1 Qualified Entities

Medicaid and CHIP Program (MACPro) (CMS-10434)

QSSI-MACPro-PRA-S17

GenIC #15 (Transition from 0938-1148) - Medicaid State Plan Eligibility

OMB: 0938-1188

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

Medicaid and CHIP Program (MACPro)
S17 - Qualified Entities PRA Document
Version 1.0
08/16/2017

Document Number: 180-QSSI-MACPro-R5.1-S17-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

CMS XLC

Table of Contents

Table of Contents
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Qualified Entities – Part 1 ................................................................................ 1
Qualified Entities – Part 2 ................................................................................ 1

List of Figures
Figure 1: Qualified Entities – Part 1 ................................................................................. 1
Figure 2: Qualified Entities – Part 2 ................................................................................. 1

List of Tables
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S17 - Qualified Entities PRA Document Version 1.0

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08/16/2017

CMS XLC

Qualified Entities – Part 1

1. S17 - Qualified Entities Screenshots
1.1

Qualified Entities – Part 1

Figure 1: Qualified Entities – Part 1

1.2

Qualified Entities – Part 2

Figure 2: Qualified Entities – Part 2

S17 - Qualified Entities PRA Document Version 1.0

1

08/16/2017


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