PRA Summary of Modifications to DRA Preprints

Summary of Modifications to DRA Preprints

Section 6083 NEMT Preprint

APPROVED PREPRINT SECTION	REVISED PREPRINT
a 1. Transportation	Requested State describe emergency and non brokered NEMT separately
	Made preprint exclusive to Brokered Transportation
	Added space to insert description of how the brokerage program operates and requested State to describe interagency or cooperative agreements with other Agencies or programs
(4) categorically needy mandatory populations	Updated list
(5) categorically needy optional populations	Updated list
	Added question (B)asking who will pay the transportation provider
	Added question (C) asking what is the source of the non-Federal share
	(D) Added attestation that State assures no agreement exists between State or any form o local government and the transportation broker to return or redirect payments back to State or form of local government.
	(E) Added attestation that State assures that payments proposed under this SPA will be made directly to transportation providers and are fully retained by the provider and not agreement exists between the State or local government and the provider to return or redirect payments back to State or local government
	(7 & 8) Added option to check that The broker is a non-governmental entity and is not a provider of transportation or the broker does provide transportation and exceptions that apply
	(8) Added option for State to check the the broker is a governmental entity and the reason/exception that would allow the broker to provide transportation

Section 6044 Benchmark Preprint

APPROVED PREPRINT SECTION	REVISED PREPRINT
Authority Citation	3.1C clarified Citation
	Added place to indicate Title of Alternative Benefit Plans
Mandatory Populations	Mandatory Populations - added more clarity by expanding information and providing a chart for the state to complete that clearly indicates the mandatory population.
Opt in Populations	Added more clarity by expanding information and providing a chart for the state to complete that clearly indicates the opt-in populations
Description of State Employee Benefits	Included space to either provide a URL link to State Employee benefit site or list the benefits.
Description of Managed Care Benefits	Included space to either provide a URL link to Managed Care Benefits or list the benefits
Benchmark Equivalent Benefits	Shortened description of assurances but also requested State to include other appropriate preventive services including emergency services and family planning services. Added request for

Attachment 4.18-F Cost Sharing

APPROVED PREPRINT SECTION	REVISED PREPRINT
Pages 1-3,	Deleted information related to individuals with family income at or below 100 percent FPL since section 1916A of the Act specifies that a State may not propose alternative cost sharing for them. A State may only propose nominal cost-sharing under section 1916 for this population, using Attachments 4.18 A – E.
Pages 4 and 6	Deleted the lists of populations and services excluded from payment of premiums and cost sharing and, instead, specified the citation of the Social Security Act with those exclusions. This was done so that the pre-print pages will not need to be revised every time the statutory exclusions are changed, such as with the Recovery Act’s exclusion of certain Indians from payment of premiums and cost sharing. A State may use the pre-print to specify additional exclusions. Other revisions were made for clarity and for consistency with section 1916A of the Act.

Attachment 4.18-G

Page 1 under section B	Included language from the proposed revised final rule that clarifies the circumstances under which alternative cost sharing under section 1916A of the Act may be charged for drugs, rather than nominal cost sharing under section 1916.
Pages 2 and 3	Deleted the list of populations or services for which cost sharing for non-preferred drugs may be waived or reduced and the list of populations or services for which cost sharing for preferred drugs may not be charged. Added the citation of the Social Security Act with those lists. This was done so that the pre-print pages will not need to be revised every time the statutory exclusions are changed, such as with the Recovery Act’s exclusions of certain Indians from payment of cost sharing. A State may use the pre-print to specify additional exclusions.
	Other revisions were made for clarity and for consistency with section 1916A of the Act.

Attachment 4.18-H

No substantive changes. Revisions were made for clarity and for consistency with section 1916A of the Act.

Citizenship – No preprint required.