Medicaid Rate Calculation. The Medicaid financing strategy used by the MDHHS, as stated in the 1115 Waiver, is to contain the growth of Medicaid expenditures, not to create savings. The Medicaid Rate Calculation is based on the actuarial documentation letter from Milliman USA. Five sets of rate calculations are required: 1) one set of factors for the 1115 state plan and 1915(i) [formerly (b)(3)] services; 2) one set of factors for 1915 (c) Habilitation Supports Waiver services; 3) one set of factors for 1915 (c) Children’s Waiver Program services; 4) one set of factors for 1915 (c) Waiver for Children with Serious Emotional Disturbances; 5) one set of factors for the 1115 Healthy Michigan Plan. The Milliman USA letter documents the calculation rate methodology and provides the required certification regarding actuarial soundness as required by the Balanced Budget Act Rules effective
Medicaid Rate Calculation. The Medicaid financing strategy used by the MDCH, and stated in the 1915(b) Waiver, is to contain the growth of Medicaid expenditures, not to create savings. The Medicaid Rate Calculation is based on the actuarial documentation letter from Milliman USA. Two sets of rate calculations are required: 1) one set of factors for the 1915(b) state plan and 1915(b)(3) services and 2) one set of factors for 1915 (c) Habilitation Supports Waiver services. The capitation rates for FY 2011 are based on recipients with scope/coverage codes 1D/2D/1F/2F/1K/2K/1P/1T/2T, The Milliman USA letter documents the calculation rate methodology and provides the required certification regarding actuarial soundness as required by the Balanced Budget Act Rules effective August 13, 2002. The chart of rates and factors contained in the actuarial documentation is included as Attachment P.7.0.1. Several groups of Medicaid eligibles are excluded from the capitation methodology/payments. The groups are identified in sections 7.4.1.3 and
Medicaid Rate Calculation. The Medicaid financing strategy used by the MDCH, and stated in the 1915(b) Waiver, is to contain the growth of Medicaid expenditures, not to create savings. The Medicaid Rate Calculation is based on the actuarial documentation letter from Milliman USA. Two sets of rate calculations are required: 1) one set of factors for the 1915(b) state plan and 1915(b)(3) services and 2) one set of factors for 1915 (c) Habilitation Supports Waiver services. The capitation rates for FY 2014 are based on recipients with scope/coverage codes 1D/2D/1F/2F/1K/2K/1P/1T/2T, The Milliman USA letter documents the calculation rate methodology and provides the required certification regarding actuarial soundness as required by the Balanced Budget Act Rules effective August 13, 2002. The chart of rates and factors contained in the actuarial documentation is included as Attachment P.7.0.1.
Medicaid Rate Calculation. The Medicaid financing strategy used by the MDCH, and stated in the 1915(b) Waiver, is to contain the growth of Medicaid expenditures, not to create savings The Medicaid Rate Calculation is based on the actuarial documentation letter from Milliman USA. Two sets of rate calculations are required: 1) one set of factors for the 1915(b) state plan and 1915(b)(3) services and 2) one set of factors for 1915 (c) Habilitation Supports Waiver services. The capitation rates for FY 2010 are based on recipients with scope/coverage codes 1D/2D/1F/2F/1K/2K/1P/1T/2T, The Milliman USA letter documents the calculation rate methodology and provides the required certification regarding actuarial soundness as required by the Balanced Budget Act Rules effective August 13, 2002. The chart of rates and factors contained in the actuarial documentation is included as Attachment P.7.0.1. Two groups of Medicaid eligibles are excluded from the capitation methodology/payments. These are the eligibles enrolled in the Children’s waiver (approximately 400 persons) and people residing in a state center for developmental disabilities who remain in ICF-MR Medicaid funding. In addition, the rate calculations and payments excluded eligibility months associated with periods of retro-eligibility including persons who are on a monthly spend-down. While these eligible months are excluded the rates calculation included FY 98 retro costs. The PIHP is responsible for service to these individuals and may use their Medicaid funding for such services, except for that period of time each month prior to when the individual is spent-down.
