CMS-37.11V Category Specific Variances in Estimates

Medicaid Program Budget Report, and Supporting Regs.

CMS37_11V.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

Category-Specific Variances in Estimates

Between Submissions, Fiscal Years and Base Year

(Dollars In Thousands)




















Total Computable



Previous Budget Submission
Current Budget Submission
Changes From Previous Budget Submission
Changes Between Fiscal Years

Base Year Submission Date:
Submission Date:
FY(1) FY(2)
From Base Year to FY(1) From FY(1) to FY(2)

Expenditures FY (1) FY(2)
FY(1) FY (2)
Dollars Percent Dollars Percent
Dollars Percent Dollars Percent

Service Category A B C
D E
F G H I
J K L M
1 Family Planning















2.A. Design, Development or Installation MMIS - In-house















2.B. Design, Development or Installation MMIS - Contract















2.C. Design, Development or Installation MMIS - Drug Claims System















3. Skilled Professional Medical Personnel















4.A. Operation of Approved MMIS - In-house















4.B. Operation of Approved MMIS - Contract















5.A Non-MMIS Systems - In-house















5.B. Non-MMIS Systems Contract















6. Peer Review Organizations















7.A. TPL Billing Offset















7.B. Assignment of Rights Billing Offset















8. Immigration Status Verification System















9. Nurse Aide Training and Competency Evaluation Programs















10 Preadmission Screening Costs















11. Resident Review Activities















12. Drug Use Review Program















13. Outstationed Eligibility Workers















14. TANF Base Allocation















15. TANF Secondary Allocation - 90%















16. TANF Secondary Allocation - 75%















17. External Quality Reviews















18. Enrollment Brokers















19. Other















20. Subtotal















21. Collections and Other Adjs















22. Total As Reported By State




































Form CMS-37.11V













Report Date:
File Typeapplication/vnd.ms-excel
AuthorMBES-CBES
Last Modified ByCMS
File Modified2005-04-11
File Created2005-01-27

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