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CMS Technical Instructions: Reporting Beneficiary Cost Sharing Data (Copayment, Coinsurance and Deductible) in T-MSIS

This technical instruction defines, specifies, and differentiates T-MSIS data elements related to select beneficiary cost sharing information (i.e., copayment, coinsurance, and deductible data). States have varied interpretations of related T-MSIS beneficiary data elements. Consistent reporting allows for accurate interpretation of the data and decreases the administrative burden placed on states and CMS to validate the data.

This technical instruction applies to Medicaid and CHIP fee-for-service (FFS) claims and managed care encounters.


Collections:

UT-21-0010

This Amendment increases payment for providers reference in Utah’s American Rescue (ARPA) Act Home and Community Based Services (HCBS) Funding Spending Plan.

PA-22-0020

CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to provide one-time lump sum supplemental payments to non-emergency medical transportation (NEMT) providers for the rate year beginning July 1, 2021 and ending June 30, 2022.

KS-22-0030

CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to rescind the authorities regarding Presumptive Eligibility (PE) authorized in sections B.1, B.2, and B.3 of DR SPA KS-20-0012.