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10.10.

Medicaid Expenditure Groups. Medicaid Expenditure Groups (MEG) are defined for the purpose of identifying categories of Medicaid or demonstration expenditures subject to budget neutrality, components of budget neutrality expenditure limit calculations, and other purposes related to monitoring and tracking expenditures under the demonstration. The Master MEG Chart table provides a master list of MEGs defined for this demonstration.

Table 3: Master MEG Chart

: wow MEG iad Per bla! ww Brief Description

Test Applies? Capita Aggregate

Childless Adult | Hypothetical Xx xX ages 19 through 64 years

All expenditures for services provided to non- pregnant, uninsured adults

who have family incomes up to 100 percent of the FPL.

All expenditures for services provided to an SUD Hypothetical xX xX individual while they are a patient in an IMD for SUD

treatment.

All additional administrative costs that are directly attributable to the

ADM N/A demonstration and not described elsewhere and are not subject to budget neutrality.

BN — budget neutrality; MEG — Medicaid expenditure group; WOW — without waiver; WW — with waiver

10.11.

Reporting Expenditures and Member Months. The state must report all demonstration expenditures claimed under the authority of title XIX of the Act and subject to budget neutrality each quarter on separate forms CMS-64.9 WAIVER and/or 64.9P WAIVER, identified by the demonstration project number assigned by CMS (11-W-00293/5). Separate reports must be submitted by MEG (identified by Waiver Name) and Demonstration Year (identified by the two-digit project number extension). Unless specified otherwise, expenditures must be reported by DY according to the dates of service associated with the expenditure. All MEGs identified in the Master MEG Chart as WW must be reported for expenditures, as further detailed in the MEG Detail for Expenditure and Member Month Reporting table below. To enable calculation of the budget neutrality expenditure limits, the state also must report member months of eligibility for specified MEGs. a. Cost Settlements. The state will report any cost settlements attributable to the demonstration on the appropriate prior period adjustment schedules (form CMS- 64.9P WAIVER) for the summary sheet line 10b (in lieu of lines 9 or 10c), or line 7. For any cost settlement not attributable to this demonstration, the adjustments should

Wisconsin BadgerCare Reform Approval Period: October 29, 2024 through December 31, 2029 Page 27