2018 (old version) | 2023 (new version) | Type of Change | Reason for Change | Burden Change |
MAPD State User Guide V7 | MAPD State User Guide V11 | Updates based on final regulation https://www.cms.gov/files/document/cms-9115-f.pdf Requiring states to submit monthly and daily MMA files. |
Y | |
Cover page | cover page | updated to current date and version | N | |
change log | Change log | Add listing of major updates in document | N | |
TOC | TOC | Revised to include new sections | N | |
List of Tables | List of Tables | Revised to adjust for revised/deleted tables | N | |
Users Guide | User Guide | Rev | general revisions and edits throughout | N |
Puerto Rico | US Territory | Rev | change to cover all territories | N |
Dual | Dually | Rev | consistent with MMCO style guide | N |
individual | beneficiary | Rev | move to person centered language/language sensitivites | N |
provides information about the TBQ Response File sent by CMS to the state & territories in response to its TBQ Request file. | provides information about the TBQ Response File sent by CMS to the state & territories in response to its TBQ Request file. Note: Territories receive the TBQ, which is the territory equivalent to the plan/state BEQ. | Rev | clarification | N |
Enterprise Identity Management | Identity Management (IDM) | Rev | agency change | N |
The state Users role is for an individual who works for or on behalf of a state Medicaid agency. State users can access Medicare eligibility, Low-Income subsidy (LIS) status, and detailed health Plan enrollment information at a beneficiary level | The statesusers’ role is for an individual who works for or on behalf of a state Medicaid agency. State users can access Medicare eligibility, Low-Income subsidy (LIS) status, and detailed health and drug Plan enrollment information at a beneficiary level | Rev | update language | N |
1.After you have received your EIDM User ID and password, navigate to the CMS Enterprise Portal: https://portal.cms.gov.https://portal.cms.gov. 2.Enter your User ID and password and click the buttonbox, “I agree to our Terms and Conditions..” 3.On the My Apps page, click the button for Request/ + Add Apps. The Access Catalog is displayed; Select Request Access for the MARx UI in the MA/MA-PD/PDP/CC box. |
1.After you have created your IDM User ID and password, navigate to the CMS Enterprise Portal. 2.Enter your User ID and password and check the box, “I agree to the Terms & Conditions..” 3.On the My Portal page, select + Add Application. 4.The Request Application Access screen is displayed; Select an Application for MARx UI in the ‘MARx – Medicare Advantage & Prescription Drug System’ box. |
Rev | update language | N |
Figure 2-1 | Figure 2-1 | Rev | remove help desk email | N |
6.Enter the RACF ID, your State/Territory from the drop down list, and the Reason for Request. a.Note: Your EUA User ID is your Resource Access Control Facility (RACF) ID. 7.Review your request information on the review page and Submit the request. 6.Complete “Identity Verification” by selecting Launch. Read through the information on the next screen (Step #1) and select Next. “Accept Terms & Conditions” on Step 2. Enter and/or verify your information on the next page (Step #3). Once your identity has been verified, return to the “Request Application Access” page. 7.Complete Step 4 (Enter Business Contact Information), Step 5 (Enter Role Details), Step 6 (Enter Reason for Request). 8.Upon approval of your request, you will have access to the MARx UI. Note: These instructions are outlined in more detail on pages 50 – 609 – 15 in the CMS EIDMEnterprise Portal User Guide. |
6.Complete “Identity Verification” by selecting Launch. Read through the information on the next screen (Step #1) and select Next. “Accept Terms & Conditions” on Step 2. Enter and/or verify your information on the next page (Step #3). Once your identity has been verified, return to the “Request Application Access” page. 7.Complete Step 4 (Enter Business Contact Information), Step 5 (Enter Role Details), Step 6 (Enter Reason for Request). 8.Upon approval of your request, you will have access to the MARx UI |
Rev | update wording | N |
general | general | Rev | update wording | N |
Residency Status Output The residency status (In Area or Out of Area) for this beneficiary in this Plan on the As of Date and is determined by the current payment month. |
Rev | Add | N | |
Bonus Payment Portion Percent Output The percentage applied to the payment to determine the bonus amount to pay the MCO. This does not apply to a PDP. |
Rev | Add | N | |
MARx Enrollment Detail (M22) screen table | Rev | deleted | N | |
N/A | Part B Enrollment Reason Codes P- Medicare Part B Immunosuppressive Drug (Part B-ID) |
Rev | Add | N |
