Persius/hicric huggingface dataset:
DEPARTMENT OF HEALTH & HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, Maryland   21244-1850 
                                                                                                                                                                           
CMCS Informational Bulletin  
 
 
DATE:   September 13, 2013  
 
FROM:   Cindy Mann, Director 
     
   
SUBJECT:   Release of Medicaid Disproportionate Share Hospital Allotment Final Rule 
 
 
Today the Centers for Medicare & Medicaid Services (CMS) issued a final rule entitled 
Disproportionate Share Hospital Payment Reductions (CMS-2367-F). 
 
The Affordable Care Act requires aggregate reductions to state Medicaid DSH allotments 
annually from fiscal year (FY) 2014 through FY 2020, at the same time as the Marketplace and 
Medicaid provide increased coverage options that will reduce uncompensated care levels for 
hospitals.  State Medicaid programs make DSH payments to qualifying hospitals that serve a 
large number of low-income individuals.  This final rule outlines the methodology CMS will use 
to implement the annual reductions for the first two years, FY 2014 and FY 2015. 
 
The final rule can be found online at the Federal Registers website: 
https://www.federalregister.gov/public-inspection 
 
For more information on this rule please visit: http://www.cms.gov/apps/media/fact_sheets.asp  
   
 
1
DEPARTMENT OF HEALTH & HUMAN SERVICES 
Health Care Financing Administration  
 Center for Medicaid and State Operations 
7500 Security Boulevard 
Baltimore, MD 21244-1850 
July 31, 1998  
Dear State Medicaid Director:  
The Balanced Budget Act of 1997 required each home health agency (HHA) to secure a surety bond in 
an amount of at least $50,000 in order to participate in either the Medicare or Medicaid programs. On 
June 1, 1998, we published a final rule in the Federal Register that established the initial submission 
date of a surety bond for Medicaid by a date specified by each State Medicaid agency, but no later than 
September 29, 1998.  
Because of significant concerns expressed by the Congress that some small agencies were having 
difficulty obtaining bonds, we have decided to suspend the submission compliance date until we can 
evaluate a General Accounting Office report that Congress has required. This suspension will be 
effectuated via a new Federal Register rule.  
The effect of the July 31, 1998, Federal Register rule is to eliminate the September 29, 1998, date by 
which current and new HHAs must submit a surety bond in order to meet the requirements of the 
January 5, 1998 regulation. We anticipate, as our notice indicates, that the date to have current and new 
HHAs show compliance for submission of a surety bond to the State will be 60 days following 
publication of an additional final rule, but no earlier than February 15, 1999.  
We will keep you informed of any new developments. If you have any other questions or concerns, 
please contact Mary Linda Morgan by phone at (410) 786-2011 or by e-mail at mmorgan1@hcfa.gov.  
Sincerely,   
/s/   
Sally K. Richardson   
Director   
Center for Medicaid and State Operations  
 
