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
No. We will not charge state-based exchanges (SBEs) or Medicaid/CHIP agencies for the Federal data hub services or underlying data.
Supplemental Links:
Date: November 18, 2012
Topics:
Affordable Care Act
Subtopics:
Enhanced Funding for Eligibility and Enrollment Systems
FAQ ID: 93271
Some services will be composite, and others atomic. For instance, it will be possible to invoke individual SSA services in a single composite service, although not all services in the composite will always need to be invoked. If the Exchange is seeking Title II income information for a member of a household who is not the applicant, then the citizenship and incarceration services would not be invoked. In contract, public MEC verification services will be separate, atomic services.
Supplemental Links:
Date: November 18, 2012
Topics:
Affordable Care Act
Subtopics:
Enhanced Funding for Eligibility and Enrollment Systems
FAQ ID: 93276
Information about the known data elements, definitions for the Federal data hub services are contained in Business Services Description (BSD) documents. The best way to access the BSDs and to avoid version control problems, is to request access to the CMS Service Catalog. States may do so by contacting dsh.support@qssinc.com and requesting the CMS Services Catalog User Intake Form. Please note that as the information published on the repository is quite technical in nature, state users should ideally have a technical background.
Supplemental Links:
Date: November 18, 2012
Topics:
Affordable Care Act
Subtopics:
Enhanced Funding for Eligibility and Enrollment Systems
FAQ ID: 93291
The Federal agencies involved in data verifications are currently involved in discussions of the overall approach to oversight and audits of safeguards. Certain agencies are expected to conduct their own independent audits.
Supplemental Links:
Date: November 18, 2012
Topics:
Affordable Care Act
Subtopics:
Enhanced Funding for Eligibility and Enrollment Systems
FAQ ID: 93296
The Federal data services hub is utilizing the same Department of Homeland Security (DHS) SAVE verification service currently available to states. States will receive both the verification data received from SAVE as well as the Federal data services hub-derived indicators of lawful presence, qualified non-citizen status, and whether the five year bar has been met where applicable.
Supplemental Links:
Date: November 18, 2012
Topics:
Affordable Care Act
Subtopics:
Enhanced Funding for Eligibility and Enrollment Systems
FAQ ID: 93301
Each federal agency has the authority to define use of its data. Therefore CMS defers to IRS, DHS and SSA who are partnering with us to provide data via the Federal data services hub. Please refer to the CMS Services Catalog to review the Business Service Description (BSD) for the verification of income service to identify the Federal tax information data elements and definitions that will be made available to states through the Federal data services hub.
Supplemental Links:
Date: November 18, 2012
Topics:
Affordable Care Act
Subtopics:
Enhanced Funding for Eligibility and Enrollment Systems
FAQ ID: 93306
Enhanced Medicaid funding for Eligibility & Enrollment (E&E) activities is available from the approval of an Advanced Planning Document (APD). An ongoing Medicaid administrative match at the 50% rate is available for activities that take place prior to an approved E&E APD, as long as the activities fall within the purview of administering the Medicaid program (42 CFR 433.15). Funding is available ongoing, subject to APD approvals. More information is available in the State Medicaid Director Letter on Enhanced Funding dated March 31, 2016 (SMD# 16-004), to be found at https://www.medicaid.gov/federal-policy-guidance/federal-policy-guidance.html.
Supplemental Links:
Date: November 18, 2012
Topics:
Affordable Care Act
Subtopics:
Enhanced Funding for Eligibility and Enrollment Systems
FAQ ID: 93321
The twenty-two standards and conditions are listed in the Medicaid Program; Mechanized Claims Processing and Information Retrieval Systems (90/10) rule issued on 12/4/2015. See https://www.federalregister.gov/documents/2015/12/04/2015-30591/medicaid-program-mechanized-claims-processing-and-information-retrieval-systems-9010.
Supplemental Links:
Date: November 18, 2012
Topics:
Affordable Care Act
Subtopics:
Enhanced Funding for Eligibility and Enrollment Systems
FAQ ID: 93331
The requirements of Circular OMB-A-87 apply to the allocation of costs for design, development, and implementation (DDI) and maintenance and operations (M&O) of eligibility and enrollment (E&E) systems including the respective benefiting health insurance affordability programs: Medicaid, CHIP (for states that have separate Title XXI programs or for portions of separate CHIP programs in states that operate a combination CHIP/Medicaid program) and to CCIIO Grant Funding if the project will include functionality for Health Insurance Exchanges.
States can request the temporary exception to Circular OMB-A-87 requirements to use Medicaid enhanced funding for DDI costs of shared eligibility services that will benefit other human service programs (SNAP, TANF, childcare, and child welfare). The exception does not apply to M&O costs, and therefore states must cost allocate to benefiting programs for these costs. For more information, please see the State Medicaid Director Letter, dated July 20, 2015, at https://www.medicaid.gov/federal-policy-guidance/downloads/smd072015.pdf.
Supplemental Links:
Date: November 18, 2012
Topics:
Affordable Care Act
Subtopics:
Enhanced Funding for Eligibility and Enrollment Systems
FAQ ID: 93341
In zONE, states can find business process models, templates for concepts of operations, and other planning and development artifacts, business and technical requirements, Requests for Proposals (RFPs), Statements of Work (SOWs), system design documents, etc. CMS Eligibility & Enrollment (E&E) state leads are available to discuss and assist states in finding the right artifacts in the zONE collaboration spaces. Your SOTA team and your E&E state lead are available to answer specific questions about what might be available soon that is not already in the CALT.
Supplemental Links:
Date: November 18, 2012
Topics:
Affordable Care Act
Subtopics:
Enhanced Funding for Eligibility and Enrollment Systems
FAQ ID: 93346