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 a covered outpatient drug is billed as an outpatient drug and not part of a bundled service, it is rebate-eligible.
Date: February 14, 2018
Topics:
Pharmacy
Subtopics:
State Drug Utilization Data
FAQ ID: 92091
As CMS is obligated by the Federal Privacy Act, 5 U.S.C. Section 552a and the HIPAA Privacy Rule, 45 C.F.R Parts 160 and 164, to protect the privacy of individual beneficiaries and other persons, all direct identifiers have been removed and data that are less than eleven (11) counts are suppressed. An asterisk (*) notes suppressed data. CMS applies counter or secondary suppression in cases where only one prescription is suppressed for primary reasons, e.g. one prescription in a state. Also, if one sub-group (e.g. number of prescription) is suppressed, then the other sub-group is suppressed.
See Also:
- What fields changed when CMS moved the State Drug Utilization Data (SDUD) to data.medicaid.gov?
- What are the data field descriptions for the State Drug Utilization Data (SDUD)?
- Is the redacted State Drug Utilization Data (SDUD) available to the public?
Date: February 14, 2018
Topics:
Pharmacy
Subtopics:
State Drug Utilization Data
FAQ ID: 91831
Since all of the states are combined in the National Totals, the state abbreviation will show on the "National Totals" and "Annual State Detail" option as "XX".
See Also:
Date: February 14, 2018
Topics:
Pharmacy
Subtopics:
State Drug Utilization Data
FAQ ID: 91811
For current versions of MDRP File Formats/Data Definitions, please refer to: https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-mdrp-file-formats-data-definitions-and-medicaid-drug-programs-mdp-email-communications/index.html
See Also:
- What fields changed when CMS moved the State Drug Utilization Data (SDUD) to data.medicaid.gov?
- Is the redacted State Drug Utilization Data (SDUD) available to the public?
Date: February 14, 2018
Topics:
Pharmacy
Subtopics:
State Drug Utilization Data
FAQ ID: 91956
No. CMS does not participate the state's in E&E or in MMIS system development life cycle (SDLC) level reviews.
Date: December 1, 2017
Topics:
Eligibility and Enrollment Systems
Subtopics:
MMIS
FAQ ID: 95056
Yes. The rules pertaining to procuring IV&V contracts (State Medicaid Director Letter 16-010) apply to both E&E and MMIS.
Date: December 1, 2017
Topics:
Eligibility and Enrollment Systems
Subtopics:
MMIS
FAQ ID: 95061
In most cases once they are created, the documents will simply be updated to account for the additional modules being planned or developed. A new document is not necessarily created for each module. If a state calls a document by a different name, the state should inform CMS of the name difference.
Date: December 1, 2017
Topics:
Eligibility and Enrollment Systems
Subtopics:
MMIS
FAQ ID: 95076
Granting CMS direct access to the state's evidence repository is the preferred method for making evidence available to CMS. If that is not possible, the state may make other secure arrangements with CMS, such as using encrypted File Transfer Protocol (FTP). It is critical to follow all Health Insurance Portability and Accountability Act (HIPAA) regulations when submitting evidence that contains personal health information (PHI) and personally identifiable information (PII).
Date: December 1, 2017
Topics:
Eligibility and Enrollment Systems
Subtopics:
MMIS
FAQ ID: 95081
No. Only the checklists pertaining to the modules undergoing review need to be included, and that only for the report created in preparation for a milestone review. However, the IV&V progress report should include risks and recommendations for the entire project--not just those about to undergo a milestone review.
Date: December 1, 2017
Topics:
Eligibility and Enrollment Systems
Subtopics:
MMIS
FAQ ID: 95086
When streamlining the core checklists (IA, TA and S&C checklists), we found that some criteria fit better in other checklists, so they were moved. To keep traceability simple for the states, we chose to keep the original identifiers for any criteria that were moved. The same holds true for criteria moved to the programmatic tab of the IV&V progress report template.
Date: December 1, 2017
Topics:
Eligibility and Enrollment Systems
Subtopics:
MMIS
FAQ ID: 95091