1 Optional Coverage of Parents and Other Caretaker Relativ

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

Medicaid and CHIP Program (MACPro)
S51 - Optional Coverage of Parents and Other
Caretaker Relatives RU PRA Document
Version 1.0
08/15/2017

Document Number: 171-QSSI-MACPro-R5.1-S51-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

CMS XLC

Table of Contents

Table of Contents
1. S51- Optional Coverage of Parents and Other Caretaker Relatives Screenshots .................... 1
1.1
1.2
1.3
1.4
1.5

Package Header ............................................................................................. 1
A. Characteristics, B. Financial Methodologies, C. Coverage Prior to January
1, 2014 and D. Income Standard Used–Path 1 ............................................... 2
D. Income Standard Used – Path 2................................................................. 2
E. Basis for Income Standard.......................................................................... 3
F. Additional Information (optional) ................................................................. 3

List of Figures
Figure 1: Package Header .............................................................................................. 1
Figure 2: Section A, Section B, Section C and Section D-Path1 ..................................... 2
Figure 3: Section D–Path 2 ............................................................................................. 2
Figure 4: Section E .......................................................................................................... 3
Figure 5: Section F .......................................................................................................... 3

List of Tables
No table of figures entries found.

S51 - Optional Coverage of Parents and Other Caretaker Relatives RU PRA Document Version
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Package Header

1. S51- Optional Coverage of Parents and Other Caretaker Relatives
Screenshots
1.1

Package Header

Figure 1: Package Header

S51 - Optional Coverage of Parents and Other Caretaker Relatives RU PRA Document Version
1.0
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1.2

A. Characteristics, B. Financial Methodologies, C. Coverage Prior to January 1, 2014 and D. Income Standard Used–Path 1

A. Characteristics, B. Financial Methodologies, C. Coverage Prior
to January 1, 2014 and D. Income Standard Used–Path 1

Figure 2: Section A, Section B, Section C and Section D-Path1

1.3

D. Income Standard Used – Path 2

Figure 3: Section D–Path 2

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1.4

E. Basis for Income Standard

E. Basis for Income Standard

Figure 4: Section E

1.5

F. Additional Information (optional)

Figure 5: Section F

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