1 State Residency

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

QSSI-MACPro-PRA-S88

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)
S88-State Residency PRA document
Version 1.0
08/21/2017

Document Number: 233-QSSI-MACPro-PRA-S88-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

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Table of Contents

Table of Contents
1. S88-State Residency - Screenshots .................................................................................. 1
1.1

State Residency .............................................................................................. 1

List of Figures
Figure 1: State Residency – 1 ......................................................................................... 1
Figure 2: State Residency – 2 ......................................................................................... 2
Figure 3: State Residency – 3 ......................................................................................... 2
Figure 4: State Residency – 4 ......................................................................................... 3

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S88-State Residency - Screenshots

1. S88-State Residency - Screenshots
1.1

State Residency

Figure 1: State Residency – 1

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S88-State Residency - Screenshots

Figure 2: State Residency – 2

Figure 3: State Residency – 3

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S88-State Residency - Screenshots

Figure 4: State Residency – 4

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