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11 Demonstration Approval: November 1, 2023, through October 31, 2028 24. Close-Out Report. Within 120 calendar days after the expiration of the demonstration, the state must submit a draft Close-Out Report to CMS for comments. a. The Close-Out Report must comply with the most current guidance from CMS. b. In consultation with CMS, and per guidance from CMS, the state will include an evaluation of the demonstration (or demonstration components) that are to phase out or expire without extension along with the Close-Out Report. Depending on the timeline of the phase-out during the demonstration approval period, in agreement with CMS, the evaluation requirement may be satisfied through the Interim and/or Summative Evaluation Reports stipulated in STC 32 and 33, respectively. c. The state will present to and participate in a discussion with CMS on the Close- Out report. d. The state must take into consideration CMS’s comments for incorporation into the final Close-Out Report. e. A revised Close-Out Report is due to CMS no later than 30 days after receipt of CMS’s comments. f. A delay in submitting the draft or final version of the Close-Out Report may subject the state to penalties described in STC 19.

25. Monitoring Calls. CMS will convene periodic conference calls with the state. a. The purpose of these calls is to discuss ongoing demonstration operation, to include (but not limited to), any significant actual or anticipated developments affecting the demonstration. Examples include implementation activities, trends in reported data on metrics and associated mid-course adjustments, budget neutrality, and progress on evaluation activities. b. CMS will provide updates on any pending actions, as well as federal policies and issues that may affect any aspect of the demonstration. c. The state and CMS will jointly develop the agenda for the calls.

26. Post Award Forum. Pursuant to 42 CFR 431.420(c), within 6 months of the demonstration’s implementation, and annually thereafter, the state shall afford the public with an opportunity to provide meaningful comment on the progress of the demonstration. At least 30 calendar days prior to the date of the planned public forum, the state must publish the date, time, and location of the forum in a prominent location on its website. The state must also post the most recent Annual Monitoring Report on its website with the public forum announcement. Pursuant to 42 CFR 431.420(c), the state must include a summary of the public comments in the next Annual Monitoring Report.

VI. MONITORING BUDGET NUETRALITY FOR THE DEMONSTRATION

26. Budget Neutrality. CMS has determined that this demonstration is budget neutral based on CMS’s assessment that the expenditure authority granted for the demonstration has minimal federal Medicaid expenditures and these populations could have been covered through waiver only authority. The state will not be allowed to obtain budget neutrality “savings” from this demonstration. The demonstration will not include a budget neutrality expenditure limit; however, the state is required to report total expenditures and member months in their