1 Adult Group

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

Medicaid and CHIP Program (MACPro)
S32 - Adult Group RU PRA Document
Version 1.0
08/16/2017

Document Number: 183-QSSI-MACPro-R5.1-S32-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

CMS XLC

Table of Contents

Table of Contents
1. S32 - Adult Group Screenshots .............................................................................. 1
1.1
1.2
1.3

Package Header ............................................................................................. 1
A. Characteristics, B. Financial Methodologies, C. Income Standard Used and
D. Coverage of Dependent Children ............................................................... 1
E. Additional Information (optional) ................................................................. 2

List of Figures
Figure 1: Package Header .............................................................................................. 1
Figure 2: Section A, Section B, Section C and Section D................................................ 1
Figure 3: Section E .......................................................................................................... 2

List of Tables
No table of figures entries found.

S32 - Adult Group RU PRA Document Version 1.0

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08/16/2017

CMS XLC

Package Header

1. S32 - Adult Group Screenshots
1.1

Package Header

Figure 1: Package Header

1.2

A. Characteristics, B. Financial Methodologies, C. Income Standard
Used and D. Coverage of Dependent Children

Figure 2: Section A, Section B, Section C and Section D

S32 - Adult Group RU PRA Document Version 1.0

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08/16/2017

CMS XLC

1.3

E. Additional Information (optional)

E. Additional Information (optional)

Figure 3: Section E

S32 - Adult Group RU PRA Document Version 1.0

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