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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 61 to 70 of 95 results

How do I create a correspondence log/ How do I update the correspondence log?

The Correspondence Log is the official record for the package. The Correspondence Log can be used as a communication tool, where CMS provides information to the state and the state can respond. Only the SPOC and the CMS Point of Contact can write in the correspondence log, but others may view the correspondence log in a package for reference.

  1. Log in to MACPro as the CMS Point of Contact.
  2. Select the "Records" tab from the upper tool bar, and then select "Submission Packages" for your state.
  3. Next, select your Package ID.
  4. You will be taken to the Summary screen of your package. Select "Related Actions" from the left panel.
  5. Next, select "Create Correspondence Log"
  6. Enter in your information and then select "Create Correspondence Log"
  7. If you should need to add an entry, follow steps 1 through 4 and then select "Add Entry to Correspondence Log".
  8. On the next screen, fill in your entry and then select "Add Entry to Correspondence Log".
  9. You may also add an entry to the correspondence log by selecting "Correspondence Log" from the left panel instead of "Related Actions" shown in Step 4. Please note that this link will only appear after you have created a correspondence log.
  10. Select "Add Entry to Correspondence" in the top right corner.
  11. Fill in your entry information and then select "Add Entry to Correspondence".

FAQ ID:93006

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How do I view approved State Plan Content with current, previous, or future effective dates?

Under the "Records" tab, select "Medicaid State Plan". Next, search for a state using the search feature in the left panel. Select the blue link for your State Plan. On the next screen you will be able to see past, current and future Health Homes Programs.

FAQ ID:92856

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What main functions can my role perform?

Primary Role Definition
CMS Package Disapprover (PD)
  • Disapproves packages
  • This role is for Central Office users
Office of Strategic Operations & Regulatory Affairs (OSORA)
  • Coordinates communication for disapproval process between CMS Offices
  • Informs CMS Point of Contact and CMS Point of Contact Admin of package clearance and documentation completion
CMS Senior Management (SrMGR)
  • Evaluates recommended disposition
  • Reviews recommended disposition of disapproval and disapproval justification
CMS Package Approver (PA)
  • Approves Medicaid SPA Packages
  • Each user with this role can be associated to one Regional Office at a time or to Central Office
CMS Point of Contact Administrator (POC Admin)
  • Oversees the submission package through the CMS senior management review process for recommended disapprovals
  • Tailors disapproval notices
Subject Matter Expert (SME)
  • Provides SME input to Review Team, upon request (offline or as SRT member)
Submission Review Team (SRT)
  • Receives package review assignments
  • Provides section assessments through the Review Tool
  • Reviews and submits notes and comments for Official and Draft Submissions
  • Provides recommendations for RAI, Approval, and Disapproval
CMS Point of Contact (CPOC)
  • Oversees the review of Official and Draft Submissions
  • Maintains the composition of the review team (selects review team members within MACPro)
  • Documents and Reviews correspondence log entries
  • Reviews team feedback within the Review Tool
  • Recommends a disposition for a submission package
  • Requests clarifications and initiates a request for additional information (RAI) from the state
  • Tailors approval notice to the state
  • Sets and manages internal milestones and reminders for SRT and Sr. Managers
  • Oversees the submission package through the CMS senior management review process for recommended approvals
  • CMS users may choose to be CPOCs for specific states within their program and authority
Report Administrator (RA)
  • Views reports and submission packages on behalf of CMS Review Team Administrators (POC Admin)
Subscriber (SUB)
  • Subscribes to specific states of interest
  • CMS users may choose to be subscribers for specific states within a program and authority

FAQ ID:92861

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What does it mean if the State allows CMS to view?

The State has the option to allow CMS to view the information in a submission package prior to submission informally by using the "Allow CMS to View" functionality. The CMS Point of Contact, Submission Review Team, and Subject Matter Expert have the ability to view these submission packages once the state has initiated the function. Please Note: This option will permit the CMS review team to see the screens in this submission package as they appear currently. It does not cause the package to be submitted as Draft or Official, and does not start a CMS review clock. Validation of the screens is not required. States must notify their CMS contact that viewing is available; MACPro does not notify CMS staff. States can deselect this option at any time

To access the submission package, go to the "Records" tab and then select "Submission Packages". Next select the link to the submission package and then in the left panel, select "Reviewable Units". You may then select the blue links to each Reviewable Unit to view the data entered by the state.

FAQ ID:92866

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Does CMS MMIS certification support non-traditional claims processing models, such as using an Administrative Services Organization or "claims processing as a service" approach?

Yes. The certification checklist defines a set of business and technical requirements that a particular Medicaid function must meet. The checklists and criteria are agnostic as to whether the requirements are met by a system built within the Medicaid Agency, a Software-as-a-Service model, a cloud-hosted model, or an ASO model.

FAQ ID:94461

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Is MITA considered during milestone reviews?

Yes, our milestone review process is fully aligned with MITA. During each milestone review, CMS will verify that the state has considered MITA maturity during system definition, and whether the state is actively moving toward higher MITA maturity as defined in the state's latest MITA State Self-Assessment. Please see 42 CFR 433.112 (b)(11).

FAQ ID:94476

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I am a vendor not currently in the Medicaid space, but interested in learning more about opportunities for MMIS and/or E&E modular solutions. Whom can I contact for more information?

CMS is looking for new innovators in the Medicaid IT space. Please direct inquiries to: mmis_mes_certification@cms.hhs.gov.

FAQ ID:94416

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I am an existing MMIS vendor under contract with a state. Who do I contact with questions about the new certification process?

Please work with your state representatives, so that they can contact CMS regional offices for quick assistance with your questions. In addition, please review other FAQs related to this topic.

FAQ ID:94431

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What is the benefit for a state to have milestone reviews with CMS?

Milestone reviews have proven to reduce risk by having earlier discussions where CMS can identify opportunities for efficiencies, facilitate collaboration with other states, and share other ideas that can save time, money, and effort. Identifying issues and opportunities earlier in the process will allow for a much greater impact than was experienced under the old process.

FAQ ID:93976

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We are procuring a COTS solution. This prevents us from providing some of the technical evidence requested in the certification checklists. Will this pose a problem?

CMS encourages the use of COTS solutions where possible, and the milestone review process supports certification of COTS products. The review criteria are intended to be tailorable to support different solutions, including COTS. In this case, the technical criteria in the checklists that do not apply to COTS may be marked ""Not Applicable"" with an explanation as to why they do not apply.

FAQ ID:93986

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