| Department of Health and Human Services |
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OMB No. 0938-0101 |
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| Centers for Medicare & Medicaid Services |
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Medicaid Program Budget Report |
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Medical Assistance Payments |
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Category-Specific Variances in Estimates |
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Between Submissions, Fiscal Years and Base Year |
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(Dollars In Thousands) |
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Total Computable |
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Previous Budget Submission |
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Current Budget Submission |
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Changes in FYS From Previous Budget Submission |
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Changes Between FYS in Current Submission |
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Base Year |
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Submission Date: |
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Submission Date: |
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FY(1) |
FY(2) |
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From Base Year to FY(1) |
From FY(1) to FY(2) |
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Net Expenditures |
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FY (1) |
FY(2) |
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FY(1) |
FY (2) |
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Dollars |
Percent |
Dollars |
Percent |
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Dollars |
Percent |
Dollars |
Percent |
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Service Category |
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A |
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B |
C |
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D |
E |
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F |
G |
H |
I |
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J |
K |
L |
M |
| 1.A. |
Inpatient Hospital - Reg. Payments |
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| 1.B. |
Inpatient Hospital - DSH |
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| 2.A. |
Mental Health Facility Services - Reg. Payments |
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| 2.B. |
Mental Health Facility - DSH |
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| 3.C. |
Nursing Facility Services |
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| 4.A. |
Intermediate Care Facility - Public |
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| 4.B. |
Intermediate Care - Private |
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| 5. |
Physicians' Services |
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| 6. |
Outpatient Hospital Services |
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| 7. |
Prescribed Drugs |
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| 7.A.1 |
Drug Rebate Offset - National |
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| 7.A.2. |
Drug Rebate Offset - State Sidebar Agreement |
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| 8. |
Dental Services |
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| 9. |
Other Practitioners |
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| 10. |
Clinic Services |
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| 11. |
Laboratory/Radiological |
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| 12. |
Home Health Services |
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| 13. |
Sterilizations |
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| 14. |
Abortions |
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| 15. |
EPSDT Screening |
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| 16. |
Rural Health |
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| 17.A. |
Medicare - Part A |
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| 17.B. |
Medicare - Part B |
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| 17.C. |
Qualified Individuals |
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| 17.D. |
Coinsurance |
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| 18.A. |
Medicaid - MCO |
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| 18.B.1. |
Prepaid Ambulatory Health Plan |
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| 18.B.2. |
Prepaid Inpatient Health Plan |
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| 18.C. |
Medicaid - Group Health |
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| 18.D. |
Medicaid - Coinsurance |
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| 18.E. |
Medicaid - Other |
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| 19. |
Home and Community |
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| 20. |
Home And Community - Disabled Elderly |
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| 21. |
Community Supported Living Arrangements |
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| 22. |
All-Inclusive Care Elderly |
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| 23. |
Personal Care Services |
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| 24. |
Targeted Case Management |
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| 25. |
Primary Care Case Management |
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| 26. |
Hospice Benefits |
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| 27. |
Emergency |
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| 28. |
Federally-Qualified Health Center |
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| 29. |
Other Care Services |
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| 30. |
Subtotal |
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| 31. |
Collections and Other Adjs |
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| 32. |
Total As Reported By State |
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| Form CMS-37.4V |
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Report Date: |
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