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
If you scroll to the bottom of the page, you'll see that the "Accept" button is grayed out. This means that you cannot accept this report. The SMI request has gone to the State Point of Contact. The SMI request will need to be reviewed again by CMS once the state responds. You are not able to send another SMI request until this request is closed.
If a state responds to an SMI request and updates a report, there will be two tasks for that report. One will be entitled "Seek More Information Response Completed" and the other will be labeled "Review Report".
For all new reports, the system will automatically generate a Report ID. The ID describes the type of report, and also includes a little code at the end. The first two letters of the code are the state or territory abbreviation (so if you want to review a report from Virginia, you'll look for VA). The next four numbers are the year of the data (so this report is from 2015). The next letters represent the type of data (Adult, Child, Health Homes, or Maternal and Infant Health) and the type of report (Quality Measures, SPA, etc.)
The MACPro State by State Measure by Measure Report provides the number of measures reported for a state in each fiscal year, the number of CHIP and Medicaid population data and programs the state reported on, and specifics on which report included information on which measures.
The MACPro Stratifications in the Core Data Report identifies if a core set measure was reported in a specific report number. You may select which core set measures are included in this report.
The MACPro Measure Reporting Status System Report will allow you to search for the status (complete or incomplete) of reports for a specific quality measure. You can select a specific measure within a specified state and year.
Go to the Actions tab, then select "Delete Annual Report". Enter in the package ID and search for the report you wish to delete. Only the State Editor and the State Director can perform this function. This action can only be taken prior to CMS Submission. Once the report is submitted, this is no longer an available action.
Compare Doc Report: After the state has responded to Clarification or RAI, CMS has the ability to see what Reviewable Units have been edited within the submission package.
- Start by logging in as the CMS Point of Contact or Submission Review Team member. Under the "Records" tab, select "Submission Packages." Select the submission package link and in the left panel, select "Compare Doc Change Report". Reviewable Units that have been edited by the state are indicated by a check mark within a green circle.
Compare Doc: While reviewing a Reviewable Unit, the CMS Point of Contact or the Submission Review Team member has access to a feature that will tell him/her exactly what fields were edited by the state during Clarification or RAI.
- Start by logging in as the CMS Point of Contact or Submission Review Team member. Select the "Tasks" tab and then select "Review Submission Package". Select a reviewable unit link. Below the Audit Information, select "View Compare Doc". New fields will expand detailing the Field Name, Old Value, Change Type, and New Value for all edits made within the Reviewable Unit by the state. In the Change Type column, different icons will appear to detail the method that was used to edit this particular field.
Once a state submits a submission package to CMS, they may not edit it while it is in review. The state may withdraw the submission package, but once withdrawn, the package cannot be edited or resubmitted.
CMS may open the package for revisions informally via a clarification request. Clarification questions are entered into the Correspondence Log. The CPOC can compile questions from the Submission Review Team members by accessing the Analyst Notes. Please note, that the reviews of every RU does not have to be completed in order to send a request for Clarification to the State. During a Clarification, the State will have the opportunity to edit content. After the state has responded to Clarification, the CMS Point of Contact must assign Submission Review Team members to Reviewable Units again and review the submission package again.
After requesting Clarification, CMS (specifically the CPOC) has the option to prevent package submission. This is a way for CMS to pull the package back from the Clarification request. This may be necessary as the clock continues during the Clarification period. The CMS review team may not continue their review while the package is back with the State for Clarification, therefore the CPOC should exercise caution when to sending a Clarification, knowing that review will be temporarily suspended.
Another option is after CMS Point of Contact has reviewed the submission package, he/she has the option to Request Additional Information regarding the submission package. All Reviewable Units must appear in the complete status (represented by a checkmark) by having at least one Review Team member complete the review in order to initiate RAI. RAI stops the 90 Day Clock. In this option, the State will have the opportunity to edit content.
Your state will determine if you qualify for Medicaid. Contact your state for renewal or application information.