SCHEDULE OF STATE DELIVERABLES DURING THE DEMONSTRATION Clause Samples

The "Schedule of State Deliverables During the Demonstration" clause defines the timeline and specific requirements for the state to submit reports, data, or other materials as part of a demonstration project. It typically outlines what deliverables are expected, the deadlines for each, and the format or method of submission. For example, the state may be required to provide quarterly progress reports, financial statements, or evaluation data at set intervals. This clause ensures accountability and transparency by clearly setting expectations for deliverables, helping both parties track progress and compliance throughout the demonstration period.
SCHEDULE OF STATE DELIVERABLES DURING THE DEMONSTRATION. Date Deliverable
SCHEDULE OF STATE DELIVERABLES DURING THE DEMONSTRATION. Timeline Deliverable STC Reference
SCHEDULE OF STATE DELIVERABLES DURING THE DEMONSTRATION. The state is held to all reporting requirements outlined in the STCs; this schedule of deliverables should serve only as a tool for informational purposes only. September 30, 2015 Complete Demonstration Extension Application (1115) and interim evaluation report March 31, 2016 Submit Interim Evaluation Report - Paragraph 30 August 1, 2016 Final Evaluation Report – Paragraph 31; Final Report - Paragraph 40. End of Demonstration Period. Monthly Deliverables Monthly call – Paragraph 36 Quarterly Deliverables Requirements for Quarterly Reports – Paragraph 37 Quarterly Budget Neutrality Reports – Paragraph 35 Expenditure Reports CMS 64 and CMS 21 - Paragraph 44 and Paragraph 54 Member Months Report – Paragraph 46 Annual Deliverables Requirement for Annual Report – Paragraph 38 Requirement for annual HCBS Report on March 31st – Paragraph 22 (h)(iii) Comparison of Costs for the DES Interagency Agreement, including how any excess revenues are spent, and for ADHS/BHS. Both reports will be due by January 15 – Paragraph 58 (b) As written in STC paragraph 37, the state is required to submit quarterly progress reports to CMS. The purpose of the quarterly report is to inform CMS of significant demonstration activity from the time of approval through completion of the demonstration. The reports are due to CMS 30 days after the end of each quarter. The following report guidelines are intended as a framework and can be modified when agreed upon by CMS and the state. A complete quarterly progress report must include the budget neutrality monitoring workbook. An electronic copy of the report narrative and the Microsoft Excel budget neutrality monitoring workbook is provided. Example: Demonstration Year: 5 (5/01/04 - 4/30/05) Federal Fiscal Quarter: 4/2004 (7/04 - 9/04) Information describing the goal of the demonstration, what it does, and key dates of approval /operation. (This should be the same for each report.) Please complete the following table that outlines all enrollment activity under the demonstration. The state should indicate “N/A” where appropriate. If there was no activity under a particular enrollment category, the state should indicate that by “0”. Population Groups (as hard coded in the CMS 64) Current Enrollees (to date) No. Voluntary Disenrolled in current Quarter No. Involuntary Disenrolled in current Quarter Population 1 – AFDC / SOBRA Cumulative Number of Voluntary Disenrollments Within Current Demonstration Year: Reasons for Voluntary Disenrollments: Cu...
