CMS-37.10 State and Local Administration

Medicaid Program Budget Report, and Supporting Regs.

CMS37_10.xls

Medicaid Program Budget Report, and Supporting Regs.

OMB: 0938-0101

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Department of Health and Human Services
















OMB No. 0938-0101

Centers for Medicare & Medicaid Services




















Medicaid Program Budget Report




State and Local Administration (In Thousands)




State:
















Submission Date:












Fiscal Year (1)



Fiscal Year (2)



State and Local Administration






Salaries and Expenses

Other Administration

FTE's Salaries and Expenses
Other Administration


FTE's






FFP
Total Comp. Fed. Share
Total Comp.
Fed. Share
Total Comp. Fed. Share Total Comp.
Fed. Share







Rates
A
B
C D E F G
H
I J
1. Family Planning



90














2. Design Develop or Install MMIS:




















A. In-house and Other State Activities



90















B. Private Sector Contractors



90















C. Drug Claims System



90














3. Skilled Professional Medical Personnel



75














4. Operation of an Approved MMIS:




















A. In-house and Other State Activities



75















B. Private Sector Contractors



75














5. Non- MMIS Systems:




















A. In-house and Other State Activities



50















B. Private Sector Contractors



50














6. Peer Review Organization



75














7. A. TPL-Billing Offset



50















B. Assignment of Rights- Billing Offset



50














8. Immigration Status System



100














9. Nurse Aide Training and Competency Evaluation Programs



50














10. Preadmission Screening Costs



75














11. Resident Review Activities



75














12. Drug Use Review Program



50














13. Outstationed Eligibility Workers



50














14. TANF Base Allocation



90














15. TANF Secondary Allocation - 90%



90














16. TANF Secondary Allocation - 75%



75














17. External Quality Reviews



75














18. Enrollment Brokers



50














19. Other Financial Participation



50














20. Subtotal (Sum of Lines 1 - 19)



















21. Collections



















22. Prior Period Adjustments



















23. Total Administration (Sum of Lines 20 - 22)









































Form CMS-37.10

















Report Date:

File Typeapplication/vnd.ms-excel
AuthorHCFA Software Control
Last Modified ByCMS
File Modified2005-04-11
File Created2001-11-19

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