N/A | Since 2005, states have been submitting files at least monthly to CMS to identify all dually eligible beneficiaries. This includes full-benefit dually eligible beneficiaries and partial-benefit dually eligible beneficiaries (i.e., those who get Medicaid help with Medicare premiums, and often for cost-sharing). The file is called the “MMA file” (after the Medicare Prescription Drug, Improvement and Modernization Act of 2003), but is occasionally referred to as the “state phase-down file.” However, federal regulations at 42 CFR 423.910 now require states, effective April 1, 2022, to submit files daily. Territories do not participate in this data exchange with CMS. |
Rev | Add | Y - requires states to also submit a MMA daily file of accretions, deletions, and changes. |
. States have the option to submit a single monthly MMA file including all known dual eligibles, or multiple MMA files throughout the month (up to one per day). Multiple files are intended to give the States the opportunity to provide current information on updated dual eligibility status. Multiple submittals should represent only those beneficiary person-months with changes in status. CMS expects that many States will opt to submit a large initial file including the bulk of enrollments for the reporting month, and smaller incremental files providing updates for changes in dual eligibility status (additions, deletions, or changes). States should not submit multiple full replacement files as CMS will not be able to process the files., | Rev | Delete | Y - requires states to also submit a MMA daily file of accretions, deletions, and changes. | |
N/A | including all known dually eligible beneficiaries and subsequent daily files that provide updates for changes in dual eligibility status (accretions, deletions, and changes). | Rev | Add | Y - requires states to also submit a MMA daily file of accretions, deletions, and changes. |
N/A | Daily submission means every business day, but if a state has no new transactions to transmit, data would not need to be submitted on a given business day. Daily submission allows the states to provide current information on updated dual eligibility status and helps promote administrative efficiencies while also benefiting dually eligible beneficiaries and providers. | Rev | Add | Y - requires states to also submit a MMA daily file of accretions, deletions, and changes. |
The monthly files will address the following program needs: Parts A and B: QMB status and related protections Part C: Plan risk adjustment Part D: Auto-enrollment and LIS deeming oState Phased-Down State Calculation. |
The MMA files will address the following Medicare program needs based on dual-status: oDual Eligible Enrollment. Parts A and B: QMB status and related protections Part C: Plan risk adjustment Part D: Auto-enrollment and LIS deeming oState Phased-Down Calculation. |
Rev | modify | N |
Medicare-Medicaid dual eligibles | full-benefit Medicare-Medicaid dually eligible beneficiaries | Rev | modify | N |
•Qualified Medicare Beneficiary (QMB), ) •Specified Low-Income Medicare Beneficiary (SLMB), and Qualified) • Individual (QI) (partial benefits)) • Prospective (PRO) records •, and State Low-Income Subsidy (LIS) applications for Part D subsidy processed since the last MMA file was created . This will allow CMS to establish the LIS status of dual eligibles, and to perform auto-assignment of beneficiaries to Medicare Part D plans. |
•Qualified Medicare Beneficiary (QMB) •Specified Low-Income Medicare Beneficiary (SLMB) •Qualifying Individual (QI) (partial -benefit dually eligible) •Retroactive (Retro) records, Prospective (PRO) records •State Low-Income Subsidy (LIS) applications for Part D subsidy processed since the last MMA file was created. |
Rev | modify | N |
This will allow CMS to establish the LIS status of dually eligible beneficiaries and to auto-assign beneficiaries to Medicare Part D plans. In addition, CMS uses QMB status to alert providers (via HETS provider eligibility query and via the Remittance Advice) as well as beneficiaries (via Medicare Summary Notice) of prohibitions on collecting cost-sharing for Medicare A/B services. Finally, CMS uses dual status to risk adjustment payments to Part C Medicare Advantage plans. | Rev | add | N | |
Phased Down State Calculation | State Phased-Down Calulation | Rev | modify | N |
One of the purposes for which the State’s monthly MMA file submission will be used is to calculate the State’s Phased-Down contribution payment. The Phase-Down process requires a monthly count of all full-benefit dual eligibles with an active Part D plan enrollment in the month. CMS will make this selection of records using dual eligibility status codes contained in the person-month record to identify all full-benefit dual eligibles (codes 02, 04, and 08). In the case where in a given month, multiple records were submitted for the same beneficiary in multiple file submittals, the last record submitted for that beneficiary shall be used to determine the final effect on the Phase-Down count. |
