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Frequently Asked Questions

Frequently Asked Questions are used to provide additional information and/or statutory guidance not found in State Medicaid Director Letters, State Health Official Letters, or CMCS Informational Bulletins. The different sets of FAQs as originally released can be accessed below.

Showing 41 to 50 of 108 results

What is the link to the Enterprise Portal?

The Enterprise Portal can be accessed at https://portal.cms.gov . Please note: EIDM is the same as the CMS Enterprise Portal.

FAQ ID:92811

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What is the difference between EIDM and MACPro?

Enterprise Identity Management (EIDM) is an identity management and services system that provides users with access to Centers for Medicare and Medicaid Services (CMS) applications. EIDM is located at https://portal.cms.gov/.

The Medicaid and CHIP Program (MACPro) system is a web-based tool for the submission, review, disposition, and management support of Medicaid and CHIP initiatives, including Quality Measures Reporting, State Plan Amendments (SPA), Waivers, Demonstrations, and Advance Planning Documents. MACPro is located at https://macpro.cms.gov.

FAQ ID:92816

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What should I do if I am experiencing connectivity issues, freezing, or slowness within MACPro?

Please provide the following information to the Help Desk:

  • Who is your Internet Service Provider (ISP) and IP address?
  • What is your location?
  • What component were you using (Quality Measures, Health Homes SPA, etc.)?
  • What is the exact time the problem occurred?
  • What exactly happened?
  • What screen were you on?
  • If an error message displayed, please provide a screenshot.
  • Did the problem resolve itself? Was a page refresh or application reboot required?

FAQ ID:92821

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What does a CMS EIDM Approver need to do if the user requesting access to MACPro is not on a list of users who should have access?

The CMS EIDM Approver would need to contact the Business Owner Point of Contact (POC) for the Medicaid and CHIP Programs that are in MACPro to request verification of the user requesting access. The Business Owner POC may need to get in touch with the relevant Medicaid/CHIP State Agency directly to verify that the user requesting access is valid.

FAQ ID:92826

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How do I change my password? / How do I reset my password if I forgot it?

As MACPro and the Enterprise Identity Management Portal (EIDM) are integrated, your EIDM credentials are what you use to log into MACPro. To reset your password for MACPro, go to the link https://portal.cms.gov  and click the blue link that says "Forgot Password" under the blue log in button on the right side of the screen. You must answer your challenge questions to be able to reset your password. If you are not sure of your challenge questions, please contact the MACPro Help Desk at macpro_helpdesk@cms.hhs.gov.

FAQ ID:92831

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What are the Implementation Guides for?

Implementation guides are documents that provide specific information on how to complete and review a specific section of MACPro as a State or CMS User.

FAQ ID:92836

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I received an unexpected error message, what should I do?

Take a screenshot (Ctrl+PrtScn [PC]) of the message you see and send an email to the MACPro Help Desk atMACPro_HelpDesk@cms.hhs.gov. (MACPro underscore Help Desk). Two ways to avoid unexpected error messages are:

  1. Never use the browser back and forth arrows to navigate through MACPro; and
  2. Do not remain inactive on MACPro for more than sixty minutes.
  3. Always log out when exiting MACPro or EIDM.
  4. If you are clicking a bookmarked link to access either MACPro or EIDM, try manually typing the link or copying and pasting the link.
  5. Try refreshing your screen or clearing your cache. You can clear your cache in your browser's Options. (If you need guidance on clearing your cache, please contact the MACPro Help Desk at MACPro_HelpDesk@cms.hhs.gov.)

FAQ ID:92841

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What federal matching rate will apply for services for which a higher payment is made under CMS 2370-F if the services also qualify for a higher FMAP under the provisions of section 4106 of the Affordable Care Act?

