Assistance of CMS in SA Program Administration

4007 - Assistance of CMS in SA Program Administration (Rev. 1, 05-21-04) The CMS RO is the representative of CMS Central Office (CO) in all certification functions and is responsible for: • Reviewing and recommending action on SA budget submittals; • Furnishing program guidance and policy interpretation to SA officials; • Coordinating communications with SAs, providers, and intermediaries on certification activities; and • Consulting on a regular basis with SAs for mutual assessment of program activities, achievement of stated objectives, and establishment of future goals. These functions are in addition to the CMS RO Director’s responsibility for assessing the adequacy of SA documentation of title XVIII certification recommendations, monitoring SA title XIX certification decisions, making the determination of acceptance for participation, denial, and termination in the title XVIII program, and for recommending the same to the RO division responsible for Medicaid. Before approving State budget submittals, the RO considers the following: • Is the SA’s plan of program activities appropriately related to the national aims and needs of CMS programs? • Is adequate provision made for deploying staff to accomplish these aims, and are the professional qualifications for these positions appropriate to the functions to be performed? • Do the workload and activity plans and the staffing estimates properly distribute emphasis upon recertification, administrative and coordinative planning, and efficient agency administration in terms of supervision, training, records control, and interdivisional relationships? • Does the budget request represent a consistent application and understanding of approved principles of reasonable cost to the SA’s specific circumstances, are the requested funds proper, and has adequate provision been made for validating the costs to be charged to certification? • Have activities not falling under the purview of survey and certification functions, such as State licensure and medical review, been appropriately excluded? • Has the SA provided for the appropriate State match for title XIX FFP?