Common use of Reporting Expenditures Under the Demonstration Clause in Contracts

Reporting Expenditures Under the Demonstration. In order to track expenditures under this demonstration, Rhode Island must report demonstration expenditures through the Medicaid and state Children's Health Insurance Program Budget and Expenditure System (MBES/CBES), following routine CMS-64 reporting instructions outlined in Section 2500 and Section 2115 of the state Medicaid Manual. All demonstration expenditures claimed under the authority of title XIX of the Act must be reported each quarter on separate Forms CMS-64.9 Waiver and/or 64.9P Waiver, identified by the demonstration project number assigned by CMS (including the project number extension, which indicates the demonstration year in which services were rendered or for which capitation payments were made). Expenditures for optional targeted low income children (CHIP Children) claimed under the authority of title XXI shall be reported each quarter on forms CMS-64.21U Waiver and/or CMS 64.21UP Waiver. a. For the extended family planning component of the demonstration, the state should report demonstration expenditures on Forms CMS-64.9 Waiver and/or 64.9P Waiver as follows: i. Allowable family planning expenditures eligible for reimbursement at the State’s Federal medical assistance percentage rate (FMAP) should be entered in Column (B) on the appropriate waiver sheets. ii. Allowable family planning expenditures eligible for reimbursement at the enhanced family planning match rate should be entered in Column (D) on the appropriate waiver sheets. b. Premiums and other applicable cost sharing contributions from enrollees that are collected by the state under the demonstration must be reported to CMS each quarter on Form CMS-64 Summary Sheet line 9.D, columns (A) and (B). Additionally, the total amounts that are attributable to the demonstration must be separately reported on the CMS-64 Narrative by demonstration year. c. For each demonstration year, twenty eight (28) separate Forms CMS-64.9 Waiver and/or 64.9P Waiver must be completed to report expenditures for the following demonstration populations and demonstration services. The waiver names to be used to identify these separate Forms CMS-64.9 Waiver and/or 64.9P Waiver appear in the second column of the tables below, labeled “CMS-64 Eligibility Group Reporting.” Expenditures should be allocated to these forms based on the guidance found below.

Reporting Expenditures Under the Demonstration. CMS-64. The following describes the reporting of expenditures subject to the budget neutrality expenditure limit: a) Tracking Expenditures. In order to track expenditures under this demonstration, Rhode Island Minnesota must report demonstration expenditures through the Medicaid and state State Children's ’s Health Insurance Program Budget and Expenditure System (MBES/CBES), following routine CMS-64 reporting instructions outlined in Section 2500 and Section 2115 of the state State Medicaid ManualManual (SMM). All demonstration Demonstration expenditures claimed under subject to the authority of title XIX of the Act must budget neutrality expenditure limit will be reported each quarter on separate Forms CMS-64.9 Waiver and/or 64.9P Waiver, identified by the demonstration project number assigned by CMS (including the project number extension, which indicates the demonstration year DY in which services were rendered or for which capitation payments were made). Expenditures DY 1 is defined as the year beginning July 1, 1995, and ending June 30, 1996, and DY 2 and subsequent DYs are defined accordingly. All other Medical Assistance payments that are not subject to the budget neutrality expenditure limit for optional targeted low income children (CHIP Children) claimed under the authority PMAP+, and are not part of any other title XXI shall XIX waiver program, should be reported each quarter on forms CMS-64.21U Waiver and/or CMS 64.21UP Waiver. a. For the extended family planning component of the demonstration, the state should report demonstration expenditures on Forms CMS-64.9 Waiver Base and/or 64.9P Waiver Base as follows:instructed in the SMM. i. Allowable family planning b) For monitoring purposes, cost settlements associated with expenditures eligible for reimbursement at subject to the State’s Federal medical assistance percentage rate (FMAP) should budget neutrality expenditure limit may be entered in Column (B) recorded on the appropriate waiver sheets. ii. Allowable family planning expenditures eligible prior period adjustment schedules (Form CMS-64.9P Waiver) for reimbursement at Summary Sheet Line 10B, in lieu of Lines 9 or 10C. For any other cost settlements not so associated, the enhanced family planning match rate should be entered in Column (D) on the appropriate waiver sheets. b. Premiums and other applicable cost sharing contributions from enrollees that are collected by the state under the demonstration adjustments must be reported to CMS each quarter on Form CMS-64 Summary Sheet line 9.Dlines 9 or 10C, columns (A) and (B). Additionally, as instructed in the total amounts that are attributable to the demonstration must be separately reported on the CMS-64 Narrative by demonstration yearSMM. c. c) For each demonstration yearDY, twenty eight (28) beginning in waiver year 8, separate Forms CMS-64.9 Waiver and/or 64.9P Waiver must be completed to report submitted reporting expenditures for the following demonstration populations and demonstration servicespopulations, by eligibility group. Payments made to provide health care services to the eligibility groups listed below are the expenditures subject to the budget neutrality expenditure limit. The State must complete separate pages for the following eligibility groups: i. Minnesota Care Children < 21 Years (waiver names to be used to identify these separate Forms CMS-64.9 Waiver and/or 64.9P Waiver appear in the second column of the tables below, labeled name: “CMS-64 Eligibility Group Reporting.” Expenditures should be allocated to these forms based on the guidance found below.MC Children<21”);

