Frequently Asked Questions

As we explained in the January 4, 2018 letter, only those items provided in the Medicaid program on a fee-for-service (FFS) basis are to be included in the aggregate expenditure calculation. DME reimbursed under a Medicaid managed care arrangement or a Medicaid competitive bidding contract are not subject to the FFP limitation. If a state is 90% managed care the state would only have to show compliance or a demonstration with the 10% of FFS utilization and expenditures for the relevant DME items.

FAQ ID:93531

So long as the MCOs are not paid on a fee-for-service (FFS) basis, MCOs are not covered under this statute or subject to the limit on FFP. Only the relevant DME items provided in FFS are included in this limit.

FAQ ID:93536

Only those items provided in the Medicaid program on a fee-for-service basis are to be included in the aggregate expenditure calculation. DME reimbursed under a Medicaid managed care arrangement or a Medicaid competitive bidding contract are not subject to the federal financial participation limitation.

FAQ ID:93541

If the HCBS waiver includes FFS payments for DME, the state’s expenditures for DME would be subject to the limit.

FAQ ID:93546

The statute and regulations require that states provide individuals several channels through which they can apply for Medicaid and CHIP coverage - by mail, in person, on line and over the telephone. Following are some guiding principles for administering telephonic applications based on successful strategies many states have in place today.

1. Accepting a Telephonic Application - States may develop their own processes for accepting and adjudicating telephonic applications. The process for accepting applications by phone must be designed to gather data into a sufficient format that will be accessible for account transfer to the appropriate insurance affordability program. For example, a customer service representative could verbally communicate application questions to the applicant, while electronically filling out the online version of the single streamlined application.
2. Voice Signatures - All applications must be signed (under penalty of perjury) in order to complete an eligibility determination. In the case of telephonic applications, states must have a process in place to assist individuals in applying by phone and be able to accept telephonically recorded signatures at the time of application submission. If applicable, states can maintain their current practices of audio recording and accepting voice signatures as required for identity proofing.
3. Records and Storage - Upon request, states must be able to provide individuals with a record of their completed application, including all information used to make the eligibility determination. As such, CMS recommends that states record all telephonic applications. This may be accomplished by taping the complete application transaction as an audio file, or by producing a written transcript of the application transaction, among other options. The length of storage of these records should comply with current regulations on application storage.
4. Confirmations and Receipts - States should provide a confirmation receipt documenting the telephonic application to the applicant. Such confirmation should be provided upon submission of the application or at any time the applicant wishes to end the customer representative interaction. Confirmation receipts can be delivered via electronic or paper mail (based on the applicant's preference). Confirmation receipts must include key information for applicants, including but not limited to the application summary, the eligibility determination summary page, a copy of the attestations/rights and responsibilities and the submission date of the signed application.

• This FAQ was released as part of a larger set. View the full set. (PDF, 295.71 KB)

FAQ ID:92156

No, an upper payment limit demonstration considers all Medicaid payments (base and supplemental). States must conduct UPL demonstrations for the applicable services described in State Medicaid Director Letter (SMDL) 13-003 regardless of whether a state makes supplemental payments under the Medicaid state plan for the services.

FAQ ID:92191

FAQ ID:92846

The spell check function is determined by your web browser and is not a feature within MACPro itself. Within Internet Explorer, there is an option to turn spelling correction on or off.

1. Under "Settings," choose the "Programs" tab and then select "Manage add-ons."
2. On the left hand tool bar, there is a "Spelling Correction" Add-on Type. There is a box labeled "Enable Spelling Correction" that can be selected.
3. Select "Enable spelling correction".

FAQ ID:92851

If there are questions or problems related to the system/website, please contact the MACPro Help Desk staff via email to MACPro_HelpDesk@cms.hhs.gov. If there are questions regarding the quality measure content or reporting please contact MAC Quality TA via the contact link at the bottom of the screen or by email to MACQualityTA@cms.hhs.gov.

FAQ ID:92726

User Management is a feature in MACPro that works in conjunction with the CMS EIDM user identification and authentication system. To request access to the MACPro application, a user must first go to the Enterprise Identity Management Portal (EIDM: https://portal.cms.gov ) and create an EIDM ID. Once an ID is created, the user must request access to the MACPro application by way of an EIDM role. Once their EIDM role request is approved, they may access MACPro via the link https://macpro.cms.gov  and enter their newly created EIDM credentials to log in. Once in MACPro, the user must request their MACPro roles and attributes via My User Profile under the Records tab. MACPro user role requests are approved by the State System Administrator, CMS System Administrator, or CMS Role Approver. Further detailed instructions can be found in the reference documents posted to Medicaid.gov (https://www.medicaid.gov/state-resource-center/medicaid-and-chip-program-portal/medicaid-and-chip-program-portal.html).

FAQ ID:92731