Page 64

TEAMKY Demonstration

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

Page 63 of 155 approval) to refund any FFP in excess of the cap to CMS. Demonstration savings from the Main Budget Neutrality Test cannot be used to offset excess spending for the SHAC.

91. SHAC Budget Neutrality Test: HRSN. The table below identifies the MEGs that are used for the SHAC Budget Neutrality Test. MEGs that are designated “WOW Only” or “Both” are the components used to calculate the budget neutrality expenditure limit. The Composite Federal Share for the SHAC Budget Neutrality Test is calculated based on all MEGs indicated as “WW Only” or “Both.” MEGs that are indicated as “WW Only” or “Both” are counted as expenditures against this budget neutrality expenditure limit. Any expenditures in excess of the limit from the SHAC Budget Neutrality Test cannot be offset by savings under the Main Budget Neutrality Test or the Hypothetical Budget Neutrality Tests.

Table 10: SHAC Budget Neutrality Test MEG PC or Agg WOW Only, WW Only, or Both DY 9 DY 10 DY 11 DY 12 DY 13 DY 14 HRSN Agg Both $6,326,698 $8,999,263 $9,539,219 $10,111,572 $10,718,266 $2,832,559 HRSN Infrastructure Agg Both $2,000,000 $184,575 $184,575 $184,575 $184,575 $0

92. Former Foster Care Youth (FFCY) Budget Neutrality. CMS has determined that the FFCY demonstration population is budget neutral based on CMS’ assessment that the waiver authorities granted for this demonstration population are unlikely to result in any increase in federal Medicaid expenditures, and that no expenditure authorities are associated with this demonstration population. The state will not be allowed to obtain budget neutrality “savings” from this demonstration population. The demonstration population will not include a budget neutrality expenditure limit. The state must report quarterly claims and report expenditures on the CMS-64 base form(s) for Medicaid State Plan populations in accordance with section 2500 of the State Medicaid Manual.

93. Composite Federal Share. The Composite Federal Share is the ratio that will be used to convert the total computable budget neutrality limit to federal share. The Composite Federal Share is the ratio calculated by dividing the sum total of FFP received by the state on actual demonstration expenditures during the approval period by total computable demonstration expenditures for the same period, as reported through MBES/CBES and summarized on Schedule C. Since the actual final Composite Federal Share will not be