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Frequently Asked Questions

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 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.

FAQ Library

Showing 1 to 10 of 17 results

What is reuse?

The Centers for Medicare & Medicaid Services expects states receiving Federal Financial Participation to share with other states project artifacts, documents and other related materials, and systems components and code for leverage and reuse.

Read the state Medicaid director letter (SMD #18-005) on reuse (PDF, 70.77 KB). Reuse can be accomplished through sharing or acquiring:

  • An entire set of business services or systems, including shared hosting of a system or shared acquisition and management of a turnkey service
  • A complete business service or a stand-alone system module
  • Subcomponents such as code segments, rule bases, configurations, customizations, and other parts of a system or module that are designed for reuse

FAQ ID:93631

How do states get started with reuse?

To get started with reuse, a state can:

FAQ ID:93636

What is the Reuse Repository, and how can states access it?

The Centers for Medicare & Medicaid Services (CMS) established the Medicaid Enterprise Systems (MES) Reuse Repository to support states’ ability to share and reuse project life cycle artifacts. The repository is available on the CMS zONE (Opportunity to Network and Engage). States must have a CMS Enterprise Identity Management login to access the Reuse Repository.

View complete instructions for accessing the Reuse Repository.

Contact MES at MES@cms.hhs.gov for additional assistance in accessing the repository.

FAQ ID:93641

Is training available for reuse concepts and tools?

The reuse webpage on Medicaid.gov features an introductory video and more information about reuse. The webpage also has policy guidance documents.

The Medicaid Enterprise Systems Reuse Repository has instructions on how to use its features. These include how to add artifacts, search for artifacts, use the discussion forum features, and more.

FAQ ID:93646

How do states share?

States can share reusable artifacts with others in several ways. States can participate in workgroups such as the Medicaid Management Information System Cohort, State Technical Advisory Group, and any other relevant state groups to facilitate knowledge sharing, partnerships, and collaboration. States with access to the Reuse Repository also may add their reusable artifacts directly to the repository.

View complete instructions for accessing the Medicaid Enterprise Systems (MES) Reuse Repository. Contact MES at MES@cms.hhs.gov for additional assistance in accessing the repository or participating in workgroups.

FAQ ID:93651

If a state is reusing a system or module already certified in another state, do they still need to go through certification review and decision?

Certification is required for any new implementation, whether it is a custom- developed module that is transferred from another state, or a commercial off-the-shelf module that is being configured and integrated. The certification process looks at the state’s implementation of the solution to ensure the state has met all federal requirements.

States may reuse system documentation and other supporting evidence from a previous state certification if it is available and applicable to their systems and has been reconfirmed by independent verification and validation.

FAQ ID:93656

What aspects of reuse do states need to be aware of when developing advance planning documents (APDs)?

APDs must demonstrate a reuse-friendly design that includes the sharing of systems, modules, code, and any other developed artifacts. States could include language describing their efforts to find and learn from or reuse components from similar systems, or efforts the state is making to ensure that other states more easily can reuse the proposed system once it is developed.

FAQ ID:93661

What is the Centers for Medicare & Medicaid Services (CMS) policy regarding ownership rights?

From an intellectual property standpoint, reuse is supported by the general grant conditions for Federal Financial Participation (FFP) under 45 CFR 95.617, which require states to "include a clause in all procurement instruments that provides that the State or local government will have all ownership rights in software or modifications thereof and associated documentation designed, developed, or installed with FFP under this subpart."

Further, according to 42 CFR 433.112(6), CMS has "a royalty free, non-exclusive, and irrevocable license to reproduce, publish, or otherwise use and authorize others to use, for Federal Government purposes, software, modifications to software, and documentation that is designed, developed, installed or enhanced with 90 percent FFP."

In practice, this means that vendors retain ownership rights to software and other products they have developed under their own initiative and funding, while states and CMS have ownership rights to and may share any software, customizations, configurations, or add-ons funded with FFP.

FAQ ID:93666

What if I encounter an account that does not appear to fit into any of a state's eligibility coverage groups?

Applicants that indicate they have a disability, need long-term care or are over age 65 are always referred to the Medicaid agency for a determination on a non-MAGI basis, regardless of income and household composition, since the FFM is evaluating eligibility for MAGI-based eligibility groups only. Additionally, applicants may always request a full Medicaid determination at the end of the application process. In assessment states, the Medicaid agency will do a final determination of eligibility for these applicants, whereas in determination states, the Medicaid agency just needs to follow up for a non-MAGI determination. The expanded flat file will contain a specific indicator showing if the applicant requested a full determination.

Supplemental Links:

FAQ ID:92136

Can states rely on the information contained in the enhanced flat files?

We believe these files have information that states can rely on. As with any transmission of data or logic process, discrepancies may arise. However, we have done quality reviews and continue to act on reports of issues as quickly as possible by investigating them and introducing systems fixes as needed. We are continuing our testing and quality assurance efforts as well. We expect that states will be doing the same on accounts transferred from states to the FFM. We will continue to rely on our daily desk officer calls and our SOTA process to follow up with states on any questions that may arise.

Supplemental Links:

FAQ ID:91906

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