CMS-10434 #15 Designation and Authority

Centers for Medicare & Medicaid
Services
CMS eXpedited Life Cycle (XLC)

Medicaid and CHIP Program (MACPro)
A1-Designation and Authority RU PRA document
Version 1.0
08/09/2017

Document Number: 162-QSSI-MACPro-PRA-A1-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

CMS XLC

Table of Contents

Table of Contents
1. A1- Designation and Authority Screenshots ......................................................... 1
1.1
1.2

Section A. Single State Agency and Section B. Attorney General
Certification ..................................................................................................... 1
Section C. Administration of the Medicaid Program and D. Additional
information (optional) ...................................................................................... 2

List of Figures
Figure 1: Section A and B ............................................................................................... 1
Figure 2: Section C and D ............................................................................................... 2

List of Tables
No table of figures entries found.

A1-Designation and Authority RU PRA document Version 1.0

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08/09/2017

CMS XLC

A1- Designation and Authority Screenshots

1. A1- Designation and Authority Screenshots
1.1

Section A. Single State Agency and Section B. Attorney General
Certification

Figure 1: Section A and B

A1-Designation and Authority RU PRA document Version 1.0

1

08/09/2017

CMS XLC

1.2

A1- Designation and Authority Screenshots

Section C. Administration of the Medicaid Program and D.
Additional information (optional)

Figure 2: Section C and D

A1-Designation and Authority RU PRA document Version 1.0

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08/09/2017