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Approval Period: April 1, 2019 through December 31, 2028 Page 25 of 28

14 years old and under 15 – 20 years old 21 – 44 years old 45 years old and older Total Most and Moderately Effective* Numerator

Denominator

Long-acting reversible contraceptiv e (LARC)* Numerator

Denominator

Total Numerator

Denominator

*This measure is calculated as per the Medicaid and CHIP Child and Adult Core Set measure for contraceptive care for all women. Measure specifications can be found at the links below: • Child Core Set (CCW-CH measure for ages 15-20): https://www.medicaid.gov/license- agreement.html?file=%2Fmedicaid%2Fquality-of-care%2Fdownloads%2Fmedicaid- and-chip-child-core-set-manual.pdf • Adult Core Set (CCW-AD measure for ages 21-44): https://www.medicaid.gov/license- agreement.html?file=%2Fmedicaid%2Fquality-of-care%2Fdownloads%2Fmedicaid- adult-core-set-manual.pdf

States needing technical assistance in applying the Core Set specifications to their family planning demonstration can send an email to MACqualityTA@cms.hhs.gov.

Table 5: Number Beneficiaries Tested for any STD by Demonstration Year Test Female Tests Total Tests Number Percent of Total Number Percent of Total Unduplicated number of beneficiaries who obtained an STD test

Table 6: Total Number of Female Beneficiaries who obtained a Cervical Cancer Screening Screening Activity Numerator* Denominator* Percent Unduplicated number of female beneficiaries who obtained a cervical cancer screening*

*This measure is calculated as per the Medicaid and CHIP Adult Core Set measure for cervical cancer screening and is defined as women ages 21 to 64 who had cervical cytology (Pap test) performed every 3 years or women ages 30 to 64