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
Does the new mandatory EQR network adequacy validation activity have to be performed by the same EQRO that performs the other mandatory activities?
No. Under section 438.356 of the Final Rule, states can contract with one or more EQROs to conduct EQR activities and other related tasks (such as production of the EQR report).
- This FAQ was released as part of a larger set. View the full set. (PDF, 185.26 KB)
I am looking for a dentist in my area who accepts Medicaid. How can I find one?
Use our dentist locator to find a dentist that accepts Medicaid.
When should MMIS and /or E&E milestone reviews be conducted?
Alignment with the state's system development life cycle happens during the Project Initiation phase, specifically during Activity 1: Consult with CMS. The state should incorporate CMS milestone reviews into the state's project schedule. The flexibility is in scheduling, not whether milestone reviews are performed. Decisions made between the state and CMS are documented in the Project Partnership Understanding document and can be updated as needed throughout the life cycle.
For E&E and MMIS, how often do the IV&V progress reports have to be submitted to CMS?
At a minimum, quarterly. Depending on the risk of project activity, the state and CMS may agree that more frequent reporting is appropriate. Any frequency greater than quarterly should be captured in the Project Partnership Understanding document.