Routing of Medicaid-only Certifications

2774 - Routing of Medicaid-only Certifications (Rev. 1, 05-21-04) While Medicaid is a State-administered program, the RO has responsibility for monitoring all Medicaid certification actions. After the SMA takes required actions, it forwards appropriate certification materials to the RO as required by the Direct Data Entry program. The RO reviews the packets for completeness, acceptability of PoC, and appropriateness of compliance decisions. Since the review is post-certification, feedback is provided to the SA on a case-by-case basis, as appropriate. Medicaid provider agreements are subject to CMS review. In the event prescribed forms, regulations, and procedures were not followed, CMS could disallow FFP in Medicaid payments to the SMA for the involved facilities, i.e., old look behind.