| Global Cap Forecast (Surplus)/Deficit |
$590.7 |
$2,039.8 |
|
| Signed Legislation |
|
|
$5.60 |
$25.70 |
| S1466 - Ambulance Bill |
1/1/24 |
Admin |
$2.50 |
$10.00 |
| S1196A - Biomarkers Coverage |
4/1/24 |
Admin |
$3.10 |
$15.70 |
| Base Revisions |
|
|
($548.60) |
$356.00 |
| Medicaid Enrollment Above Financial Plan Projections |
1/1/24 |
Admin |
$402.00 |
$356.00 |
| Delayed Recoupment of Hospital Advances |
1/1/24 |
Admin |
($950.60) |
$0.00 |
| Financial Plan Support |
|
|
$950.60 |
$0.00 |
| Reimbursement of Prior-Year Financial Plan Support of Delayed Hospital Recoupments |
1/1/24 |
Admin |
$950.60 |
$0.00 |
| Global Cap Index Update |
|
|
($263.10) |
($157.80) |
| Global Cap (Surplus)/Deficit |
|
|
$735.10 |
$2,263.70 |
|
| Budget Actions |
|
|
($768.00) |
($1,154.90) |
|
| Hospital Actions |
|
|
($21.30) |
($42.50) |
| Reduce Hospital Capital Rate Add-on by 10% |
10/1/24 |
Art. VII |
($21.30) |
($42.50) |
| Nursing Home Actions |
|
|
($102.40) |
($102.40) |
| Unallocated Nursing Home VAPAP Reduction |
4/1/24 |
Admin |
($75.00) |
($75.00) |
| Reduce Nursing Home Capital Rate Add-on by 10% (Excluding NH Pediatric Beds) |
4/1/24 |
Art. VII |
($27.40) |
($27.40) |
| Other Long-Term Care Actions |
|
|
($232.60) |
($563.60) |
| Institute Plan Penalty for Electronic Visit Verification (EVV) Non-Compliance |
1/1/25 |
Admin |
$0.00 |
($20.00) |
| Reduce Managed Long-Term Care (MLTC) Quality Pool |
4/1/24 |
Admin |
($29.60) |
($29.60) |
| Require Dual-Eligibile Special Needs Plans (DSNPs) to Cover Medicaid Dental Benefits in Medicare |
1/1/25 |
Admin |
($3.00) |
($10.00) |
| Transition to One Statewide Fiscal Intermediary & Recalibrate Administrative Reimbursement |
4/1/24 |
Art. VII/Admin |
($200.00) |
($504.00) |
| Managed Care Actions |
|
|
($238.20) |
($238.20) |
| Remove 1% Across the Board Increase for Health Plans |
4/1/24 |
Art. VII |
($204.40) |
($204.40) |
| Reduce Mainstream Managed Care (MMC) Quality Pool |
4/1/24 |
Admin |
($33.80) |
($33.80) |
| Pharmacy Actions |
|
|
($32.40) |
($67.00) |
| Streamline Medicaid Drug Cap |
10/1/24 |
Art. VII |
($5.00) |
($10.00) |
| Pharmacy Enhancements and Integration Specialty Drug Management |
10/1/24 |
Art. VII |
($9.40) |
($25.00) |
| Reduce Coverage for Certain Over-The-Counter (OTC) Pharmaceuticals |
10/1/24 |
Art. VII |
($18.00) |
($32.00) |
| Other Actions |
|
|
($141.20) |
($141.20) |
| Procurement Savings and Efficiencies |
4/1/24 |
Admin |
($5.00) |
($5.00) |
| OHIP Non-Personal Service Reduction |
4/1/24 |
Admin |
($25.00) |
($25.00) |
| Increase in Expected Audit Recoveries |
4/1/24 |
Admin |
($100.00) |
($100.00) |
| Early Intervention - Teletherapy Reimbursement |
4/1/24 |
Admin |
($6.50) |
($6.50) |
| Early Intervention - Group Session Billing |
4/1/24 |
Admin |
($4.70) |
($4.70) |
| Total Global Cap (Surplus) / Deficit |
|
|
($32.80) |
$1,108.90 |
|
| 1115/SOTS/Additional Investments |
|
|
$492.80 |
$542.40 |