CMS uses the state’s MMA file submission to calculate the State Phased-Down contribution payment. The Phased-Down process requires a monthly count of all full-benefit dually eligible beneficiaries with an active Part D plan enrollment in the month. CMS will make this selection of records using dual eligibility status codes contained in the person-month record to identify all full-benefit dually eligible beneficiaries (codes 02, 04, and 08). For more information on the State Phased-Down contribution payment, click here. In the case wherein a given month, multiple records were submitted for the same beneficiary in multiple file submittals, CMS uses the last record submitted for that beneficiary to determine the final effect on the Phased-Down count. |
Rev | modify | N |
State LIS Applications | State Low-Income (LIS) Applications | Rev | modify | N |
The file may also include records for those beneficiaries for whom the state has made a low-income subsidy determination , i.e., since the last file was created. | The file may also include records for those beneficiaries for whom the state has made a low-income subsidy determination for an individual applying to the state, i.e., since the last file was created. | Rev | modify | N |
States are strongly encouraged to use the SSA subsidy application (SSA-1020) for subsidy applicants unless a beneficiary specifically requests the state make the subsidy determination using a state application form. | States areCMS strongly encourages states to use the SSA subsidy application (SSA-1020) for subsidy applicants unless a beneficiary specifically requests the state make the subsidy determination using a state application form. | Rev | modify | N |
If a beneficiary requests a state determination or refuses to use the SSA application, the state must use its own application and process the case using federal LIS income, family size, and resource rules. The state follows its process for taking applications. The state is then responsible for notices, appeals, and redeterminations for subsidy cases it has determined using a state application form. | If a beneficiary requests a state determination or refuses to use the SSA application, the state must use its application and process the case using federal LIS income, family size, and resource rules. Refer to 42 CFR § 423.904 (c). The state follows its process for taking applications. The state is then responsible for notices, appeals, and redeterminations for subsidy cases it has determined using a state application form. For more information, please refer to section 10.3.3, The State Application in the CMS Guidance to States on the Low-Income Subsidy. | Rev | modify | N |
Each state will send at least one MMA Request file to CMS between the first and the end of the enrollment month. If a State submits only one file, this submittal must be a complete monthly dual eligible enrollment file. If a State chooses to submit multiple files, a State may either submit one complete MMA Request file and submit beneficiaries and subsequent daily files includingthat include only file accretions and, deletions, or a State may conceivably also submit multiple files throughout the month each consisting only of partial enrollments, as long as the accrual of all those file submissionand changes in dual eligibility status. Daily means every business day, but if no new transactions are available to transmit, data would deliver, not need to be submitted on a given business day. | Each state will send at least one comprehensive MMA Request file to CMS between the start and the end of the enrollment month including all known dually eligible. beneficiaries and subsequent daily files that include only file accretions, deletions, and changes in dual eligibility status. Daily means every business day, but if no new transactions are available to transmit, data would , not need to be submitted on a given business day. | Rev | modify | N |
By month’s end, a complete representation of all dual eligible enrollment in the state for that month. •If the State submits multiple MMA Request files per any given month, once a file has been accepted, any. Subsequent submissions in the same month will be treated as a unique submission and processed like the first file. For each state file accepted and processed successfully, CMS will send aan MMA Response file within 24 to -48 hours. |
By month’s end, all file submissions for the month will result in a complete representation of all dually eligible beneficiaries enrolled in the state for that month. •States submit a full monthly file and subsequent daily (accretions, deletions, and changes) MMA Request files during the month. Subsequent submissions in the same month will be treated as a unique submission and processed like the first file. For each state file accepted and processed successfully, CMS will send aan MMA Response file within 24 to48 hours. |
Rev | N | |
