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
Will states need to modify already approved contracts to add the final capitation rates to the contract to comply with section 438.3(c), which requires that the payment term be included in the contract?
Yes. We remind states that the requirement that the final capitation rate be specified in the contract is not a new requirement, see section 438.6(c)(2)(ii) of the 2002 final rule. The amount of payment for performance-in this context, the final capitation rate-is a primary component of any contract and must be included for purposes of verifying claims for Federal Financial Participation (FFP) on the CMS-64. In the Final Rule at page 27595, in the context of risk adjustment, CMS suggested that the payment terms under the contract could be identified in an appendix, or additional supporting documentation, to the contract for ease of updating the information when risk adjustment is applied. The state must submit a formal contract amendment when the final capitation rates differ from the payment terms in an approved contract.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 185.26 KB)
FAQ ID:93171
SHARE URLWhere can I find general information on the change in matching rates for External Quality Review (EQR)?
CMS released an Informational Bulletin (CIB) discussing the change in federal financial participation (FFP) for EQR that was effective May 6, 2016. The CIB includes revised claiming instructions for the CMS-64 and a sample form. It is available at Medicaid.gov on the EQR webpage, under Technical Assistance Documents, and available at https://www.medicaid.gov/federal-policy-guidance/downloads/cib061016.pdf (PDF, 279.08 KB).
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 185.26 KB)
FAQ ID:93471
SHARE URLCan CMS please clarify if only audited financial statements that are done on a formal Generally Accepted Accounting Principles (GAAP) basis can be used to meet the requirements in section 438.3(m)? Audits can also be done following statutory accounting principles or government auditing standards and it is not clear if states and managed care plans have flexibility in which standard to apply.
The regulation at section 438.3(m) has a general reference to "generally accepted accounting principles" and "generally accepted auditing principles." This means that states have the flexibility to specify the applicable generally accepted accounting and auditing principles for the audited financial reports in the managed care plan contracts. The federal regulation does not endorse a particular standard.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 185.26 KB)
FAQ ID:93466
SHARE URLMy state is planning for our upcoming EQRO contracting. When does CMS plan to publish a protocol for the new activity relating to the validation of network adequacy?
CMS expects to first issue revised protocols for the current mandatory and optional EQR-related activities in the Fall of 2017. We expect to issue the protocol for the new mandatory EQR activity relating to the validation of network adequacy later in 2017 or early 2018. States will have up to one year from the publication of the protocol to implement the new mandatory EQR activity.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 185.26 KB)
FAQ ID:94656
SHARE URLIf I have additional questions about EQR and claiming for EQR, who can I ask?
For questions related to state expenditure reporting and claiming instructions for EQR activities, please contact your CMS regional office financial representative. For specific external quality review questions, including what activities qualify for enhanced match, please contact the Division of Quality and Health Outcomes at ManagedCareQualityTA@cms.hhs.gov.
Supplemental Links:
- This FAQ was released as part of a larger set. View the full set. (PDF, 185.26 KB)
FAQ ID:94666
SHARE URLWhat browsers are compatible with MACPro?
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. |
FAQ ID:92846
SHARE URLIs there spell check in MACPro?
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".
FAQ ID:92851
SHARE URLWho should be contacted with questions?
If there are questions or problems related to the system/website, please contact the MACPro Help Desk staff via email to MACPro_HelpDesk@cms.hhs.gov. If there are questions regarding the quality measure content or reporting please contact MAC Quality TA via the contact link at the bottom of the screen or by email to MACQualityTA@cms.hhs.gov.
FAQ ID:92726
SHARE URLHow do I add new users to the system?
User Management is a feature in MACPro that works in conjunction with the CMS EIDM user identification and authentication system. To request access to the MACPro application, a user must first go to the Enterprise Identity Management Portal (EIDM: https://portal.cms.gov ) and create an EIDM ID. Once an ID is created, the user must request access to the MACPro application by way of an EIDM role. Once their EIDM role request is approved, they may access MACPro via the link https://macpro.cms.gov and enter their newly created EIDM credentials to log in. Once in MACPro, the user must request their MACPro roles and attributes via My User Profile under the Records tab. MACPro user role requests are approved by the State System Administrator, CMS System Administrator, or CMS Role Approver. Further detailed instructions can be found in the reference documents posted to Medicaid.gov (https://www.medicaid.gov/state-resource-center/medicaid-and-chip-program-portal/medicaid-and-chip-program-portal.html).
FAQ ID:92731
SHARE URLDo I have to log out of the system when I am finished working in the application and want to exit the system?
Yes, before logging out, save any information you have entered. Select the Logout link when you're finished with the application site and then close your browser. By doing so, you prevent others from potentially gaining access to your application in your absence.
FAQ ID:92736
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