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TEAMKY Demonstration
Approval Period: January 1, 2025 through December 31, 2029
Page 51 of 155 Table #3: Master MEG Chart MEG Which BN Test Applies? WOW Per Capita WOW Aggregate WW Brief Description covered under Medicaid provided to qualifying beneficiaries for up to 60 days immediately prior to release from participating facilities. Reentry Non- Service Hypo 4
X
Expenditures for allowable planning and non-services for the reentry demonstration initiative. HRSN SHAC
X
Expenditures for HRSN services described in Section VII. HRSN Infrastructure SHAC
X
Expenditures for planning and supporting the HRSN initiative, as described in Section VII. ADM N/A
All additional administrative costs that are directly attributable to the demonstration and not described elsewhere and are not subject to budget neutrality.
75. Reporting Expenditures and Member Months. The state must report all demonstration expenditures claimed under the authority of title XIX of the Act and subject to budget neutrality each quarter on separate forms CMS-64.9 WAIVER and/or 64.9P WAIVER, identified by the demonstration project number assigned by CMS (11-W--00306/4). Separate reports must be submitted by MEG (identified by Waiver Name) and Demonstration Year (identified by the two-digit project number extension). Unless specified otherwise, expenditures must be reported by DY according to the dates of service associated with the expenditure. All MEGs identified in the Master MEG Chart as WW must be reported for expenditures, as further detailed in the MEG Detail for Expenditure and Member Month Reporting table below. To enable calculation of the budget neutrality expenditure limits, the state also must report member months of eligibility for specified MEGs.
a. Cost Settlements. The state will report any cost settlements attributable to the demonstration on the appropriate prior period adjustment schedules (form CMS-64.9P WAIVER) for the summary sheet line 10b (in lieu of lines 9 or 10c), or line 7. For any cost settlement not attributable to this demonstration, the adjustments should be