cc:   
All HCFA Regional Administrators   
All HCFA Associate Regional Administrators for Medicaid and State Operations   
Lee Partridge - American Public Human Services Association   
Jennifer Baxendell - National Governors' Association   
Joy Wilson - National Conference of State Legislatures
September 15, 1997 
Dear State Medicaid Director: 
The Balanced Budget Act of 1997 (HR2015) signed by President Clinton on August 5, 
1997, includes a number of provisions which affect the administration of the 
Medicaid Program. One such provision, section 4753(F) requires the electronic 
transmission of all claims data by States to HCFA on or after January 1, 1999. 
Specifically, the law requires the electronic submission of claims data in the format 
specified by the Health Care Financing Administration (HCFA) and consistent with the 
Medicaid Statistical Information System (MSIS), including detailed individual enrollee 
encounter data. 
This new requirement specifically affects your State since you do not currently 
participate in the MSIS. This system is HCFA's electronic alternative to the annual 
hard-copy filing of the HCFA- 2082 report. States participating in MSIS submit 
quarterly data tapes. Once the State successfully passes the MSIS system testing 
process, the State can request to be exempted from the annual HCFA- 2082 report. 
Over 30 States currently participate in MSIS. 
The new section 4753(F) of the Social Security Act requires that all States submit 
their Medicaid claims data through MSIS. To facilitate State compliance with this new 
statutory requirement, we encourage States to participate in MSIS for Federal Fiscal 
Year (FFY) 1998 reporting, or sooner if requested. We believe we can provide better 
technical support if additional States are incorporated on a flow basis. 
An MSIS overview and specifications can be electronically downloaded from HCFA's 
Internet Site (www.hcfa.gov/medicaid/m2082.htm). These are Word Perfect 6.1 files 
which consist of the State participation procedures manual, the tape specifications 
and data dictionary. If you do not have internet access, HCFA will be glad to furnish 
you with printed copies of these MSIS materials upon request. 
We look forward to working with you to successfully implement MSIS on a national 
basis. Once we have all States participating in MSIS we will have a national Medicaid 
Database which will provide useful comparative and analytical information to both 
HCFA and our State partners. 
Please distribute this letter to the appropriate State staff who will be responsible for 
planning your State's participation in MSIS. We are sensitive to the resource 
pressures you face, and will work closely with your staff to provide whatever 
implementation support we can. 
Questions related to this letter, MSIS materials, or to MSIS participation, should be 
addressed to Betty Kern at (410) 786-0141, or BKern@HCFA.gov. 
Sincerely,  Rachel Block  
Director, Data and Systems Group  
Center for Medicaid and State Operations  
cc:  
All Associate Regional Administrators - Division of Medicaid
SMD Letter - Medical Child Support Working Group 8/31/00  
August 31, 2000  
Dear State Medicaid Director:  
The Child Support Performance and Incentive Act of 1998 directed the Secretary of Health and 
Human Services and the Secretary of Labor to jointly establish a Medical Child Support Working 
Group. The purpose of the Working Group was to identify impediments to the effective 
enforcement of medical support by State Child Support Enforcement agencies and recommend 
solutions to these impediments. This letter transmits to you the Medical Child Support Working 
Group's Report to Secretary Donna E. Shalala and Secretary Alexis M. Hermann, "Twenty-One 
Million Children's Health: Our Shared Responsibility."  
The Working Group was comprised of a diverse membership including representatives of the 
Departments of Health and Human Services and Labor, Child Support Enforcement, Medicaid and 
State Children's Health Insurance Program (SCHIP) agencies, unions, courts, employers, health 
plan administrators, and advocates for children and parents. The Working Group's report contains 
seventy-six recommendations that seek to increase the number of children with private health care 
coverage and expand access to publicly-funded health care coverage for children who cannot obtain 
private coverage. The report includes recommendations to improve coordination between State IV-
D, Medicaid and SCHIP agencies.  
Of the 21 million children who are eligible for child support services, approximately 3 million are 
without health care coverage. Lack of such coverage affects children's current and future health and 
their ability to be productive citizens.  
The Working Group's report is being posted on the Administration for Children and Families' web 
site at www.acf.dhhs.gov/programs/cse. For additional information, please contact Sue Knefley at 
sknefley@hcfa.gov or 410-786-0488.  
Sincerely,  
/S/  
Timothy M. 
Westmoreland 
Director  
file:///F|/New%20Website%20Content/PCPG%20Files/2000/2000/smd083100b.asp (1 of 2)4/12/2006 1:02:05 PM SMD Letter - Medical Child Support 
Working Group 8/31/00  
Enclosure  
cc: All HCFA Regional Administrators All HCFA Associate Regional Administrators for Medicaid  and State Operations Lee Partridge - Director, Health Policy Unit, American Public Human 
Services Association Joy Wilson - Director, Health Committee, National Conference of State 
Legislatures Matt Salo - Director, Health Legislation, National Governors' Association  
<% 'Sitewide navigation info / do NOT edit %>  
file:///F|/New%20Website%20Content/PCPG%20Files/2000/2000/smd083100b.asp (2 of 2)4/12/2006 1:02:05 PM
DEPARTMENT OF HEALTH & HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, Maryland   21244-1850 
 
Center for Medicaid, CHIP and Survey & Certification 
           
                    SMDL # 10-007 
 
 May 10, 2010          
 
 
Dear State Medicaid Director: 
 
  
This letter updates the March 5, 2010, letter outlining the methodology for the recalculation of 
the State Phased-down Contribution rates based on the increased Federal matching rates 
calculated in accordance with Section 5001 of the American Recovery and Reinvestment Act 
2010.  As stated in that letter, CMS would notify you of the State contribution per-capita rates 
for full-benefit dual eligible individuals enrolled in Part D on a quarterly basis prior to each fiscal 
quarter through December 2010.  For the third quarter of FY 2010, April through June 2010, 
these rates are unchanged from those rates used for Quarter 2, 2010 as contained in our letter to 
you dated March 5, 2010.  For States with credit balances sufficient to cover the full amount due, 
you may continue to not pay until your credit balance is eliminated.   
 
