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
States are required to implement the limits set by the ACA FULs in their reimbursement methodologies as of the effective date of the final rule with comment, that is, April 1, 2016. The FULs are to be applied as an aggregate upper limit, so the states have flexibility to determine payment rates for individual drugs in accordance with the approved State plan, such that the total reimbursement for all drugs to which the FUL applies does not exceed the FUL in the aggregate. Many states have FULs as part of their ""lower of"" logic in their state plans already. While we recognize that many states will be using NADAC or their own AAC methodology, and many of these values will be below the FULs, we still ask that states include in their state plans, either as a part of their lower of methodology or in a separate entry or description in the state plan, how they intend to meet the FULs in the aggregate.
CMS will not publish a FUL price for a FUL product group where the agency does not have a corresponding NADAC to compare to the 175 percent of the weighted average of AMPs for the FUL product group. For further information please see the Methodology and Data Elements Guide on the Medicaid.gov website at on the Medicaid.gov website at https://www.medicaid.gov/Medicaid-CHIP-Program-Information/ByTopics/Benefits/Prescription-Drugs/Federal-Upper-Limits.html.
Supplemental Links:
States are required to apply the ACA FULs, in the aggregate, as of the effective date of the final rule with comment, that is, April 1, 2016. A SPA is not required to begin applying the ACA FULs in the aggregate.
Supplemental Links:
Contact your state Medicaid agency. They can help you get replacement cards and answer your questions about what services are covered, providers to use, and how to renew your eligibility.
| Browser | Comments |
| Microsoft Internet Explorer 11, 10, 9, and 8 |
Microsoft Internet Explorer 10, 9, and 8 are depreciated and will not be supported in a future release of MACPro. Microsoft Internet Explorer 11 is supported on Windows 8.x tablet. |
| Mozilla Firefox | Mozilla Firefox updates automatically. MACPro supports the most recent stable version of Mozilla Firefox. |
| Google Chrome | Google Chrome updates automatically. MACPro supports the most recent stable version of Google Chrome. |
| Apple Safari | Apple Safari is only supported on Mac operating systems. |
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.
- Under "Settings," choose the "Programs" tab and then select "Manage add-ons."
- 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.
- Select "Enable spelling correction".
Under the "Records" tab, select "Medicaid State Plan". Next, search for a state using the search feature in the left panel. Select the blue link for your State Plan. On the next screen you will be able to see past, current and future Health Homes Programs.
| Primary Role | Definition |
| CMS Package Disapprover (PD) |
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| Office of Strategic Operations & Regulatory Affairs (OSORA) |
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| CMS Senior Management (SrMGR) |
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| CMS Package Approver (PA) |
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| CMS Point of Contact Administrator (POC Admin) |
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| Subject Matter Expert (SME) |
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| Submission Review Team (SRT) |
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| CMS Point of Contact (CPOC) |
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| Report Administrator (RA) |
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| Subscriber (SUB) |
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The State has the option to allow CMS to view the information in a submission package prior to submission informally by using the "Allow CMS to View" functionality. The CMS Point of Contact, Submission Review Team, and Subject Matter Expert have the ability to view these submission packages once the state has initiated the function. Please Note: This option will permit the CMS review team to see the screens in this submission package as they appear currently. 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. States must notify their CMS contact that viewing is available; MACPro does not notify CMS staff. States can deselect this option at any time
To access the submission package, go to the "Records" tab and then select "Submission Packages". Next select the link to the submission package and then in the left panel, select "Reviewable Units". You may then select the blue links to each Reviewable Unit to view the data entered by the state.
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Report Name |
Description |
Available For |
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Clock Status Report |
View the regulatory clock statuses |
CPOC, CMS Disapproval Coordinator, SRT Admin CMS Report Admin, |
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State Agency Profile Report |
Overview of a State's Medicaid Plan including the prior 12 months' submission package history |
CPOC, CMS Disapproval Coordinator, SRT Admin, CMS Report Admin, CSA, SRT |
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Submission Detail Report |
View details on packages by date |
CPOC, CMS Disapproval Coordinator, SRT Admin, CMS Report Admin, SME, PA, PD,SRRVW, SRT |
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Submission Statistics Detail Report |
View all Submission Packages currently in review |
CPOC, CMS Disapproval Coordinator, SRT Admin, CMS Report Admin, SME, PA, PD, SRRVW, SRT |
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Submission Statistics Summary Report |
View summary of Submission Packages in a specific review status within a specified date range. |
CPOC, CMS Disapproval Coordinator, SRT Admin, CMS Report Admin, SME, PA, PD,SRRVW, SRT |
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Submission Summary Report |
Overview of submitted packages by date |
CPOC, CMS Disapproval Coordinator, SRT Admin, CMS Report Admin, SME, PA, PD,SRRVW, SRT |
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Staff Workload Report |
View the number of Submission Packages assigned to each CPOC and SRT member, as of the report run date. |
CMS Disapproval Coordinator, SRT Admin, CMS Report Admin, CSA |