Crosswalk (CMS-37.10)

CMS-37 - Crosswalk (rev 4-11-2014 by OSORA PRA).xlsx

Medicaid Program Budget Report and Supporting Regs. (CMS-37)

Crosswalk (CMS-37.10)

OMB: 0938-0101

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Crosswalk for the Implementation of the Affordable Care Act of 2009 and Additional Revisions for Certification (CMS-37.10) MBES/CBES
Line #s on Current CMS-37.10 Type of Change Rational for Change
4 Eligibility Determination Staff Aministrative Expenditure Lines and 1 line for Non-Emergency Medical Transportation were added to CMS-37.10 Series
1.  Line  28.E- Eligibility DeterminationStaff- Cost of In-House
Activities.
It is a Line Item added to CMS 37.10, for Eligibility Determination Staff - Cost of In-House Activities. On Column (a) the total Computable amount of expenditures of the Cost of in house eligibility determination staff performing application, on-going case maintenance and renewal activities. The MBES will automaticallyenter in column (b) and Column (d) at 75% of Column(a). To comply with Affordable Care Act (ACA) Sections 1411.-1415
2. Line 28F-  Eligibility Determination Staff- Cost of Private
Sector Contarctor.
It is a Line Item added to CMS 37.10 for Eligibility Determination Staff - Cost of Private Sector Contractor. On Column (a) the total Computable amount of expenditures of the Cost of Private Sector Cotractor for eligibility determination staff performing application, on-going case maintenance and renewal activities. The MBES will automaticallyenter in column (b) and Column (d) at 75% of Column(a). To comply with Affordable Care Act (ACA) Sections 1411.-1415
2. Line 28G-  Eligibility Determination Staff- Cost of In-House
Activities at 50% FFP
This is a line item added to CMS 37.10 for Eligibility Staff of in house activities for performing policy, outreach and post eligibility activities. Total complutable expenditure will be reimbursable at 50%, will be automatically calculated on Columns (b) and (d). To comply with Affordable Care Act (ACA) Sections 1411.-1415
2. Line 28H-  Eligibility Determination Staff- Cost of Private
Sector Contarctor at 50% FFP
This is a line item added to CMS 37.10 for Eligibility Staff of Private Sector Contractor activities for performing policy, outreach and post eligibility activities. Total complutable expenditure will be reimbursable at 50%, will be automatically calculated on Columns (b) and (d). To comply with Affordable Care Act (ACA) Sections 1411.-1415
2. Line 29- Non-Emergency Medical Transportation This line item to identify a ride or reimbursement for a ride, provided to a Medicaid Beneficiary with no other transportation resources can receive services from a medical provider. This services will be provided on an emergency basis, such as trips to the emergency room for life threatening situation, To Comply with 42CFR431.53; 440.170; 440.170(a);
440.170(a)(4).



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