1 Adult Group - Presumptive Eligibility – Territories

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

QSSI-MACPro-PRA-S32T

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

OMB: 0938-1188

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

Medicaid and CHIP Program (MACPro)
S32T-Adult Group - Presumptive Eligibility PRA
document
Version 1.0
08/21/2017

Document Number: 241-QSSI-MACPro-PRA-S32T-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

CMS XLC

Table of Contents

Table of Contents
1. S32T-Adult Group - Presumptive Eligibility – Screenshots ................................................... 1
1.1

Adult Group - Presumptive Eligibility ............................................................... 1

List of Figures
Figure 1: Adult Group - Presumptive Eligibility – 1 .......................................................... 1
Figure 2: Adult Group - Presumptive Eligibility – 2 .......................................................... 2
Figure 3: Adult Group - Presumptive Eligibility – 3 .......................................................... 2
Figure 4: Adult Group - Presumptive Eligibility – 4 .......................................................... 3
Figure 5: Adult Group - Presumptive Eligibility – 5 .......................................................... 3

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S32T-Adult Group - Presumptive Eligibility – Screenshots

1. S32T-Adult Group - Presumptive Eligibility – Screenshots
1.1

Adult Group - Presumptive Eligibility

Figure 1: Adult Group - Presumptive Eligibility – 1

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S32T-Adult Group - Presumptive Eligibility – Screenshots

Figure 2: Adult Group - Presumptive Eligibility – 2

Figure 3: Adult Group - Presumptive Eligibility – 3

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S32T-Adult Group - Presumptive Eligibility – Screenshots

Figure 4: Adult Group - Presumptive Eligibility – 4

Figure 5: Adult Group - Presumptive Eligibility – 5

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