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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 31 to 40 of 41 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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Regulations at 42 CFR 438.104(b) (1) (IV) prohibit Medicaid managed care plans from seeking to influence enrollment in their plan in conjunction with the sale or offering of "private insurance." Does this prohibit a carrier that offers both a qualified health plan (QHP) and a Medicaid managed care plan from marketing both products?

The regulation only prohibits insurance policies that would be sold ""in conjunction with"" enrollment in the Medicaid managed care plan. Section 438.104 alone does not prohibit a Medicaid managed care plan from providing information about a Qualified Health Plans (QHP) to potential enrollees who could enroll in such a plan as an alternative to the Medicaid managed care plan due to a loss of Medicaid eligibility or to potential enrollees who may consider the benefits of selecting an Medicaid managed care plan that has a related QHP in the event of future eligibility changes. However, Medicaid managed care plans should consult their contracts and the State Medicaid agency to ascertain if other provisions exist that may prohibit or limit such activity.

Section 438.104(b)(1)(iv) implements a provision in section 1932(d)(2)(C) of the Social Security Act, titled ""Prohibition of Tie-Ins."" In promulgating regulations implementing this provision, CMS clarified that we interpreted it to preclude tying enrollment in the Medicaid managed care plan with purchasing (or the provision of) other types of private insurance. We do not intend the statutory prohibition of tie-ins to apply to a discussion of a possible alternative to the Medicaid managed care plan, which a QHP could be if the consumer is determined to be not Medicaid eligible or loses Medicaid eligibility.

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FAQ ID:94351

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Do the terms of the contract between the State Medicaid agency and a Medicaid managed care plan apply to that organization's qualified health plan (QHP)?

States are encouraged to review their managed care contracts to clearly identify the legal entity with which they are contracted for Medicaid coverage since federal Medicaid managed care regulations do not address this aspect of contracting. If the party to the contract is an entity (such as a parent company) that has a contract with a state Medicaid agency to provide benefits as a Medicaid managed care plan and is also a QHP issuer, then some contractual provisions may apply to both. Although the federal Medicaid regulations do not apply to a QHP issuer or QHP, state law, regulation, or contract language may have implications for the QHP issuer. If changes are needed to narrow the scope of the contract to apply only to the Medicaid managed care plan, we encourage states to make those changes so as to ensure consistent understanding and application of the Medicaid contract terms.

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FAQ ID:94371

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If an individual who may already be enrolled in a Medicaid managed care plan, or is eligible to enroll in a Medicaid managed care plan, calls the plan's customer service unit with questions about that plan's Medicaid MCO and/or QHP products, can the Medicaid managed care plan answer consumer questions without violating the Medicaid marketing rules at 42 CFR 438.104?

Yes. Responding to direct questions from consumers is not generally a violation of 42 CFR 438.104. Proactive consumer inquiries to a health plan for information about coverage options, benefits, or provider networks is no different than a consumer obtaining information from the health plan's website. So long as the limits on marketing are satisfied and respected (e.g., the information is accurate and does not mislead, confuse or defraud beneficiaries or the state Medicaid agency), responding to direct questions from potential enrollees with accurate information is not prohibited.

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FAQ ID:94391

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