Thank you for your continued support.  If you have questions regarding this information or any 
of the phased-down State Contribution per capita rates, you may contact Denise Franz at 
denise.franz@cms.hhs.gov or at 410-786-6117.    
 
 
            Sincerely, 
 
            /s/ 
 
            Cindy Mann 
            Director 
 
 
cc:  
CMS Regional Administrators  
 
CMS Associate Regional Administrators  
Division of Medicaid and Childrens Health  
  Page 2  State Medicaid Director 
 
Ann C. Kohler  
NASMD Executive Director 
American Public Human Services Association  
 
Joy Wilson  
Director, Health Committee  
National Conference of State Legislatures  
 
Matt Salo  
Director of Health Legislation  
National Governors Association  
 
Debra Miller  
Director for Health Policy  
Council of State Governments  
 
Christine Evans M.P.H. 
Chief, Government Relations  
Association of State and Territorial Health Officials 
 
Alan R. Weil, J.D., M.P.P. 
Executive Director 
National Academy for State Health Policy
September 8, 2000  
Dear State Health Official:  
As you know, enrollment of children in Medicaid and the State Children's Health Insurance 
Program (SCHIP) is one of the highest priorities of the Department of Health and Human 
Services (HHS) and the Health Care Financing Administration (HCFA). On October 12, 1999, 
the President directed the Secretaries of HHS, Education, and Agriculture to focus children's 
health insurance outreach in a place where we know we can find uninsured children - schools. 
Since then, a cross-Departmental workgroup has gathered information about school-based 
outreach from national, regional, State, and local health and education sources. Additionally, a 
National Summit was held in November, 1999, to identify promising outreach practices. Based 
upon information gathered through these efforts, the three Departments developed the enclosed 
report providing recommendations and a work plan to help you initiate and sustain school-based 
outreach.  
Over the next several months, these three Departments will be working in partnership with State 
and local agencies to operationalize the work plan outlined in the report. Instructional school 
based outreach guides discussed in the work plan will soon be released to assist States, school 
districts, providers, and other interested partners in better understanding specific ways school 
based outreach efforts can be developed and enhanced. These "how-to" guides will be distributed 
to each Medicaid and State Children's Health Insurance Program (SCHIP) State Agency, 
provider groups, hospitals, and every school district in the country. The guides will also be 
available on the Internet at http://www.HCFA.gov and http://www.InsureKidsNow.gov.  
Coordinated outreach through schools can significantly enhance enrollment of eligible low-
income children into Medicaid and SCHIP. Section Four of the enclosed report highlights 
several successful strategies for school-based enrollment that may be of particular interest to 
States. In addition, new legislation effective October 1, 2000, allows schools to share Free and 
Reduced Price Lunch eligibility information with Medicaid and SCHIP unless the parent 
indicates he or she does not want his or her information shared.  
Please let us know how we can assist you in your school-based enrollment and outreach 
efforts, and do not hesitate to contact your Health Care Financing Administration (HCFA) 
Regional Office with additional questions about this important effort.  
Sincerely,   /s/  
Timothy W. Westmoreland  
 
Director  
 
Enclosures  
-Report (PDF)  
-Appendices (PDF)
DEPARTMENT OF HEALTH & HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, Maryland   21244-1850 
 
Center for Medicaid and CHIP Services 
 
CMCS Informational Bulletin 
 
 
DATE:   July 03, 2012 
 
FROM:   Cindy Mann, Director 
Center for Medicaid and CHIP Services (CMCS)  
 
