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Section 06: Demonstration Benefits and Cost Sharing Requirements Both the benefits provided under the demonstration and the cost sharing requirements applicable to members will not differ from those provided under the Medicaid State Plan. South Carolina does not have cost sharing requirements in the Medicaid State Plan. Section 07: Delivery System and Payment Rates for Services The delivery system used to provide benefits to the demonstration participants will not differ from the Medicaid State Plan. Participants will be enrolled into managed care. No deviation will be made for services furnished through fee-for-service. Likewise, no deviations will be made for managed care capitation rates and contracting requirements. Current State Plan rules and internal procedures that govern mandatory assignment to managed care will continue to operate in their current form. No new quality-based supplemental payments are being made to any providers or class of providers under this demonstration. Section 08: Implementation of Demonstration After CMS approval, SCDHHS will develop a communication and implementation plan that clearly lays out timing, content, and the methodology by which participants will be notified of program changes. SCDHHS will also develop educational materials for internal staff and external stakeholders to ensure clear communication with participants. SCDHHS will work with partner agencies to negotiate data-sharing agreements that will allow for enhanced data matching, which will provide external validation of community engagement qualifying activities to the greatest extent possible. Partner agencies may include the Department of Education, the Department of Employment and Workforce, the Department of Social Services, and the Commission on Higher Education. The demonstration will operate statewide. SCDHHS is requesting a five-year waiver approval for this demonstration. The demonstration will not affect or modify other components of the state’s current Medicaid and CHIP programs. Section 09: Demonstration Financing and Budget Neutrality The budget neutrality requirements for Section 1115 waivers ensure that Medicaid demonstration projects do not increase federal Medicaid spending beyond what it would have been without the waiver. As a result, states must design their 1115 waiver proposals so that the projected costs under the waiver are equal to or less than the expected costs to the federal government without the waiver. The budget neutrality formula compares Without Waiver (WOW) expenditures to With Waiver (WW) expenditures, ensuring that WOW costs are greater than or equal to WW costs using the per member per month (PMPM) methodology approach. 11