As noted earlier, states must submit an Operations APD to request this funding. CMS will monitor state implementation of the enhanced 75 percent FFP through ongoing review of state eligibility system implementation and operations, as well as through revised claims reporting. Specifically, CMS is revising the CMS-64-10 and 37-10 forms to separately capture eligibility determination system related maintenance and operations costs. We will separately track costs related to IT systems and eligibility determination staff as follows:
- For the IT and systems maintenance and operations, costs will be reported on the CMS-64-10 and 37-10 on line 28C - Operation of an approved Medicaid eligibility determination system/cost of in-house activities - 75 percent FFP and 28D - Operation of an approved Medicaid eligibility determination system/cost private sector contractors- 75 percent FFP.
- For the Eligibility Determination workers staffing eligible for enhanced match, costs will be reported on the CMS-64-10 and 37-10 on line 28E - Eligibility Determination staff - cost of in-house activities - 75 percent FFP and 28F- Eligibility Determination staff - cost of private sector contractors - 75 percent FFP.
- For the Eligibility Determinations workers staffing eligible for regular administrative match, costs will be reported on the CMS-64-10 and 37-10 on line 28G - Eligibility Determination staff - cost of in-hour activities - 50 percent FFP and 28 H - cost of private sector contractors - 50 percent FFP.
As this enhanced match is implemented, CMS will closely monitor implementation and reporting, and if necessary, will revise how this data is collected on the estimate and expenditure reporting forms to ensure states and CMS have the proper break out to track these activities and their related claims.
Furthermore, CMS will continue to work with states over time to ensure that their systems continue to remain compliant with the Seven Conditions and Standards. For example, under the Reporting Condition, state systems should be able to produce accurate data that are necessary for oversight, administration, evaluation, integrity and transparency. CMS has recently provided technical specifications for the Transformed Medicaid Statistical Information System (TMSIS) data file to states following more than a year of collaboration with states participating in the T-MSIS pilot. CMS envisions that the T-MSIS data file will be submitted on a monthly basis. We anticipate releasing additional guidance on this subject in the coming weeks.
As with all expenditures, federal match must be properly claimed and is subject to review and approval. Again, CMS will work closely with the each state to review and approve costs covered and will use the APD process to confirm with states specific implementation details, before states start to submit claims.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 105.59 KB)