N/A | oNote: State MMA Request files submitted successfully between 6:00 a.m. – 5:30 p.m. (ET) will be processed the same day. MMA Response files are processed and sent to states between 9:00 a.m. -10:00 a.m. (ET) the following day. oFiles received after 5:30 p.m. (ET) will be processed the following day and the response file sent the next day. oExample: The state submits an MMA request file to CMS and it is received at 6 pm on 6/21 after the cutoff processing time of 5:30 p.m. The file is processed on the next day 6/22 and the response file is sent on 6/23. •Unexpected system issues or planned outages will cause delays in states receiving the MMA Response File within the 24-48-hour window. CMS issues a notification to states via email advising of all delays. If you are not receiving the notifications, contact the MAPD Help Desk at 800-927-8069. |
Rev | Add | N |
State File Cutoff Processing Times 6:00 pm weekdays |
State File Cutoff Processing Times 5:30 pm |
Rev | revision | N |
Retro DET Records | 5.2 Retro DET Records + new section with examples of most common situations | Rev | Add | N |
Prospective Ful Dual Eligibles | Prospective Full-Benefit Dually Eligible Individuals | Rev | revision | N |
N/A | Dual Status Codes - new section 5.7 | Rev | Add | N |
N/A | Part Immunosuppressive Drug (Part B) - new section 5.8 | Rev | Add | N |
After searching to find a match for the beneficiary, the primary match routine returns a response to the MBDSS State Phase Down process indicating the outcome of the search. Based on the response it receives, the MBDSS State Phase Down process will take the following actions: •If the Primary Match routine returns a response that it finds a unique match for the beneficiary and the beneficiary does not reside in the Archive database, the MBDSS State Phase Down process will perform the updates under the matched beneficiary’s record. •If the Primary Match routine returns a response that it finds a unique match for the beneficiary and the beneficiary resides in the Archive database, the MBDSS State Phase Down process will reject the beneficiary’s MMA Request record. •Otherwise, the MBDSS State Phase Down process continues its attempt to find a match for the beneficiary by invoking the Secondary Match routine. |
After searching to find a match for the beneficiary, the primary match routine returns a response to the MBD State Phased-Down process indicating the outcome of the search. | Rev | revision | N |
The Institutional Status Indicator is an indicator of nursing facility, ICFMR (inpatient psychiatric hospital), or Most non-institutionalized dually eligible beneficiaries pay small co-payments for prescription drugs covered under Medicare Part D. However, section 1860D-14 (a)(1)(D)(i) of the Social Security Act eliminates Medicare Part D co-payments for full-benefit dual eligible beneficiaries who would be institutionalized if they were not receiving services under a home and community-based services. Information about the indicator: Values are ‘Y’, ‘N’ or ‘H’ – A value of ‘Y’ indicates that the beneficiary was enrolled in a Medicaid paid institution for the full reporting month, or is projected by the State to remain in the institution for the remainder of the month. A value of ‘H’ (HCBS) is valid for an eligibility month/year no earlier than January 2012, in which a full-benefit dual eligible beneficiary received home and community based services. This includes home and community based services deliveredwaiver authorized by a state under a section 1115 demonstration, under a 1915, or subsections (c) or (d) waiver, of section 1915, or under a state plan amendment under section 1915(i), or if such services are provided through enrollment in a Medicaid managed care organization with a contract under section 1903(m) or under section 1932 of the Social Security Act. This is a keySince January 1, 2012, states have identified their full-benefit dually eligible beneficiaries (dual status codes 02, 04, 08) who are receiving certain home- and community-based services (HCBS) and coded these beneficiary’s “H” for HCBS in the Institutional Indicator field in establishing correct on the MMA file. •Y – Indicates that a full-benefit dually eligible beneficiary copays. is enrolled in a Medicaid-paid institution for the full reporting month, or is projected by the state to be in the institution for the remainder of the month. •H (HCBS) – Indicates that a full-benefit dually eligible beneficiary receives HCBS. States need to submit not only accurate current-month institutional status, but retroactive records reflecting institutional status changes (including H codes) in prior months. This is important so beneficiaries are charged the correct Part D copay amount. Errors in coding this field can have significant financial impacts on beneficiaries. This is also necessary to ensure that there is closure on the Part D Plan’s responsibility for copay amounts during the span of coverage. States that submit retroactive records in their files are asked to cover any unreported past changes in institutional status. For example, if a state has reported a beneficiary for the first time as having institutional status in February, even though the first full month in the institution was January, a retroactive enrollment record is needed showing this update. For more information on submitting retro DET records, refer to section 5.2.2, Retro DET records. |
