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TEAMKY Demonstration

Approval Period: January 1, 2025 through December 31, 2029

Page 50 of 155 b. Net expenditures and prior period adjustments of the Medicaid program that are paid in accordance with the approved state plan, and

c. Medical assistance expenditures and prior period adjustments made under section 1115 demonstration authority with dates of service during the demonstration extension period; including those made in conjunction with the demonstration, net of enrollment fees, cost sharing, pharmacy rebates, and all other types of third party liability or CMS payment adjustments.

73. Program Integrity. The state must have processes in place to ensure there is no duplication of federal funding for any aspect of the demonstration. The state must also ensure that the state and any of its contractors follow standard program integrity principles and practices including retention of data. All data, financial reporting, and sources of non- federal share are subject to audit.

74. Medicaid Expenditure Groups. Medicaid Expenditure Groups (MEG) are defined for the purpose of identifying categories of Medicaid or demonstration expenditures subject to budget neutrality, components of budget neutrality expenditure limit calculations, and other purposes related to monitoring and tracking expenditures under the demonstration. The Master MEG Chart table provides a master list of MEGs defined for this demonstration.

Table #3: Master MEG Chart MEG Which BN Test Applies? WOW Per Capita WOW Aggregate WW Brief Description SUD Hypo 1 X

X All expenditures for services provided to an individual while they are a patient in an IMD for SUD treatment, described in Section XIV. RRSS Hypo 2 X

X All expenditures for RRSS services, described in Section XIV. SMI MCO Hypo 3 X

X All managed care expenditures for services provided to an individual while they are a patient in an IMD for SMI treatment described in of Section XV. SMI FFS Hypo 3 X

X All FFS expenditures for services provided to an individual while they are a patient in an IMD for SMI treatment described in of Section XV Reentry Hypo 4 X

X Expenditures for targeted services that are otherwise