|
| 1115 Waiver (State Share) |
|
|
$451.00 |
$473.70 |
| Medicaid Hospital Global Budget Initiative ($550M Gross) |
1/1/24 |
Admin |
$275.00 |
$275.00 |
| Patient Centered Medical Homes (PCMH) Enhancement for Adults/Kids |
4/1/24 |
Admin |
$73.80 |
$73.80 |
| Substance Use Disorder Amendment |
1/1/24 |
Admin |
($22.00) |
($22.00) |
| Continuous Eligibility for Kids (0-6) in Medicaid and CHIP |
1/1/25 |
Art. VII |
$7.60 |
$30.30 |
| 1115 Additional State Match |
4/1/24 |
Admin |
$116.70 |
$116.70 |
| State of the State Investments |
|
|
$41.80 |
$68.70 |
| Increase Children's Access to Healthcare |
|
|
$13.70 |
$21.80 |
| Increase reimbursement rates for Early Intervention by 5% |
4/1/24 |
Admin |
$6.10 |
$6.10 |
| 4% Early Intervention Rate Modifier for Rural and Underserved Areas |
4/1/25 |
Admin |
$0.00 |
$0.50 |
| Increase rates for children's mental health provided in integrated settings |
10/1/24 |
Admin |
$7.60 |
$15.20 |
| Expand Access to Primary Care |
|
|
$19.90 |
$38.30 |
| Increase rates for mental health provided in integrated settings |
10/1/24 |
Admin |
$13.50 |
$27.00 |
| Increase rates for healthcare providers serving individuals with physical, intellectual, or developmental disabilities. |
10/1/24 |
Admin |
$5.20 |
$10.40 |
| Expand coverage for Adverse Childhood Experiences (ACE) Screening to adults |
10/1/24 |
Admin |
$1.20 |
$0.90 |
| Other SOTS |
|
|
$0.10 |
$0.50 |
| Ensure access to comprehensive gender-affirming treatments in Medicaid |
1/1/25 |
Admin |
$0.10 |
$0.50 |
| Other Mental Health SOTS (Medicaid Impacts) |
|
|
$8.10 |
$8.10 |
| Fund New Community-Based Mental Health Teams |
4/1/24 |
Admin |
$4.00 |
$4.00 |
| Establish New Youth Assertive Community Treatment (ACT) Teams Statewide |
4/1/24 |
Admin |
$4.00 |
$4.00 |
| Total Global Cap (Surplus)/Deficit |
|
|
$460.00 |
$1,651.30 |
|
| Legislative Adds |
|
|
($460.00) |
($102.30) |
|
| Adds |
|
|
$1,177.60 |
$27.60 |
| Financially Distressed and Safety-Net Hospitals Support |
4/1/24 |
Admin |
$500.00 |
$0.00 |
| Healthcare Safety Net Transformation Program |
4/1/24 |
Art. VII |
$300.00 |
$0.00 |
| Hospital One-Time Investment |
4/1/24 |
Art. VII |
$200.00 |
$0.00 |
| Nursing Home/ALP/Hospice One-Time Investment |
4/1/24 |
Art. VII |
$150.00 |
$0.00 |
| Local Medicaid Share of Additional 1.3% COLA |
4/1/24 |
Art. VII |
$26.60 |
$26.60 |
| Pediatric Clinic Rate Increase |
4/1/24 |
Art. VII |
$1.00 |
$1.00 |
| Avails |
|
|
($1,637.60) |
($129.90) |
| Support Essential Plan Operations with Federal Funds |
4/1/24 |
Admin |
($95.30) |
($103.30) |
| Available HCBS eFMAP |
4/1/24 |
Admin |
($365.60) |
$0.00 |
| Financial Plan Support of Hospital Investments and OSA COLA |
4/1/24 |
Admin |
($826.60) |
($26.60) |
| Healthcare Stability Fund Offsets |
4/1/24 |
Art. VII |
($350.00) |
$0.00 |
| Total Global Cap (Surplus)/Deficit |
|
|
$0.00 |
$1,549.00 |
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