The indicator represents a full-benefit dually eligible beneficiary who receives Medicaid-covered nursing facility, (inpatient psychiatric hospital), or certain HCBS care. This field, located at item 17 on the MMA Request File, establishes which full-benefit dually eligible beneficiaries (dual status codes 02, 04, 08) qualify for $0 Part D co-payments. Most non-institutionalized dually eligible beneficiaries pay small co-payments for prescription drugs covered under Medicare Part D. However, section 1860D-14 (a)(1)(D)(i) of the Social Security Act eliminates Medicare Part D co-payments for full-benefit dual eligible beneficiaries who would be institutionalized if they were not receiving services under a home and community-based services. waiver authorized by a state under a section or subsections (c) or (d) of section 1915, or under a state plan amendment under section 1915(i), or if such services are provided through enrollment in a Medicaid managed care organization with a contract under section 1903(m) or under section 1932. ince January 1, 2012, states have identified their full-benefit dually eligible beneficiaries (dual status codes 02, 04, 08) who are receiving certain home- and community-based services (HCBS) and coded these beneficiary’s “H” for HCBS in the Institutional Indicator field in establishing correct on the MMA file. •Y – Indicates that a full-benefit dually eligible beneficiary copays. is enrolled in a Medicaid-paid institution for the full reporting month, or is projected by the state to be in the institution for the remainder of the month. •H (HCBS) – Indicates that a full-benefit dually eligible beneficiary receives HCBS. States need to submit not only accurate current-month institutional status, but retroactive records reflecting institutional status changes (including H codes) in prior months. This is important so beneficiaries are charged the correct Part D copay amount. Errors in coding this field can have significant financial impacts on beneficiaries. This is also necessary to ensure that there is closure on the Part D Plan’s responsibility for copay amounts during the span of coverage. For example, if a state has reported a beneficiary for the first time as having institutional status in February, even though the first full month in the institution was January, a retroactive enrollment record is needed showing this update. For more information on submitting retro DET records, refer to section 5.2.2, Retro DET records. |
Rev | revision | N |
6.2 MMA Request File Dataset Naming Coventions - Deleted | Rev | deletion | N | |
MMA Request File Layout - Beneficiary dual status codes 09 – Eligible is entitled to Medicare – Other Dual Eligibles but without Medicaid coverage, includes Pharmacy Plus and 1115 drug-only demonstration. |
MMA Request File Layout - Beneficiary dual status codes delete 09 | Rev | deletion | N |
MMA Response File Specifications This file will be automatically returned to the state upon the successful processing of aan MMA Request File through the same electronic file transfer used to submit the file to CMS. There may be a delay in sending the response file based upon job scheduling. |
MMA Response File specifications This file will be automatically returned to the state upon the successful processing of an MMA Request File through the same electronic file transfer used to submit the file to CMS. Unexpected system issues or planned outages will cause delays in states receiving the MMA Response File within the 24-48-hour window. CMS issues a notification to states via email advising of all delays. Notifications are posted on the State Data Resource Center website and can be found here: Medicare Data -> Data File Exchange-> MMA Information -> MMA Announcements or by clicking here. |
Rev | add | N |
Section 7.2.4 Plan Benefit Package Enrollment | Section 7.2.4 Plan Benefit Package Enrollment - removed the Updated list of values Beneficiary Enrollment Type Code (item 211 | Rev | deletion | N |
7.3 MMA Response File Dataset Naming Convetions - MMA Response File Dataset Naming conventions | 7.3 MMA Response File Dataset Naming Conventions - Remove MMA Response File Dataset Naming Conventions | Rev | deletion | N |
Beneficiary Enrollment Type Code | Beneficiary Enrollment Type Code -change D System Generated enrollment to CMS Annual Rollover I Non-MMP Plan to I - Invalid Submitted Value M Default for FA Demo Plan to Default for Financial Alignment Demeo Plan N: Rollover by plan transaction |
Rev | revision | N |
MMA Response File Detail Record | Add item 342 - Date Beneficiary Last Used the Dual/LIS Special Election Period (Election Type "L" | Rev | add | N |
