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.
Frequently Asked Questions
Our state uses multiple cost centers (routine and ancillary) in the calculation of our inpatient hospital Upper Payment Limit (UPL). Do the templates permit the use of multiple cost centers?
Yes, the templates allow the use of multiple cost centers. For example, if the state uses a cost methodology for ancillary services and a per-diem methodology for routine services, the state will complete one cost template and one per-diem template in order to account for these two cost centers. Every hospital would be featured in each of the two templates; however, to differentiate their provider information, the state would append the Medicare Certification Number (Medicare ID) (variable 112) with a letter, such as an -A or a -B. For example, if the Medicare ID was 123456, it would be depicted in the cost template as 123456-A and in the per diem template as 123456-B. If a Medicare Certification Number is not available then the state should append the Medicaid Provider Number. If there are multiple cost centers under either the cost or per-diem methodology, the state would separate out the cost centers within their respective templates. Each cost center should be associated with only one appended letter and these should be described in the notes tab. When using multiple cost centers, the state should insert a new tab in the templates that summarizes the UPL gap calculations for each of the ownership categories (state government owned, non-state government owned, and private), unless a summary worksheet is already included in the workbook.
FAQ ID:92261
SHARE URLOur state uses multiple cost centers with varying cost-to-charge ratios in our calculation of the inpatient hospital Upper Payment Limit (UPL). Does the template accommodate this?
Yes, the template allows the use of multiple cost centers with multiple cost-to-charge ratios. The state would separately report the costs and payments associated with each of the cost centers in the cost template. To differentiate the cost centers, the state would append the Medicare Certification Number (Medicare ID) (variable 112) with a letter, for example an -A, -B, or -C, that would be used as a unique identifier for each cost center.
FAQ ID:92266
SHARE URLThe Inpatient Hospital Services (IPH), Outpatient Hospital Services (OPH), and Nursing Facility (NF) templates do not include fields to sum the Upper Payment Limit (UPL) gap by ownership category (private, Non-State Governmental Organization (NSGO), State Government Ownded (SGO). How should these totals be presented in the template?
The total UPL gap by ownership category can be shown by inserting a new tab in the file with these calculations, unless a summary worksheet is already included in the workbook. If there are any questions about how to add this tab, please reach out to your CMS Regional Office or send a follow-up question (with your template) to the UPL mailbox and additional guidance will be provided.
FAQ ID:92281
SHARE URLHow do I withdraw a submission package?
A State may withdraw a submission package once it has been submitted to CMS. Withdrawing a submission package takes it out of contention and the submission package cannot be edited or resubmitted. Log in as State Point of Contact, and select the "Records" tab. Then select "Submission Packages" for your State. Next, select the link to the submission package you wish to withdraw. In the left panel, select "Related Actions". Next, select "Withdraw Submission Package". Then select the green button labeled "Withdraw Submission Package". A box will pop up, select "Yes". Once the submission package is withdrawn, you will be redirected to the Records screen. A yellow notification will appear briefly at the top of the page indicating "Action Completed Successfully".
FAQ ID:92891
SHARE URLHow do I allow CMS to view my submission package prior to submitting?
After the State Editor has forwarded the submission package to the State Point of Contact for Reviewing, the State Point of contact should log into MACPro. Then go to the "Records" tab and select "Submission Packages" for your state. Select the submission package you wish for CMS to view. In the left panel, select "Related Actions". Next, select "Allow CMS to View Screen". On the Allow CMS to View Screen page, select "Yes" under Visibility Setting, and then select the green "Update Visibility" button in the bottom right corner.
Note: Selecting this option will permit the CMS review team to see the screens in this submission package as they are now. It does not cause the package to be submitted as Draft or Official, and does not start a CMS review clock. Validation of the screens is not required. Notify your CMS contact that viewing is available and who you wish to see it; MACPro does not notify CMS staff. You can deselect this option at any time.
FAQ ID:92896
SHARE URLWhat functions can my role perform?
Refer to the table below.
| Role | Actions |
| State Editor (SE) |
|
| State Point of Contact (SPOC) |
|
| State Director (State Director) |
|
| State System Administrator (SSA) |
|
FAQ ID:92901
SHARE URLHow do I assign a SPA ID?
The SPA ID is assigned by the State Editor and entered in a field in Official Submission packages. The SPA ID (SS-YY-NNNN-xxxx) is assigned by the State in Official Submission Packages and consists of the State abbreviation (SS), they year (YY), a four character sequence number (NNNN), and an optional four character alpha and numeric (xxxx).
FAQ ID:92906
SHARE URLHow do I access previous submission packages for my state?
Select the "Records" tab in the upper tool bar. Select "Submission Packages" for your state and then search for the package you would like to view.
FAQ ID:92911
SHARE URLWhat is the difference between a Draft Submission Package and Official Submission Package?
|
Official Submission Package CMS suggests initially submitting simple program amendments or new programs that are similar to existing programs as official submission packages. |
Draft Submission Package CMS suggests submitting complex programs or new Health Home models and new targeted amendments as draft submission packages. |
| Official submissions start the 90 day policy clock upon submission to CMS for review and disposition. |
Drafts submitted to CMS do not start the 90 Day Policy Clock. |
| CMS may review and view package. | States may allow CMS to view the submission package informally prior to official submission. |
| CMS may approve, disapprove, request additional information (RAI), or submit a clarification for the official submission package. | CMS may review, but cannot approve, disapprove, implement an RAI, or request clarification for the draft submission package. |
| The State may allow CMS to view the submission package informally prior to official submission. | When CMS returns the package to the State they may provide feedback in the correspondence log or offline. |
| If the state chooses not to edit the returned draft package, it may be closed and converted to an official package for submission to CMS starting the 90 Day Policy Clock. | |
| If the state chooses to edit the returned submission package, the state must re-submit the draft to CMS as a draft submission package for re-review prior to closing the draft submission and converting to an official submission package. | |
| Closed draft submissions cannot be edited. | |
| Official submissions that were converted from drafts cannot be edited with the exception of the SPA ID and proposed effective date prior to submissions to CMS. |
FAQ ID:92916
SHARE URLWhat is the difference between the SPA ID and Package ID?
The package ID is an auto-generated ID consists of the two letter state abbreviation, the year, the authority in this case MH for Medicaid Health Homes, an automatic number assignment, and the letter O for official or D for draft. The package ID is used to track this submission package. The SPA ID (SS-YY-NNNN-xxxx) is assigned by the State in Official Submission Packages and consists of the State abbreviation (SS), they year (YY), a four-character sequence number (NNNN), and four-character optional alpha and numeric (xxxx).
FAQ ID:92921
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