Frequently Asked Questions

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

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

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

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

Generally, the purpose of the 1202 payment increase is to directly benefit physicians performing primary care services. In the instance of salaried physicians, including those working for clinics or other employing organizations that bill on the Medicaid physician fee schedule, this could come in the form of an increased salary. Alternatively, where there is an employment agreement between the physician and the employing entity, the employment agreement might account for the payment increase by noting that the physician accepts his or her salary as payment in full, regardless of Medicaid reimbursement levels.

FAQ ID:91081

To the extent that physicians are already receiving payment for Medicaid services that is at least equal to the Medicare rate as required under section 1202 of the ACA, no additional payment under section 1202 should be made to either a managed care health plan or to a group practice or similar organization that employs physicians. The additional payment is to ensure that payment to the physician is at least equal to the 1202 Medicare rate.

FAQ ID:91086

States that pay for vaccine administration using the vaccine product codes were required to include a crosswalk to their administration codes as part of their ACA 1202 state plan amendment (SPA). They will therefore be required to submit a new SPA to reflect any changes in those codes. If a state does not use vaccine product codes to pay for vaccine administration and therefore there is no crosswalk in their 1202 SPA, then no updates are necessary to reflect the code changes.

FAQ ID:91091

Yes. The original SPAs contained a list of codes that had been added since 2009 that the state was planning on reimbursing at the higher ACA 1202 rate. Therefore, if a state adds codes, it should submit a revised SPA page, updating that list of codes eligible for higher payment.

FAQ ID:91096

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.

Supplemental Links:

• This FAQ was released as part of a larger set. View the full set.

FAQ ID:91076

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.

Supplemental Links:

• This FAQ was released as part of a larger set. View the full set.

FAQ ID:91271