Common use of Certification of Public Expenditures Clause in Contracts

Certification of Public Expenditures. The State must certify that the following conditions for non-Federal share of Demonstration expenditures are met: a) Units of government, including governmentally operated health care providers, may certify that State or local tax dollars have been expended as the non-Federal share of funds under the Demonstration. b) To the extent the State utilizes certified public expenditures (CPEs) as the funding mechanism for title XIX (or under section 1115 authority) payments, CMS must approve a cost reimbursement methodology. This methodology must include a detailed explanation of the process by which the State would identify those costs eligible under title XIX (or under section 1115 authority) for purposes of certifying public expenditures. i. To the extent that Arizona institutes the use of CPEs, the requirements of this term and condition fully apply. The State is subject to any policy guidance or regulation released by CMS regarding the use of CPEs. ii. The disproportionate share hospital (DSH) payment methodology for Arizona State Hospital (ASH) and the Maricopa Medical Center will be cost reimbursement and will utilize CPEs as the funding system. The methodology and the cost identification/reconciliation process, as approved by CMS, is included as an amendment to the DSH methodology in Attachment D. c) To the extent the State utilizes CPEs as the funding mechanism to claim Federal match for payments under the Demonstration to non-governmental providers, the governmental entity appropriating funds to the provider must certify to the State the amount of such tax revenue (State or local) appropriated to the non-governmental provider used to satisfy demonstration expenditures. The non-governmental provider that incurred the cost must also provide cost documentation to support the State’s claim for Federal match. d) The State may use intergovernmental transfers to the extent that such funds are derived from State or local tax revenues and are transferred by units of government within the State. Any transfers from governmentally operated health care providers must be made in an amount not to exceed the non-Federal share of title XIX payments. Under all circumstances, health care providers must retain 100 percent of the claimed expenditure. Moreover, no pre-arranged agreements (contractual or otherwise) exist between health care providers and State and/or local government to return and/or redirect any portion of the Medicaid payments. This confirmation of Medicaid payment retention is made with the understanding that payments that are the normal operating expenses of conducting business, such as payments related to taxes, (including health care provider-related taxes), fees, business relationships with governments that are unrelated to Medicaid and in which there is no connection to Medicaid payments, are not considered returning and/or redirecting a Medicaid payment.

Certification of Public Expenditures. The State state must certify that the following conditions for non-Federal share of Demonstration demonstration expenditures are met: a) Units of government, including governmentally operated health care providers, may certify that State state or local tax dollars have been expended as the non-Federal share of funds under the Demonstrationdemonstration. b) To the extent the State state utilizes certified public expenditures (CPEs) as the funding mechanism for title XIX (or under section 1115 authority) payments, CMS must approve a cost reimbursement methodology. This methodology must include a detailed explanation of the process by which the State state would identify those costs eligible under title XIX (or under section 1115 authority) for purposes of certifying public expenditures. i. To the extent that Arizona institutes the use of CPEs, the requirements of this term and condition fully apply. The State state is subject to any policy guidance or regulation released by CMS regarding the use of CPEs. ii. The disproportionate share hospital (DSH) payment methodology for Arizona State Hospital (ASH) and the Maricopa Medical Center will be cost reimbursement and will utilize CPEs as the funding system. The methodology and the cost identification/reconciliation process, as approved by CMS, is are included as an amendment to the DSH methodology in Attachment D.C. c) To the extent the State state utilizes CPEs as the funding mechanism to claim Federal match for payments under the Demonstration demonstration to non-governmental providers, the governmental entity appropriating funds to the provider must certify to the State state the amount of such tax revenue (State state or local) appropriated to the non-governmental provider used to satisfy demonstration expenditures. The non-governmental provider that incurred the cost must also provide cost documentation to support the Statestate’s claim for Federal match. d) The State state may use intergovernmental transfers to the extent that such funds are derived from State state or local tax revenues and are transferred by units of government within the Statestate. Any transfers from governmentally operated health care providers must be made in an amount not to exceed the non-Federal share of title XIX payments. Under all circumstances, health care providers must retain 100 percent of the claimed expenditure. Moreover, no pre-arranged agreements (contractual or otherwise) exist between health care providers and State state and/or local government to return and/or redirect any portion of the Medicaid payments. This confirmation of Medicaid payment retention is made with the understanding that payments that are the normal operating expenses of conducting business, such as payments related to taxes, (including health care provider-related taxes), fees, business relationships with governments that are unrelated to Medicaid and in which there is no connection to Medicaid payments, are not considered returning and/or redirecting a Medicaid payment.