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Table 6. Budget Neutrality Test Corrective Action Plan Calculation

Demonstration Year Cumulative Target Definition Percentage

DY 13 Cumulative budget neutrality limit 2.0 percent plus:

DY 13 through DY 14 Cumulative aa ene limit 2.0 percent

DY 13 through DY 15 Cumulative aan neutrality limit 5 percent

DY 13 through DY 16 Cumulative anes hii 1.0 percent

DY 13 through DY 17 Cumulative oe neutrality limit 0.5 percent

DY 13 through DY 18 Cumulative budget neutrality limit 0.0 percent

XII. EVALUATION OF THE DEMONSTRATION

67. Cooperation with Federal Evaluators. As required under 42 CFR 431.420(f), the state shall cooperate fully and timely with CMS and its contractors in any federal evaluation of the demonstration or any component of the demonstration. This includes, but is not limited to, commenting on design and other federal evaluation documents and providing data and analytic files to CMS, including entering into a data use agreement that explains how the data and data files will be exchanged, and providing a technical point of contact to support specification of the data and files to be disclosed, as well as relevant data dictionaries and record layouts. The state shall include in its contracts with entities who collect, produce or maintain data and files for the demonstration, that they shall make such data available for the federal evaluation as is required under 42 CFR 431.420(f). This may also include the state’s participation — including representation from the state’s contractors, independent evaluators, and organizations associated with the demonstration operations, as applicable — in a federal learning collaborative aimed at cross-state technical assistance, and identification of lessons learned and best practices for demonstration measurement, data development, implementation, monitoring and evaluation. The state may claim administrative match for these activities. Failure to comply with this STC may result in a deferral being issued as outlined in STC 31.

68. Independent Evaluator. The state must use an independent entity (herein referred to as the Independent Evaluator) to conduct an evaluation of the demonstration to ensure that the necessary data is collected at the level of detail needed to research the approved hypotheses. The Independent Evaluator must sign an agreement to conduct the demonstration evaluation in an independent manner in accordance with the CMS- approved Evaluation Design. When conducting analyses and developing the evaluation reports, every effort should be made to follow the approved methodology. However, the state may request, and CMS may agree to, changes in the methodology in appropriate

circumstances.

Building and Transforming Coverage, Services and Supports for a Healthier Virginia Approval Period: August 1, 2026 through December 31, 2031

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