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 verification services will be available from the Federal data services hub on October 1, 2013 ("Day 1")?
The Federal data services hub will provide the following services on Day 1. CMS is also pursuing data sources for additional verifications through the Federal data services hub and will keep states updated as they are confirmed:
- Social Security Number (SSN) verification via the Social Security Administration (SSA)
- Citizenship verification via SSA or the Department of Homeland Security (DHS) when relevant
- Incarceration verification via SSA
- Title II benefit income information via SSA (monthly and annual amounts)
- Quarters of coverage information via SSA
- MAGI income information from the Internal Revenue Service (IRS)
- Max APTC from IRS
- Immigration status verification via DHS, as well as a translation to indicators for lawful presence, qualified non-citizen, and five year bar status.
- Public minimum essential coverage (MEC) verification from Federal agencies
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 104.38 KB)
FAQ ID:93266
SHARE URLWill CMS charge state-based exchanges (SBEs) or Medicaid/CHIP agencies for any of the Federal data hub services or underlying data? If so, which ones and how much?
No. We will not charge state-based exchanges (SBEs) or Medicaid/CHIP agencies for the Federal data hub services or underlying data.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 104.38 KB)
FAQ ID:93271
SHARE URLAre all of the Federal data hub services separate ("atomic"), such as SSN validation, and citizenship, or will they be wrapped into a single, "composite" service?
Some services will be composite, and others atomic. For instance, it will be possible to invoke individual SSA services in a single composite service, although not all services in the composite will always need to be invoked. If the Exchange is seeking Title II income information for a member of a household who is not the applicant, then the citizenship and incarceration services would not be invoked. In contract, public MEC verification services will be separate, atomic services.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 104.38 KB)
FAQ ID:93276
SHARE URLWhat will a State need to do to invoke the Federal data hub services?
All transactional requests to the Federal data services hub shall be performed via web services. These services shall be invoked by State IT systems via application programming interfaces (API) or Web APIs that are accessed via secure Hypertext Transfer Protocol (HTTP) and shall be executed on the system hosting the requested services. The CMS web services shall accept request from trusted sources, perform the function based on the request, and return a response to the State system. CMS shall publish these web services in the CMS Service Catalog, which shall contain all services available to the states and the definitions of the standards that must be met to request the service and standard data format for the data provided when making the request and the data that shall be returned.
CMS is still determining the best mechanism for how batch and bulk data transactions will be designed and implemented. At this stage, CMS believes that there shall be a need to establish both web services and possibly alternate interfaces to meet batch and bulk data transaction requirements.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 104.38 KB)
FAQ ID:93281
SHARE URLHow do I learn which data elements and definitions will be available for each Federal data hub service?
Information about the known data elements, definitions for the Federal data hub services are contained in Business Services Description (BSD) documents. The best way to access the BSDs and to avoid version control problems, is to request access to the CMS Service Catalog. States may do so by contacting dsh.support@qssinc.com and requesting the CMS Services Catalog User Intake Form. Please note that as the information published on the repository is quite technical in nature, state users should ideally have a technical background.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 104.38 KB)
FAQ ID:93291
SHARE URLWill each Federal agency conduct its own audits of safeguards?
The Federal agencies involved in data verifications are currently involved in discussions of the overall approach to oversight and audits of safeguards. Certain agencies are expected to conduct their own independent audits.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 104.38 KB)
FAQ ID:93296
SHARE URLWill the DHS data available through the Federal data services hub include the same data elements as is currently provided directly to states?
The Federal data services hub is utilizing the same Department of Homeland Security (DHS) SAVE verification service currently available to states. States will receive both the verification data received from SAVE as well as the Federal data services hub-derived indicators of lawful presence, qualified non-citizen status, and whether the five year bar has been met where applicable.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 104.38 KB)
FAQ ID:93301
SHARE URLCan states use the data verified through the Federal data services hub for other programs, aside from Medicaid/CHIP eligibility?
Each federal agency has the authority to define use of its data. Therefore CMS defers to IRS, DHS and SSA who are partnering with us to provide data via the Federal data services hub. Please refer to the CMS Services Catalog to review the Business Service Description (BSD) for the verification of income service to identify the Federal tax information data elements and definitions that will be made available to states through the Federal data services hub.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 104.38 KB)
FAQ ID:93306
SHARE URLWhat is the effective date for enhanced Medicaid funding and for how long is it available?
Enhanced Medicaid funding for Eligibility & Enrollment (E&E) activities is available from the approval of an Advanced Planning Document (APD). An ongoing Medicaid administrative match at the 50% rate is available for activities that take place prior to an approved E&E APD, as long as the activities fall within the purview of administering the Medicaid program (42 CFR 433.15). Funding is available ongoing, subject to APD approvals. More information is available in the State Medicaid Director Letter on Enhanced Funding dated March 31, 2016 (SMD# 16-004), to be found at https://www.medicaid.gov/federal-policy-guidance/federal-policy-guidance.html.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 104.38 KB)
FAQ ID:93321
SHARE URLWhat are the Standards and Conditions for Medicaid IT that are required for purposes of receiving the enhanced Medicaid funding?
The twenty-two standards and conditions are listed in the Medicaid Program; Mechanized Claims Processing and Information Retrieval Systems (90/10) rule issued on 12/4/2015. See https://www.federalregister.gov/documents/2015/12/04/2015-30591/medicaid-program-mechanized-claims-processing-and-information-retrieval-systems-9010.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 104.38 KB)
FAQ ID:93331
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