In qualifying states, certain United States Preventive Services Task Force (USPSTF) grade A or B preventive services and vaccine administration codes are eligible for a one percent FMAP increase under section 4106 of the Affordable Care Act (which amended sections 1902(a)(13) and 1905(b) of the Act). Some of these services may also qualify as a primary care services eligible for an increase in the payment rates under section 1202 of the Affordable Care Act. For these services the federal matching rate is 100 percent for the difference between the Medicaid rate as of July 1, 2009 and the payment made pursuant to section 1202 (the increase). The federal matching payment for the portion of the rate related to the July 1, 2009 base payment would be the regular Federal Medical Assistance Percentage (FMAP) rate, except that this rate would be increased by one percent if the provisions of section 4106 of the Affordable Care Act are applicable.

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FAQ ID:91076

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When will states begin making higher payment for Evaluation and Management services reimbursed fee for service under CMS 2370-F?

Effective for dates of service on and after January 1, 2013 through December 31, 2014, states are required by law to reimburse qualified providers at the rate that would be paid for the service (if the service were covered) under Medicare. Most states and the District of Columbia will need to submit a Medicaid state plan amendment (SPA) to increase Medicaid rates up to this level. The Centers for Medicare & Medicaid Services (CMS) has issued a state plan amendment (SPA) preprint for the purpose of expediting review and approval of the primary care payment increase.

For dates of service starting January 1, 2013 qualified providers are entitled to receive the higher payment in accordance with the approved Medicaid state plan amendment. States may not have attestation procedures or higher fee schedule rates in place on January 1, 2013. In that event, providers will likely continue to be reimbursed the 2012 rates for a limited period of time. Once attestation procedures are in place and providers are identified as eligible for higher payment, the state will make one or more supplemental payments to ensure that providers receive payment for the difference between the amount paid and the Medicare rate. Qualified providers should receive the total due to them under the provision in a timely manner.

A state may draw federal financial participation for the higher payments only after the SPA methodology is approved.

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FAQ ID:91271

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Which Medicaid providers qualify for payment under CMS 2370-F? Can physicians qualify solely on the basis of meeting the 60 percent claims threshold, irrespective of specialty designation? Would Board certified "general surgeons" qualify for higher payment if they actually practice as general practitioners?

The statute specifies that higher payment applies to primary care services delivered by a physician with a specialty designation of family medicine, general internal medicine, or pediatric medicine. The regulation specifies that specialists and subspecialists within those designations as recognized by the American Board of Medical Specialties (ABMS) the American Osteopathic Association (AOA) or the American Board of Physician Specialties (ABPS) also qualify for the enhanced payment. Under the regulation, "general internal medicine" encompasses internal medicine and all subspecialties recognized by the ABMS, ABPS and AOA. In order to be eligible for higher payment:

  1. Physicians must first self-attest to a covered specialty or subspecialty designation.
  2. As part of that attestation they must specify that they either are Board certified in an eligible specialty or subspecialty and/or that 60 percent of their Medicaid claims for the prior year were for the Evaluation and Management (E&M) codes specified in the regulation. It is quite possible that physicians could qualify on the basis of both Board certification and claims history.

Only physicians who can legitimately self-attest to a specialty designation of (general) internal medicine, family medicine or pediatric medicine or a subspecialty within those specialties recognized by the American Board of Physician Specialties (ABPS), American Osteopathic Association (AOA) or American Board of Physician Specialties (ABPS) qualify.

It is possible that a physician might maintain a particular qualifying Board certification but might actually practice in a different field. A physician who maintains one of the eligible certificates, but actually practices in a non-eligible specialty should not self-attest to eligibility for higher payment. Similarly, a physician Board certified in a non-eligible specialty (for example, surgery or dermatology) who practices within the community as, for example, a family practitioner could self-attest to a specialty designation of family medicine, internal medicine or pediatric medicine and a supporting 60 percent claims history. In either case, should the validity of that physician's self-attestation be reviewed by the state as part of the annual statistical sample, the physician's payments would be at risk if the agency finds that the attestation was not accurate.

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FAQ ID:91276

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