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Pennsylvania Keystones of Health Section 1115 Demonstration Approval Period: December 26, 2024 through December 31, 2029 Page 63 of 90 limit, CMS will require the state to submit a corrective action plan for CMS review and approval. CMS will use the threshold levels in the tables below as a guide for determining when corrective action is required. Table 9: Budget Neutrality Test Corrective Action Plan Calculation Demonstration Year Cumulative Target Definition Percentage DY 1 Cumulative budget neutrality limit plus: 2.0 percent DY 1 through DY 2 Cumulative budget neutrality limit plus: 1.5 percent DY 1 through DY 3 Cumulative budget neutrality limit plus: 1.0 percent DY 1 through DY 4 Cumulative budget neutrality limit plus: 0.5 percent DY 1 through DY 5 Cumulative budget neutrality limit plus: 0.0 percent

14. SCHEDULE OF STATE DELIVERABLES FOR THE DEMONSTRATION PERIOD Due Deliverable STC Administrative 30 calendar days after demonstration approval State acceptance of demonstration Waivers, STCs, and Expenditure Authorities Approval letter Post-Approval Protocols 120 calendar days after approval date Reentry Demonstration Initiative Implementation Plan STC 5.10 6 months after approval date Reentry Demonstration Initiative Reinvestment Plan STC 5.11 90 calendar days after approval date Protocol for Assessment of Beneficiary Eligibility and Needs, and Provider Qualifications for HRSN Services STC 6.7 90 calendar days after approval date Maintenance of Effort (MOE) Plan for Baseline Social Services Expenditure STC 6.16 9 months after approval date HRSN Implementation Plan STC 6.19 Monitoring and Evaluation Deliverables 150 calendar days after approval date Monitoring Protocol(s) STC 10.4