Global Cap Forecast with Legislation (Surplus)/Deficit |
|
|
($437.04) |
$344.57 |
|
Global Cap Index Inflation ‐ CMS Office of the Actuary Medicaid Projection (5‐Year Rolling Average) |
4/1/2022 |
Article VII |
($366.00) |
($899.38) |
Health Care Bonus ‐ State Total |
4/1/2022 |
Article VII |
$922.75 |
$0.00 |
Financial Plan Support for Health Care Bonuses |
4/1/2022 |
Article VII |
($922.75) |
$0.00 |
Global Cap (Surplus)/Deficit |
|
|
($803.04) |
($554.81) |
|
Budget Actions |
|
|
$844.25 |
$627.01 |
|
Hospital Actions |
|
|
$350.00 |
$350.00 |
Distressed Hospital Pool |
4/1/2022 |
Admin |
$100.00 |
$100.00 |
Distressed Provider Account Investment (inc. $100M of Financial Plan Resources) |
10/1/2021 |
Admin |
$250.00 |
$250.00 |
|
Long Term Care Actions |
|
|
$48.80 |
($15.30) |
Nursing Home Reforms |
|
|
$161.50 |
$161.50 |
Nursing Home Support for Compliance with Staffing Regulations |
4/1/2022 |
Admin |
$61.50 |
$61.50 |
Increase Nursing Home Vital Access Provider (VAP) Funding |
4/1/2022 |
Article VII |
$100.00 |
$100.00 |
|
LTC--Medicaid Diversion |
|
|
($110.56) |
($150.56) |
Expansion of Licensed Home Care Service Agencies (LHCSA) Marketplace |
4/1/2022 |
Admin |
$0.00 |
($40.00) |
Long Term Service and Support (LTSS) Coverage in Essential Plan |
1/1/2023 |
Article VII |
($110.56) |
($110.56) |
|
LTC Other Reforms |
|
|
($2.13) |
($26.23) |
LHCSA Request for Offer (RFO) Re‐estimate |
5/1/2022 |
Admin |
$0.00 |
($25.00) |
LTSS Services Authorization Guidelines |
7/1/2022 |
Article VII |
$0.00 |
($5.00) |
Increasing Private Duty Nursing (PDN) Reimbursement for Nurses Servicing Adult Members |
4/1/2022 |
Article VII |
$19.45 |
$25.60 |
Use of Federal HCBS funding to support PDN Reimbursement |
4/1/2022 |
Admin |
($19.45) |
$0.00 |
Alzheimer's Program under Medicaid |
4/1/2022 |
Admin |
$1.37 |
$1.37 |
Fully Implement the Duals Integration Roadmap |
4/1/2022 |
Admin |
($3.50) |
($23.20) |
|
Managed Care Actions |
|
|
($34.43) |
($264.68) |
Postpartum Women in Essential Plan |
1/1/2023 |
Article VII |
$0.00 |
($165.00) |
Moving Integrated Plans to Middle of the Rate Range |
4/1/2022 |
Admin |
$20.00 |
$20.00 |
Restore MMC/MLTC Quality Pools (1‐Year Restoration) |
4/1/2022 |
Admin |
$77.25 |
$0.00 |
Utilize Child Health Plus (CHP) to Access Federal Funding for Enhanced Pregnancy Coverage |
3/1/2023 |
Admin |
($183.00) |
($171.00) |
Applied Behavior Analysis (ABA) Rates to Incentivize Providers in Managed Care |
4/1/2022 |
Admin |
$36.61 |
$36.61 |
Adjust HIV SNP Rates to Reflect High Needs Model |
4/1/2022 |
Admin |
$14.72 |
$14.72 |
|
Pharmacy Actions |
|
|
$0.00 |
$5.00 |
Establishing Parity and Uniform Clinical Standards across both Medical and Retail Pharmacy Benefits in Fee‐ For‐Service (FFS) |
10/1/2023 |
Admin |
$0.00 |
$5.00 |
|
Other Actions |
|
|
$462.35 |
$498.37 |
Increase Medicaid Trend Factor by 1% to Recognize Provider Cost Increases |
4/1/2022 |
Article VII |
$318.31 |
$318.31 |
Restoration of 1.5% Across the Board (ATB) |
4/1/2022 |
Admin |
$140.76 |
$140.76 |
Investment in Children's Behavioral Health Services |
4/1/2022 |
Admin |
$37.26 |
$42.83 |
Use of Federal HCBS funding to support Children's Behavioral Health Services |
