Form CMS-116, also known as the Medicaid Statistical Information System (MSIS) Provider Reconciliation Report, should be completed by states that participate in the Medicaid program. Here are some content points relevant to who should complete this form:
1. State Medicaid Agencies: Each state that operates a Medicaid program is required to complete Form CMS-116. This applies to all 50 states, as well as the District of Columbia, Puerto Rico, and other U.S. territories.
2. Medicaid Providers: The form collects information related to Medicaid reimbursements and payments made to healthcare providers. Therefore, providers who offer services covered by Medicaid should be aware of the implications of this form, as it affects their reimbursements.
3. State Fiscal Agents: CMS-116 requires reconciliation between the states' Medicaid management information system (MMIS) and the CMS-64 reports filed by state fiscal agents. State fiscal agents, who are responsible for processing Medicaid claims on behalf of states, play a crucial role in ensuring accurate completion of the form.
4. Medicaid Administrators: As administrators, it is their responsibility to oversee the Medicaid program's financial management. They must reconcile and submit Form CMS-116 to the Centers for Medicare & Medicaid Services (CMS) to maintain program integrity and transparency.
5. Accountants and Financial Personnel: To properly complete Form CMS-116, states often require engagement from their accounting and financial departments. These professionals play a vital role in reconciling and compiling the necessary financial data for accurate reporting.
6. CMS (Centers for Medicare & Medicaid Services): CMS is the federal agency responsible for administering the Medicaid program. While not directly responsible for completing the form, they review the submitted CMS-116 reports for each state to ensure compliance with federal regulations and guidelines.
7. Auditors: Form CMS-116 is subject to audit by state and federal auditors to verify the accuracy and completeness of the financial data and claims reporting. Auditors play a crucial role in identifying potential fraud, waste, or abuse in the Medicaid program.
Understanding who should complete Form CMS-116 helps establish accountability and ensures accurate reporting of Medicaid program expenditures. Compliance with this reporting requirement helps maintain transparency, reliability, and the integrity of the Medicaid program.