SUBJECT:   Clarification on State Medicaid Manual Vendor Access to Eligibility  
   
   
The Centers for Medicare & Medicaid Services (CMS) is providing clarification to Section 2080.18, 
State Contracts with Outside Parties to Verify for Providers a Medicaid Recipients Eligibility of the 
State Medicaid Manual.  The guidance was created for the eligibility verification process in which 
vendors have direct access to Medicaid Management Information Systems (MMIS) utilizing a 
proprietary method for verification of real time eligibility.  Since the issuance of this guidance, CMS 
adopted the Health Insurance Portability and Accountability (HIPAA) standards of X12 transactions.   
The guidance stated in the State Medicaid Manual does not impact the number of trading partners 
who can and are able to submit batch or real-time Electronic Data Interchange (EDI) transactions 
utilizing the 270/271 transactions.   
 
By law, all covered entities, including health plans, providers and clearinghouses, must be in 
compliance with the updated versions of the transaction standards adopted on January 19, 2009, by 
January 1, 2012.  The updated versions of the X12 Version 5010 and NCPDP Telecommunication 
D.0 and Medicaid Subrogation 3.0 standards must be used by covered entities to exchange electronic 
transactions between trading partners. Small health plans have until January 1, 2013 to implement 
NCPDP 3.0.   
 
If you have questions about this Informational Bulletin, please contact Thomas Novak at 
Thomas.Novak@cms.hhs.gov or 215-861-4216. 
 
Page 1 of 1
January 27, 1998  
Dear State Medicaid Director:  
The purpose of this letter is to provide you with instructions for reporting the new uninsured low-
income children Medicaid coverage group on the HCFA-2082 statistical report.  
The Balanced Budget Act (BBA) of 1997 created a State Childrens Health Insurance Program 
(CHIP), designed to expand health care coverage to uninsured low-income children. Many States 
have begun implementing the provisions of this Act, which was effective October 1997.  
The BBA allows States the option to expand health care coverage to children under a new Title 
XXI program or through expansion of their Medicaid program. States opting to expand coverage 
through their Medicaid programs will create an important new group of Medicaid eligibles. As 
States work to implement this new coverage, we wanted to offer guidance on the procedure for 
statistical reporting of this important group on the HCFA-2082. Expanded eligibles under Title 
XXI who are not covered by the State's Medicaid program will not be included in the HCFA-
2082 report at this time.  
The basic statistical report for the Medicaid program is the hard-copy form HCFA-2082. The 
optional State reporting alternative to the HCFA-2082 is quarterly transmissions of eligibility and 
claims data tapes through the Medicaid Statistical Information System (MSIS). States which 
provide individual eligibility data records through MSIS should code the new Medicaid eligibles 
based on the expansion for uninsured low-income children with a Maintenance-Assistance-Status 
(MAS) of "6" and a Basis-of-Eligibility (BOE) of "4." For hard-copy HCFA-2082 reporting in 
States which have not yet implemented MSIS, these individuals should be reported in the category 
"Other" for MAS and "Child" for BOE. Although the hard-copy HCFA-2082 reporting does not 
uniquely identify the uninsured low-income children group, this reporting scenario eliminates the 
need for interim changes in the hard-copy reporting forms prior to national implementation of 
MSIS in January 1999.  
We believe that this new group is critically important and that these changes are needed to track 
the effect of Medicaid expansions on this population. Please communicate these instructions to the 
appropriate State staff. Refer questions regarding these instructions to Roger Buchanan at 410-
786-0780 (or E-mail at rbuchanan@hcfa.gov).  
Sincerely,  
Rachel Block Director Data and Systems Group  
cc: All HCFA Regional Administrators All HCFA Associate Regional Administrators, for 
Medicaid and State Operations Lee Partridge, American Public Welfare Association Joy Wilson, 
National Conference of State Legislatures Jennifer Baxendell, National Governors Association
DEPARTMENT OF HEALTH AND HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, MD 21244-1850 
 
Center for Medicaid and CHIP Services 
 
CMCS Informational Bulletin 
  
 
DATE:  November 29, 2011 
 
FROM:  Cindy Mann, Director 
  Center for Medicaid and CHIP Services (CMCS) 
 
SUBJECT:   State Flexibility, Resources to Implement Affordable Insurance Exchanges 
 
Today, the Department of Health and Human Services (HHS) awarded nearly $220 million in Affordable 
Insurance Exchange grants to 13 States to help them create Exchanges.  The Department also released 
several Frequently Asked Questions providing answers to key questions States need to know as they work 
to set up these new marketplaces.  Critical among these are that States that run Exchanges have more 
options than originally proposed when it comes to seamlessly determining eligibility for premium tax 
credits, Medicaid, and CHIP.  And States have more time to apply for Level One Exchange grants. 
 
