below). This is different from the rules governing a separate CHIP program, which preclude coverage for insured children.

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FAQ ID:92616

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Does 2001(a)(5)(B) of the Affordable Care Act impact children eligible in a separate or Medicaid expansion that are currently covered at income levels above 133 percent of the FPL?

No. States continue to have the option to cover children above 133 percent of the FPL either under a Medicaid expansion or separate program. States must maintain CHIP "eligibility standards, methodologies, and procedures" for children that are no more restrictive than those in effect on March 23, 2010 as specified under the "maintenance of effort" provision at 2105(d)(3) of the Act. A parallel requirement in Medicaid can be found at sections 1902(a)(74) and 1902(gg) of the Act. These provisions are effective through September 30, 2019.

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FAQ ID:92621

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Will states continue to receive the CHIP enhanced FMAP for children currently enrolled in a separate CHIP up to 133 percent of the FPL after the transition to coverage of these children under the Medicaid mandatory group for poverty-level related children?

Yes. The CHIP enhanced FMAP will continue to be available for children whose income is greater than the Medicaid applicable income level (defined in section 457.301 and based on the 1997 Medicaid income standard for children) after these children transition to Medicaid. This includes children who previously qualified for CHIP in a separate program and uninsured children whose family incomes are up to 133 percent of the Federal poverty level, and therefore will be eligible for Medicaid in 2014. Regular Medicaid matching rates will apply for all other children covered under the mandatory group for children aged 6-18-children with income no more than 100 percent FPL and insured children with income above 100 percent to 133 percent FPL.

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FAQ ID:92626

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