Frequently Asked Questions

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

To get started with reuse, a state can:

• Review the state Medicaid director letter (SMD #18-005) on reuse (PDF, 70.77 KB)
• View the introductory video  to get familiar with the concept and framework of reuse
• Contact the Medicaid Enterprise Systems (MES) at MES@cms.hhs.gov to request access to the MES Reuse Repository

FAQ ID:93636

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

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

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

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

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

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

CMS acknowledges the customary practice of reimbursing out-of-state or out-of-network providers at a base rate minus a defined percentage. The applicable Medicare rate effectively becomes the ‘floor’ for payments to eligible providers for eligible services rendered in CYs 2013 and 2014. Health plans may pay above that rate but not below.

Supplemental Links:

• This FAQ was released as part of a larger set. View the full set.

FAQ ID:92131

No. The only expenditures that count against the CHIP allotment and must be reported on the CMS-21 are those related to the Medicaid rate in effect on July 1, 2009. The difference between those rates and the 2013 and 2014 Medicare rates eligible for 100 percent FMAP are Medicaid expenditures and are reported on the CMS 64.9.

Supplemental Links:

• This FAQ was released as part of a larger set. View the full set.

FAQ ID:92116