1 Presumptive Eligibility for Pregnant Women

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

Medicaid and CHIP Program (MACPro)
S28a-Presumtpive Eligibility for Pregnant Women
PRA document
Version 1.0
08/17/2017

Document Number: 207-QSSI-MACPro-PRA-S28a-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

CMS XLC

Table of Contents

Table of Contents
1. S28a-Presumptive Eligibility for Pregnant Women – Screenshots ..................... 1
1.1

Presumptive Eligibility for Pregnant Women ................................................... 1

List of Figures
Figure 1: Presumptive Eligibility for Pregnant Women– 1 ............................................... 1
Figure 2: Presumptive Eligibility for Pregnant Women – 2 .............................................. 2
Figure 3: Presumptive Eligibility for Pregnant Women – 3 .............................................. 2
Figure 4: Presumptive Eligibility for Pregnant Women – 4 .............................................. 3

S28a-Presumtpive Eligibility for Pregnant Women PRA document Version 1.0

i

08/17/2017

CMS XLC

S28a-Presumptive Eligibility for Pregnant Women – Screenshots

1. S28a-Presumptive Eligibility for Pregnant Women –
Screenshots
1.1

Presumptive Eligibility for Pregnant Women

Figure 1: Presumptive Eligibility for Pregnant Women– 1

S28a-Presumtpive Eligibility for Pregnant Women PRA document Version 1.0

1

08/17/2017

CMS XLC

S28a-Presumptive Eligibility for Pregnant Women – Screenshots

Figure 2: Presumptive Eligibility for Pregnant Women – 2

Figure 3: Presumptive Eligibility for Pregnant Women – 3

S28a-Presumtpive Eligibility for Pregnant Women PRA document Version 1.0

2

08/17/2017

CMS XLC

S28a-Presumptive Eligibility for Pregnant Women – Screenshots

Figure 4: Presumptive Eligibility for Pregnant Women – 4

S28a-Presumtpive Eligibility for Pregnant Women PRA document Version 1.0

3

08/17/2017