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 main functions can my role perform?
| Primary Role | Definition |
| CMS Package Disapprover (PD) |
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| Office of Strategic Operations & Regulatory Affairs (OSORA) |
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| CMS Senior Management (SrMGR) |
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| CMS Package Approver (PA) |
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| CMS Point of Contact Administrator (POC Admin) |
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| Subject Matter Expert (SME) |
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| Submission Review Team (SRT) |
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| CMS Point of Contact (CPOC) |
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| Report Administrator (RA) |
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| Subscriber (SUB) |
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FAQ ID:92861
SHARE URLWhat 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
SHARE URLDoes 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
SHARE URLIs 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
SHARE URLI 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
SHARE URLI 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
SHARE URLWhat 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
SHARE URLWe 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
SHARE URLHow many certification reviews will each state go through with CMS?
It depends. We consider various factors. If a state is developing a complete MMIS solution with one release date, then there will be three reviews: Project Initiation Review, Operational Milestone Review, and MMIS Certification Final Review. If a state has multiple release dates with a modular or agile approach, the state would have one set of three certification reviews with CMS for each module the state would like CMS to certify. Each state will start its certification effort by having an initial consultation with CMS to determine how CMS can schedule milestone reviews that fit with the state's plan.
FAQ ID:94011
SHARE URLOur state is using an agile approach to develop our MMIS and/or E&E replacement. How will the milestone review milestone review process support this approach?
CMS has developed a milestone review process that is flexible enough to be placed over several development methodologies. CMS wants to ensure that the milestone reviews benefit and do not burden the state. CMS works with each state individually to ensure that the timing of the milestones fit within the state's internal development timeline.
FAQ ID:94001
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