Common use of Enforcement of Budget Neutrality Clause in Contracts

Enforcement of Budget Neutrality. CMS will enforce budget neutrality over the life of the Demonstration, rather than annually. However, no later than 6 months after the end of each DY, or as soon thereafter as data are available, the State will calculate annual expenditure targets for the IPC component of the Demonstration for the completed year. This amount will be compared with the actual claimed FFP for Medicaid. Using the schedule below as a guide, if the State exceeds these targets, it will submit a corrective action plan to CMS for approval. The State will subsequently implement the corrective action plan. Year Cumulative Target Expenditures Percentage 2011 DY 1 budget limit amount +4 percent 2012 DY 1 and 2 combined budget limit amount +2 percent 2013 DYs 1 through 3 combined budget limit amount +0 percent

Enforcement of Budget Neutrality. CMS will enforce budget neutrality over the life of the Demonstration, rather than annually. However, no later than 6 months after the end of each DY, DY or as soon thereafter as the data are available, the State will calculate annual expenditure targets for the IPC component of the Demonstration for the completed year. This amount will be compared with the actual claimed FFP for Medicaid. Using the schedule below as a guide, if the State exceeds these targets, it will submit a corrective action plan to CMS for approval. The State will subsequently implement the approved corrective action plan. Year Cumulative Target Expenditures Percentage 2011 DY 1 budget limit amount +4 percent 2012 DY 1 and 2 combined 7 budget limit amount +2 percent DY 2013 DYs 1 7 through 3 combined 8combined budget limit amount +0 percent

Enforcement of Budget Neutrality. CMS will enforce budget neutrality over the life of the Demonstration, rather than annually. However, no later than 6 months after the end of each DY, or as soon thereafter as data are available, the State will calculate annual expenditure targets for the IPC component of the Demonstration for the completed year. This amount will be compared with the actual claimed FFP for Medicaid. Using the schedule below as a guide, if the State exceeds these targets, it will submit a corrective action plan to CMS for approval. The State will subsequently implement the corrective action plan. Year Cumulative Target Expenditures Percentage 2011 DY 1 budget limit amount +4 percent 2012 DY 1 and 2 combined budget limit amount +2 percent 2013 DYs 1 through 3 combined budget limit amount +0 percentpercent WellCare Contract #0654