4/1/2022 |
Admin |
($37.26) |
$0.00 |
Increase Top 20 Orthotics and Prosthetics Codes to Medicare Rates |
4/1/2022 |
Admin |
$3.75 |
$3.75 |
Establish Unique Identifier for All Unenrolled Provider Types |
4/1/2022 |
Admin |
($5.00) |
($5.00) |
Promote Access to Primary Care |
4/1/2022 |
Admin |
$4.93 |
$6.60 |
Eliminate Unnecessary Requirements from the Utilization Threshold (UT) Program |
4/1/2022 |
Article VII |
($0.23) |
($0.23) |
Enhanced Durable Medical Equipment (DME) Management |
7/1/2022 |
Admin |
($0.17) |
($8.65) |
|
Maternal Health Actions |
|
|
$4.34 |
$26.76 |
Improve and Expand Access to Prenatal and Postnatal Care |
6/1/2022 |
Article VII |
$6.34 |
$18.76 |
Advancing Comprehensive Maternal Care in Managed Care |
10/1/2022 |
Admin |
$15.00 |
$25.00 |
Maternal Health Investments ‐ Avoided Costs |
4/1/2022 |
Admin |
($17.00) |
($17.00) |
|
Other State of the State Actions |
|
|
$13.19 |
$26.86 |
Create an Center of Medicaid Innovation to Lower Costs and Improve Care |
4/1/2022 |
Admin |
$1.20 |
$1.20 |
Promote Health Equity and Continuity of Coverage for Vulnerable Seniors |
1/1/2023 |
Article VII |
$5.00 |
$20.00 |
Patient Access and Developer Portals |
4/1/2022 |
Admin |
$4.06 |
$2.73 |
Health Care Bonus Enforcement |
4/1/2022 |
Admin |
$2.93 |
$2.93 |
|
Adds |
|
|
$904.83 |
$408.63 |
Additional Hospital Funding |
4/1/2022 |
Admin |
$800.00 |
$100.00 |
Maternal Health for Postpartum Coverage for Undocumented |
3/1/2023 |
Article VII |
$2.33 |
$53.88 |
Medicaid Coverage for Undocumented Age 65+ |
1/1/2023 |
Article VII |
$56.45 |
$229.25 |
Additional QIVAPP Support |
4/1/2022 |
Admin |
$37.40 |
$0.00 |
Medicare Savings Program Expansion |
1/1/2023 |
Article VII |
$5.20 |
$20.90 |
Medicaid Ambulance Billing |
7/1/2022 |
Article VII |
$3.45 |
$4.60 |
Avails |
|
|
($946.04) |
($480.83) |
Other Revisions and Timing of Payments Across Fiscal Years |
4/1/2022 |
Admin |
($342.34) |
($336.93) |
Mainstream Managed Care Non‐Federal Share Assumption |
4/1/2022 |
Admin |
($486.00) |
$0.00 |
Temporary Support for One‐time COVID‐related Hospital Expenses |
4/1/2022 |
Admin |
($84.00) |
($84.00) |
CDPAP Request for Offer (RFO) Re‐estimate |
4/1/2022 |
Article VII |
($25.00) |
($25.00) |
Elderly Pharmaceutical Insurance Coverage (EPIC) Savings Offset related to MSP Expansion |
1/1/2023 |
Article VII |
($8.70) |
($34.90) |
Total Global Cap (Surplus)/Deficit |
|
|
$0.00 |
$0.00 |
Home Care Minimum Wage Increase |
10/1/2022 |
Article VII |
$362.58 |
$964.91 |
Lost MOE Savings associated with the use of Federal HCBS funding in FY 2024 |
4/1/2023 |
Admin |
$0.00 |
$289.00 |
Use of Federal HCBS funding to support Home Care Minimum Wage Increase |
10/1/2022 |
Admin |
($362.58) |
($702.42) |
Home Care Minimum Wage Increase Supported Outside the Global Cap |
|
|
$0.00 |
$551.48 |
Financial Plan Support of Home Care Minimum Wage Increase |
4/1/2023 |
Admin |
$0.00 |
($262.48) |
Financial Plan Support of Lost MOE Savings |
4/1/2023 |
Admin |
$0.00 |
($289.00) |
Total Financial Plan Support For Min Wage Increase in FY 2024 |
|
|
$0.00 |
($551.48) |
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