FM9
CMS-Required Outcome
CMS-required outcome
The system tracks that Medicaid premiums and cost sharing incurred by all individuals in the Medicaid household does not exceed an aggregate limit of five percent of the family's income. If the beneficiaries at risk of reaching the aggregate family limit, the system tracks each family's incurred premiums and cost sharing without relying on beneficiary documentation.
Default metrics
- Count/percentage of family’s below/at/exceeding threshold. (The last of these indicates an overpayment by the household.)
Regulatory sources