SCHEDULE OF STATE DELIVERABLES DURING THE DEMONSTRATION. The state is held to all reporting requirements outlined in the STCs; this schedule of deliverables should serve only as a tool for informational purposes only. September 30, 2015 Complete Demonstration Extension Application (1115) and interim evaluation report March 31, 2016 Submit Interim Evaluation Report - Paragraph 30 August 1, 2016 Final Evaluation Report – Paragraph 31; Final Report - Paragraph 40. End of Demonstration Period. Monthly Deliverables Monthly call – Paragraph 36 Quarterly Deliverables Requirements for Quarterly Reports – Paragraph 37 Quarterly Budget Neutrality Reports – Paragraph 35 Expenditure Reports CMS 64 and CMS 21 - Paragraph 44 and Paragraph 54 Member Months Report – Paragraph 46 Annual Deliverables Requirement for Annual Report – Paragraph 38 Requirement for annual HCBS Report on March 31st – Paragraph 22 (h)(iii) Comparison of Costs for the DES Interagency Agreement, including how any excess revenues are spent, and for ADHS/BHS. Both reports will be due by January 15 – Paragraph 58 (b) Section 1115 demonstrations are valued for information on health services, health services delivery, health care delivery for uninsured populations, and other innovations that would not otherwise be part of Medicaid programs. CMS encourages states with demonstration programs to conduct or arrange for evaluations of the design, implementation, and/or outcomes of their demonstrations. The CMS also conducts evaluation activities. The CMS believes that all parties to demonstrations; states, Federal Government, and individuals benefit from state conducted self-evaluations that include process and case-study evaluations— these would include, but are not limited to: 1) studies that document the design, development, implementation, and operational features of the demonstration, and 2) studies that document participant and applicant experiences that are gathered through surveys, quality assurance activities, grievances and appeals, and in-depth investigations of groups of participants and applicants and/or providers (focus groups, interviews, other). These are generally studies of short-term experiences and they provide value for quality assurance and quality improvements programs (QA/QI) that are part of quality assurance activities and/or demonstration refinements and enhancements. Benefit also derives from studies of intermediate and longer-term investigations of the impact of the demonstration on health outcomes, self-assessments of health status, an...
SCHEDULE OF STATE DELIVERABLES DURING THE DEMONSTRATION. Date Deliverable TITLE Title Line One – Arizona Health Care Cost Containment System -- AHCCCS, A statewide Approach of Cost Effective Health Care Financing Title Line Two - Section 1115 Quarterly Report Demonstration/Quarter Reporting Period: INTRODUCTION: ENROLLMENT INFORMATION: Note: Enrollment counts should be person counts, not participant months. Population 2 - SSI Population 3 – ALTCS DD Etcetera Outreach/Innovative Activities: Operational/Policy Developments/Issues: Financial/Budget Neutrality Developments/Issues: Consumer Issues: Quality Assurance/Monitoring Activity: ESI Issues (through December 31, 2013): Family Planning Extension Program (through December 31, 2013: Enclosures/Attachments: State Contact(s): Date Submitted to CMS: Eligibility Requirements 1. The hospital has a Medicaid Inpatient Utilization Rate (MIUR) which is at least one standard deviation above the mean MIUR for all hospitals receiving a Medicaid payment in the state (“Group 1”) 1. The hospital has at least two (2) obstetricians who have staff privileges at the hospital and who have agreed to provide obstetric services to Medicaid patients 2. The hospital is outside a Metropolitan Statistical The hospital has an MIUR of at least 1 percent A. The hospital meets all of the requirements of 1 above (Group 1) and is a privately owned or privately operated hospital licensed by the state of Arizona (“Group 1A”) 2. The hospital has a Low Income Utilization Rate (LIUR) that exceeds 25% (“Group 2”) 2.A. The hospital meets all of the requirements of 2 above (Group 2) and is a privately owned or privately operated hospital licensed by the state of Arizona (“Group 2A”) 3. The hospital is a governmentally- operated hospital (“Group 4”) Area and has at least two (2) physicians with staff privileges to perform non-emergency obstetric procedures 3. The patients of the hospital are predominantly under 18 years of age 4. The hospital was in existence on December 22, 1987 but did not offer non-emergency obstetric services as of that date Notice that within Column A, there are six group numbers assigned. Group 1 and Group 2 contain those hospitals that are “deemed” to be DSH hospitals under federal Medicaid law. Group 1A, Group 2A, and Group 4 contain additional hospitals that the state has designated to be DSH hospitals within its federal authority to do so. The criteria listed in Columns B and C are federal eligibility requirements which apply regardless of whether or not the hospital is deemed ...
SCHEDULE OF STATE DELIVERABLES DURING THE DEMONSTRATION. Timeline Deliverable STC Reference State Name of Demonstration Section 1115 Quarterly Report Demonstration Year, Quarter X Fiscal Quarter Date Submitted

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