Reporting Expenditures Under the Demonstration. In order to track expenditures under this demonstration, Rhode Island Maryland must report demonstration expenditures through the Medicaid and state Children's Health Insurance Program CHIP Budget and Expenditure System (MBES/CBES), ; following routine CMS-64 reporting instructions outlined in Section section 2500 and Section section 2115 of the state Medicaid Manual. All demonstration expenditures claimed under the authority of title XIX of the Act must be reported each quarter on separate Forms CMS-64.9 Waiver and/or 64.9P CMS-64.9P Waiver, identified by the demonstration project number assigned by CMS (including the project number extension, which indicates the demonstration year in which services were rendered or for which capitation payments were made). Expenditures for optional targeted low income children (CHIP ChildrenMCHP and MCHP Premium children) claimed under the authority of title XXI shall must be reported each quarter on forms CMS-64.21U Waiver and/or CMS 64.21UP CMS-64.21UP Waiver. a. . For the extended family planning component of the demonstrationmonitoring purposes, the state should report demonstration expenditures on Forms CMS-64.9 Waiver and/or 64.9P Waiver as follows: i. Allowable family planning expenditures eligible for reimbursement at the State’s Federal medical assistance percentage rate (FMAP) should cost settlements must be entered in Column (B) recorded on the appropriate waiver sheets. ii. Allowable family planning expenditures eligible prior period adjustment schedules (Forms CMS-64.9 Waiver) for reimbursement at the enhanced family planning match rate Summary Line 10B, in lieu of Lines 9 or l0C. For any other cost settlements (i.e., those not attributable to this demonstration), the adjustments should be entered reported on lines 9 or 10C, as instructed in Column (D) on the appropriate waiver sheets. b. State Medicaid Manual. The 44. Premium and Cost Sharing Contributions. Premiums and other applicable cost sharing contributions from enrollees that are collected by the state State from enrollees under the demonstration must be reported to CMS each quarter on Form CMS-64 Summary Sheet line 9.D, columns (A) A and (B). Additionally, the total amounts B. In order to assure that these collections are attributable properly credited to the demonstration must demonstration, premium and cost-sharing collections (both total computable and federal share) should also be reported separately reported by DY on the Form CMS-64 Narrative by demonstration year. c. For each demonstration yearNarrative. In the calculation of expenditures subject to the budget neutrality expenditure limit, twenty eight (28) separate Forms CMS-64.9 Waiver and/or 64.9P Waiver must be completed premium collections applicable to report expenditures for the following demonstration populations and demonstration serviceswill be offset against expenditures. The waiver names These section 1115 premium collections will be included as a manual adjustment (decrease) to be used to identify these separate Forms CMS-64.9 Waiver and/or 64.9P Waiver appear in the second column of the tables below, labeled “CMS-64 Eligibility Group Reportingdemonstration’s actual expenditures on a quarterly basis.” Expenditures should be allocated to these forms based on the guidance found below.

Reporting Expenditures Under the Demonstration. In order to track expenditures under this demonstrationDemonstration, Rhode Island must report demonstration Demonstration expenditures through the Medicaid and state State Children's Health Insurance Program Budget and Expenditure System (MBES/CBES), following routine CMS-64 reporting instructions outlined in Section 2500 and Section 2115 of the state State Medicaid Manual. All demonstration Demonstration expenditures claimed under the authority of title XIX of the Act must be reported each quarter on separate Forms CMS-64.9 Waiver and/or 64.9P Waiver, identified by the demonstration Demonstration project number assigned by CMS (including the project number extension, which indicates the demonstration year in which services were rendered or for which capitation payments were made). Expenditures for optional targeted low income children (CHIP Children) claimed under the authority of title XXI shall be reported each quarter on forms CMS-64.21U Waiver and/or CMS 64.21UP Waiver. a. a) For the extended family planning component of the demonstrationDemonstration, the state State should report demonstration Demonstration expenditures on Forms CMS-64.9 Waiver and/or 64.9P Waiver as follows: i. Allowable family planning expenditures eligible for reimbursement at the State’s Federal medical assistance percentage rate (FMAP) should be entered in Column (B) on the appropriate waiver sheets. ii. Allowable family planning expenditures eligible for reimbursement at the enhanced family planning match rate should be entered in Column (D) on the appropriate waiver sheets. b. b) Premiums and other applicable cost sharing contributions from enrollees that are collected by the state State under the demonstration Demonstration must be reported to CMS each quarter on Form CMS-64 Summary Sheet line 9.D, columns (A) and (B). Additionally, the total amounts that are attributable to the demonstration Demonstration must be separately reported on the CMS-64 Narrative Narr by demonstration Demonstration year. c. c) For each demonstration Demonstration year, twenty eight twenty-four (2824) separate Forms CMS-64.9 Waiver and/or 64.9P Waiver must be completed to report expenditures for the following demonstration Demonstration populations and demonstration Demonstration services. The waiver names to be used to identify these separate Forms CMS-64.9 Waiver and/or 64.9P Waiver appear in the second column of the tables below, labeled “CMS-64 Eligibility Group Reporting.” brackets. Expenditures should be allocated to these forms based on the guidance found below.