8.1 BEQ Request File Dataset Naming Convention | 8.1 Remove BEQ Reques File Dataset Naming Conventions | Rev | deletion | N |
9.1 BEQ Response File Dataset Naming Convention | 9.1 Remove BEQ Response File Dataset Naming Conventions | Rev | deletion | N |
9.3 BEQ Response File Detail Record Layout | 9.3 BEQ Response File Detail Record Layout - add Medicare Part A Entitlement Dates (2nd occurrence in Positions 1735-1750) Medicare Part B Entitlement Dates (2nd occurrence in Positions 1751-1766) |
Rev | Add | N |
BEQ Response File Detail Record Layout Item 155 Values: A – Part D: Auto -enrolled by CMS. B –: Beneficiary election. C – Part D: Facilitated enrollment by CMS. D – System-Generated Enrollment(D: CMS Annual Rollover). I – Assigned to Plan-submitted transactions with enrollment source other than any of the following: B,E,F,G,H and blank |
BEQ Response File Detail Record Layout Item 155 Values: A – Auto -enrolled by CMS. B –: Beneficiary election. C – Facilitated enrollment by CMS. D – CMS Annual Rollover. I: Invalid Submitted Value. An indicator providing the type of enrollment performed. Values: A – Part D: Auto -enrolled by CMS. B –: Beneficiary election. C – Part D: Facilitated enrollment by CMS. D – System-Generated Enrollment(D: CMS Annual Rollover). E –: Plan -submitted auto-enrollments. F –: Plan -submitted facilitated enrollments. G –: Point of Sale (POS) submitted enrollments. H –: CMS or plan submitted re- assignment enrollments. I – Assigned to Plan-submitted transactions with enrollment source other than any of the following: B,E,F,G,H and blank I: Invalid Submitted Value. J –: State-submitted MMP passive enrollment. K –: CMS-submitted MMP passive enrollment. L –: Beneficiary MMP election. M: Default for Financial Alignment Demo Plan enrollments submitted without an Enrollment Source Code (M is not submitted on an enrollment). N: Rollover by plan transaction. |
Rev | revise | N |
9.3 BEQ Response File Detail Record Layout | 9.3 BEQ Response File Detail Record Layout - add Medicare Part A Entitlement Dates (1st occurrence in Positions 48-63) Medicare Part B Entitlement Dates (1st occurrence in Positions 64-79) |
Rev | add | N |
10.1 TBQ Request File Dataset Naming conventions | 10.1 TBQ Request File Dataset Naming conventions - removed | Rev | deletion | N |
10.1 TBQ Response File Dataset Naming conventions | 10.1 TBQ Response File Dataset Naming conventions - removed | Rev | deletion | N |
11.3 Note: The Medicare Beneficiary Identifier (MBI), items 256-265, will not be populated until February 2018. | Note deleted. | Rev | deletion | N |
TBQ Response File Detail Record, Item 72, Beneficiary's Part B Enrollment Reason Code (Occurrence 1) | TBQ Response File Detail Record, Add P= Part B Immunosuppresive Drug (PART B-ID) | Rev | Add | N |
TBQ Response File Detail Record | TBQ Response File Detail Record, Add Item 286, Date Beneficiary Last Used the Dual/LIS SEP (Election Type "L" | Rev | Add | N |
12.1 Puerto Rico Dual Eligibles Request File Dataset Naming Conventions | 12.1 Puerto Rico Dual Eligibles Request File Dataset Naming Conventions - removed | Rev | deletion | N |
12.5 Puerto Rico Dual Eligibles Response File Dataset Naming Conventions | 12.1 Puerto Rico Dual Eligibles Response File Dataset Naming Conventions - removed | Rev | deletion | N |
12.7 Note: The Medicare Beneficiary Identifier (MBI), items 256-265, will not be populated until February 2018. | Note deleted. | Rev | deletion | N |
Glossary - Managed Care Organization (MCO) A type of contract under which CMS pays for each beneficiary, based on demographic characteristics and health status; also referred to as Risk In a Risk contract, the MCO accepts the risk if the payment does not cover the cost of services, but keeps the difference if the payment is greater than the cost of services. Risk is managed through a membership where the high costs for very sick beneficiaries are balanced by the lower cost for a larger number of relatively healthy beneficiaries. |
Glossary - Managed Care Organization (MCO) A type of Medicare Part C or D contract under which CMS pays for each beneficiary, based on demographic characteristics and health status; also referred to as Risk contract. In a Risk contract, the MCO accepts the risk if the payment does not cover the cost of services, but keeps the difference (subject to any risk corridors) if the payment is greater than the cost of services. |
Rev | revision | N |
Glorssary -Medicaid A jointly funded, Federal-State health insurance program for certain low-income and needy people. It covers approximately 36 million beneficiaries including children, the aged, blind, and/or disabled, and people eligible to receive Federally assisted income maintenance payments. |
Glorssary -Medicaid A jointly funded, Federal-State health insurance program for certain low-income people. It covers approximately 72.2 million beneficiaries. |
Rev | Revision | N |
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