Exchange Grants 
 
Todays awards bring to 29 the number of States that are making significant progress in creating 
Affordable Insurance Exchanges.  States receiving funding today include: Alabama, Arizona, Delaware, 
Hawaii, Idaho, Iowa, Maine, Michigan, Nebraska, New Mexico, Rhode Island, Tennessee and Vermont. 
 
States have many opportunities to apply for funding. To accommodate State legislative sessions and to 
give States more time to apply, HHS also announced a six-month extension for Level One establishment 
grant applications.  Applications now will be accepted until June 29, 2012 (the original deadline was 
December 30, 2011). 
 
FAQs 
 
HHS is also releasing Frequently Asked Questions (FAQs) in anticipation of State legislative sessions 
beginning in January.  Answers will help advance State policy development for Exchanges.  For example, 
they clarify that Exchange grants can be used to build a State Exchange that is operational after 2014; that 
State-based Exchanges will not be charged for accessing Federal data needed to run Exchanges in 2014; 
and that State insurance rules and operations will continue even if the Federal government is facilitating 
an Exchange in the State.  HHS will also allow greater flexibility in eligibility determinations, allowing, 
for example, a State-based Exchange to permit the Federal government to determine eligibility for 
premium tax credits.  In addition, we intend to permit additional options for determining eligibility for 
Medicaid, CHIP, and premium tax credits under a State-based and Federally-facilitated Exchange.    
 
For more information on the States receiving grants, visit:  
 http://www.healthcare.gov/news/factsheets/2011/05/exchanges05232011a.html   For FAQs, visit:  http://cciio.cms.gov/resources/regulations/index.html#hie 
For more information on Affordable Insurance Exchanges: visit: 
http://www.HealthCare.gov/law/features/choices/exchanges/index.html.
DEPARTMENT OF HEALTH AND HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, MD 21244-1850 
 
Center for Medicaid and CHIP Services 
 
CMCS Informational Bulletin 
  
 
DATE:  July 16, 2012 
     
FROM:  Cindy Mann, JD  
  Director 
  Center for Medicaid, CHIP and Survey & Certification (CMCS) 
 
SUBJECT:   Adult Quality Grants: Measuring and Improving the Quality of Care in 
Medicaid 
 
On July 13, 2012 the Centers for Medicare & Medicaid Services (CMS) released a two-year 
funding opportunity announcement open to all 50 States, the District of Columbia, and territorial 
Medicaid agencies.  This grant opportunity, funded by the Affordable Care Act, is designed to 
support State Medicaid agencies in building capacity to collect, report, and analyze data on the 
Initial Core of Set of Health Care Quality Measures for adults enrolled in Medicaid.  A total of 
56 grant awards are available in the amount of up to $1 million for each 12-month budget period 
over the two-year project period (an estimated total of up to $2 million per Grantee).   
 
This is a competitive, performance-based grant opportunity where grants will be awarded with 
consideration to: (1) available funding; and (2) the quality of each application and the applicants 
demonstrated ability to meet the goals of the project.  Programmatic questions about the Adult 
Medicaid Quality Grants should be directed to: MedicaidAdultMeasures@cms.hhs.gov.     
 
The electronic application for this project can be found at http://www.grants.gov by searching 
the downloadable application page by the CFDA number 93.609.  CMS will host a 
teleconference for potential applicants on July 30th from 3-4 pm EST.  Information regarding 
the teleconference will available on the CMS website at http://www.medicaid.gov/Medicaid-
CHIP-Program-Information/By-Topics/Quality-of-Care/Quality-of-Care-%E2%80%93-
Performance-Measurement.html.   
 
The application due date for this funding opportunity is August 31, 2012.  We hope you will find 
this information helpful.