CMS-10434 #15 Organization and Administration

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

Medicaid and CHIP Program (MACPro)
A4-Organization and Administration RU PRA
document
Version 1.0
08/21/2017

Document Number: 242-QSSI-MACPro-PRA-A4-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

CMS XLC

Table of Contents

Table of Contents
1. A4-Organization and Administration Screenshots ............................................... 1
1.1
1.2
1.3

1.4

Section A. Description of the Organization and Functions of the Single State
Agency ............................................................................................................ 1
Section B. Entities that Determine Eligibility or Conduct Fair Hearings Other
than the Medicaid Agency ............................................................................... 3
Section C. Supervision of the Administration of the State Plan through a State
Agency Other Than the Medicaid Agency and Section D. Supervision of the
Administration of the State Plan through Local Government Entities .............. 4
Section E. Coordination with Other Executive Agencies and Section F.
Additional information (optional) ...................................................................... 5

List of Figures
Figure 1: Section A Screenshot 1 .................................................................................... 1
Figure 2: Section A Screenshot 2 .................................................................................... 2
Figure 3: Section B .......................................................................................................... 3
Figure 4: Section C and D ............................................................................................... 4
Figure 5: Section E and F................................................................................................ 5

List of Tables
No table of figures entries found.

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A4-Organization and Administration Screenshots

1. A4-Organization and Administration Screenshots
1.1

Section A. Description of the Organization and Functions of the
Single State Agency

Figure 1: Section A Screenshot 1

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A4-Organization and Administration Screenshots

Figure 2: Section A Screenshot 2

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1.2

A4-Organization and Administration Screenshots

Section B. Entities that Determine Eligibility or Conduct Fair
Hearings Other than the Medicaid Agency

Figure 3: Section B

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1.3

A4-Organization and Administration Screenshots

Section C. Supervision of the Administration of the State Plan
through a State Agency Other Than the Medicaid Agency and
Section D. Supervision of the Administration of the State Plan
through Local Government Entities

Figure 4: Section C and D

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1.4

A4-Organization and Administration Screenshots

Section E. Coordination with Other Executive Agencies and
Section F. Additional information (optional)

Figure 5: Section E and F

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