Common use of Budget Neutrality Annual Expenditure Limit Clause in Contracts

Budget Neutrality Annual Expenditure Limit. The annual budget neutrality expenditure limit for the demonstration as a whole is the sum of limit A and limit B. The overall budget neutrality expenditure limit for the demonstration is the sum of the annual budget neutrality expenditure limits. The federal share of the overall budget neutrality expenditure limit represents the maximum amount of FFP that the Commonwealth may receive for expenditures on behalf of demonstration populations as well as demonstration services described in Table B, Table C and Table D of STC 38-40 during the demonstration period. Limit A. For each year of the budget neutrality agreement an annual budget neutrality expenditure limit is calculated for each EG described as follows: An annual EG estimate must be calculated as a product of the number of eligible member months reported by the Commonwealth under section XIII, STC 91 for each EG, including the hypothetical populations, times the appropriate estimated per member/per month (PMPM) costs from the tables in STCs 109, 110 and 111 below, and summing the results of those calculations. The annual limits will then be added together to obtain a budget neutrality limit for the entire demonstration period; Starting in SFY 2006, actual expenditures for the CommonHealth EG will be included in the expenditure limit for the Commonwealth. The amount of actual expenditures to be included will be the lower of the trended baseline CommonHealth costs, or actual CommonHealth per member per most cost experience for SFYs 2018-2022; The amount of actual expenditures included will be the lower of the trended baseline costs, or actual per member per most cost experience for each eligibility group in SFYs 2018-2022; Historical PMPM costs used to calculate the budget neutrality expenditure limit in prior demonstration periods are provided in Attachment D. Limit B. The Commonwealth’s annual DSH allotment.

Budget Neutrality Annual Expenditure Limit. The annual budget neutrality expenditure limit for the demonstration as a whole is the sum of limit A and limit B. The overall budget neutrality expenditure limit for the demonstration is the sum of the annual budget neutrality expenditure limits. The federal share of the overall budget neutrality expenditure limit represents the maximum amount of FFP that the Commonwealth may receive for expenditures on behalf of demonstration populations as well as demonstration services described in Table B, Table C and Table D of STC 38-40 during the demonstration period. Limit A. For each year of the budget neutrality agreement an annual budget neutrality expenditure limit is calculated for each EG described as follows: An annual EG estimate must be calculated as a product of the number of eligible member months reported by the Commonwealth under section XIII, STC 91 95 for each EG, including the hypothetical populations, times the appropriate estimated per member/per month (PMPM) costs from the tables in STCs 109111, 110 112 and 111 113 below, and summing the results of those calculations. The annual limits will then be added together to obtain a budget neutrality limit for the entire demonstration period; Starting in SFY 2006, actual expenditures for the CommonHealth EG will be included in the expenditure limit for the Commonwealth. The amount of actual expenditures to be included will be the lower of the trended baseline CommonHealth costs, or actual CommonHealth per member per most cost experience for SFYs 2018-2022; The amount of actual expenditures included will be the lower of the trended baseline costs, or actual per member per most cost experience for each eligibility group in SFYs 2018-2022; Historical PMPM costs used to calculate the budget neutrality expenditure limit in prior demonstration periods are provided in Attachment D. Limit B. The Commonwealth’s annual DSH allotment.

Budget Neutrality Annual Expenditure Limit. The annual budget neutrality expenditure limit for the demonstration as a whole is the sum of limit A and limit B. The overall budget neutrality expenditure limit for the demonstration is the sum of the annual budget neutrality expenditure limits. The federal share of the overall budget neutrality expenditure limit represents the maximum amount of FFP that the Commonwealth may receive for expenditures on behalf of demonstration populations as well as demonstration services described in Table B, Table C and Table D of STC 38-40 during the demonstration period. Limit A. For each year of the budget neutrality agreement an annual budget neutrality expenditure limit is calculated for each EG described as follows: An annual EG estimate must be calculated as a product of the number of eligible member months reported by the Commonwealth under section XIII, STC 91 105 for each EG, including the hypothetical populations, times the appropriate estimated per member/per month (PMPM) costs from the tables in STCs 109, 110 and 111 123-126 below, and summing the results of those calculations. The annual limits will then be added together to obtain a budget neutrality limit for the entire demonstration period; Starting in SFY 2006, actual expenditures for the CommonHealth EG will be included in the expenditure limit for the Commonwealth. The amount of actual expenditures to be included will be the lower of the trended baseline CommonHealth costs, or actual CommonHealth per member per most cost experience for SFYs 2018-2022; The amount of actual expenditures included will be the lower of the trended baseline costs, or actual per member per most cost experience for each eligibility group in SFYs 2018-2022; Historical PMPM costs used to calculate the budget neutrality expenditure limit in prior demonstration periods are provided in Attachment D. Limit B. The Commonwealth’s annual DSH allotment.