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.
Frequently Asked Questions
What is the applicability of Minimum Acceptable Risk Standards for Exchanges (MARS-E) 2.0 to states' Medicaid Management Information Systems (MMIS)?
MARS-E 2.0 compliance is not required by CMS for states' MMIS, but CMS recommends that states follow applicable national privacy and security standards and practices for their MMIS. MARS-E 2.0 compliance is required for states' Medicaid/CHIP Eligibility and Enrollment (E&E) systems in order to maintain their Authority to Connect with CMS. Link for more information about MARS-E 2.0: https://www.medicaid.gov/federal-policy-guidance/downloads/cib-09-23-2015.pdf (PDF, 105.5 KB).
FAQ ID:94871
SHARE URLCan state Medicaid agencies access federal financial participation (FFP) to support system changes necessary to meet HIPAA, NIST cybersecurity, or MARS-E 2.0 standards?
For E&E and MMIS, enhanced FFP funding is available at 90 percent via the usual Advanced Planning Document process.
FAQ ID:94876
SHARE URLI have a question about my Medicaid account. What is your phone number?
Contact your state Medicaid agency. They can help you get replacement cards and answer your questions about what services are covered, providers to use, and how to renew your eligibility.
FAQ ID:94571
SHARE URLHow do I apply for (or renew) Medicaid or CHIP?
Your state will determine if you qualify for Medicaid. Contact your state for renewal or application information.
FAQ ID:93381
SHARE URLWho can tell me if I am eligible for Medicaid?
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Since Medicaid is administered by the Medicaid agency in your state, eligibility may vary from one state to another. Contact your state Medicaid Agency with questions, or see if you qualify by applying. CMS is the federal agency that works with state Medicaid agencies to make sure they comply with federal laws and regulations.
FAQ ID:94506
SHARE URLI want to apply for Medicaid or get coverage for my child. Who do I contact?
Your state will determine if you qualify for Medicaid. Contact your state for renewal or application information.
FAQ ID:94516
SHARE URLI want to talk to someone at the federal level. Who do I contact?
State Medicaid and CHIP agencies have the primary responsibility for operation of the Medicaid and CHIP programs and they are your first and primary resource for assistance with your Medicaid and CHIP related questions, particularly as it relates to your eligibility status or benefits. If you have already contacted your State Medicaid Agency, you may contact the Centers for Medicare and Medicaid Services as follows:
Toll-Free: 877-267-2323
Local: 410-786-3000
TTY Toll-Free: 866-226-1819
TTY Local: 410-786-0727
Medicaid.gov Mailbox: Medicaid.gov@cms.hhs.gov
FAQ ID:94561
SHARE URLHow should a state that has a section 1915(c) home and community-based services waiver that is limited to EPSDT-age individuals but includes services related to Autism Spectrum Disorder (ASD) that are now available through the state plan respond to this policy clarification?
The ASD-related services should be provided through the Medicaid state plan for the EPSDT-eligible individuals, rather than the 1915(c) waiver. CMS will work with states to ensure that such services are able to be made available under the state plan. Accordingly, CMS with also work with states to remove the service from the 1915(c) home and community-based services waiver at the next amendment or renewal, whichever comes first.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 252.32 KB)
FAQ ID:93206
SHARE URLHas CMS mandated Applied Behavior Analysis (ABA) services for children under 21 with Autism Spectrum Disorder (ASD)?
No. Applied Behavior Analysis (ABA) is one treatment modality for ASD. CMS is not endorsing or requiring any particular treatment modality for ASD. State Medicaid agencies are responsible for determining what services are medically necessary for eligible individuals. States are expected to adhere to long-standing EPSDT obligations for individuals from birth to age 21, including providing medically necessary services available for the treatment of ASD.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 252.32 KB)
FAQ ID:93211
SHARE URLWhen will CMS begin to assess state compliance with coverage requirements for children with Autism Spectrum Disorder (ASD)?
There is no specific time frame for CMS review of state practices in this area. The CMCS Informational Bulletin released July 7, 2014 (see http://www.medicaid.gov/Federal-PolicyGuidance/Downloads/CIB-07-07-14.pdf (PDF, 143.2 KB)), related to Autism Spectrum Disorder discusses the obligations under the Medicaid statute and regulations that are already in effect. However, CMS recognizes that states may not have focused on the application of these requirements in this area. As a result, a state may need time to review its current program policies to determine if changes are needed to existing state regulations and/or policy to ensure compliance. States may also want to confer with the stakeholder community for public input on the benefit design of autism services for children. CMS believes states should complete this work expeditiously and should not delay or deny provision of medically necessary services. CMS is available to provide technical assistance to states to ensure the availability of services that children may need.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 252.32 KB)
FAQ ID:93221
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