1 Mandatory Eligibility Groups

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

Medicaid and CHIP Program (MACPro)
S4 - Mandatory Eligibility Groups RU PRA
Document
Version 1.0
08/16/2017

Document Number: 190-QSSI-MACPro-R5.1-S4-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

CMS XLC

Table of Contents

Table of Contents
1. S4 - Mandatory Eligibility Groups Screenshots .................................................... 1
1.1
1.2
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1.4

Package Header ............................................................................................. 1
Mandatory Coverage – Section A - Part 1 ....................................................... 1
Mandatory Coverage – Section A-Part 2 and Section B ................................. 2
Mandatory Coverage – Section C ................................................................... 2

List of Figures
Figure 1: Package Header .............................................................................................. 1
Figure 2: Section A-Part 1 ............................................................................................... 1
Figure 3: Section A-Part 2 and Section B ........................................................................ 2
Figure 4: Section C.......................................................................................................... 2

List of Tables
No table of figures entries found.

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Package Header

1. S4 - Mandatory Eligibility Groups Screenshots
1.1

Package Header

Figure 1: Package Header

1.2

Mandatory Coverage – Section A - Part 1

Figure 2: Section A-Part 1

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1.3

Mandatory Coverage – Section A-Part 2 and Section B

Mandatory Coverage – Section A-Part 2 and Section B

Figure 3: Section A-Part 2 and Section B

1.4

Mandatory Coverage – Section C

Figure 4: Section C

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