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
Can a state type information and data into unlocked fields in the Upper Payment Limit (UPL) templates or must the data from state-developed UPL reports/workbooks be mapped through, for example, V-Look-ups into the UPL templates?
Yes. Mapping data, through V-Look-ups, for example, is a much easier and consistent process for current and future UPL submissions. However, a state may choose to type information and data into unlocked fields in the UPL templates. When a state chooses to input data directly (not through a V-Look-up) into the template, it still must provide the supporting documentation with the source data. Additionally, the state should explain how it mapped data from the supporting documentation into the template. The Centers for Medicare & Medicaid Services utilizes the supporting information to confirm that the information in the templates is correct.
FAQ ID:92451
SHARE URLHow does this durable medical equipment (DME) limit on federal financial participation (FFP) affect those states that are 90% managed care?
As we explained in the January 4, 2018 letter, only those items provided in the Medicaid program on a fee-for-service (FFS) basis are to be included in the aggregate expenditure calculation. DME reimbursed under a Medicaid managed care arrangement or a Medicaid competitive bidding contract are not subject to the FFP limitation. If a state is 90% managed care the state would only have to show compliance or a demonstration with the 10% of FFS utilization and expenditures for the relevant DME items.
FAQ ID:93531
SHARE URLDo the managed care organizations (MCOs), who are contracted to provide services to our Medicaid clients, have to comply with the durable medical equipment (DME) limit on federal financial participation (FFP)?
So long as the MCOs are not paid on a fee-for-service (FFS) basis, MCOs are not covered under this statute or subject to the limit on FFP. Only the relevant DME items provided in FFS are included in this limit.
FAQ ID:93536
SHARE URLAre states that provide durable medical equipment (DME) through a managed care arrangement required to submit the reconciliation data?
Only those items provided in the Medicaid program on a fee-for-service basis are to be included in the aggregate expenditure calculation. DME reimbursed under a Medicaid managed care arrangement or a Medicaid competitive bidding contract are not subject to the federal financial participation limitation.
FAQ ID:93541
SHARE URLCenters for Medicare & Medicaid Services is saying this durable medical equipment (DME) limit on federal financial participation is applicable only to fee for service (FFS). How about the Home and Community-Based Services (HCBS) waiver programs?
If the HCBS waiver includes FFS payments for DME, the state’s expenditures for DME would be subject to the limit.
FAQ ID:93546
SHARE URLCan a state use an Upper Payment Limit (UPL) demonstration that was submitted within the fiscal year for purposes of demonstrating that a State Plan Amendment (SPA) change complies with the regulations in order to meet the State Medicaid Director Letter (SMDL) requirements?
Yes, a demonstration submitted within the fiscal year that is used to document that SPA methodology changes comply with the UPL requirements may be used to satisfy the SMDL requirements as long as no subsequent changes are made to the state's provider payment methodology prior to the state's annual submission and CMS has reviewed and accepted the demonstration.
FAQ ID:92216
SHARE URLAre there any circumstances that would allow a state to apply the same Upper Payment Limit (UPL) demonstration to multiple years?
When the data that factors into the state's UPL demonstration has not changed from one year to the next, then the state could apply the same overall UPL demonstration to the following year. The state must submit a justification to support the application of a previous year's UPL demonstration to another year.
FAQ ID:92221
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
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