Form CMS 37.3 CMS 37.3 Medicaid Program Budget Report

CMS 37.3

State: Massachusetts

Medicaid Program Budget Report
Estimated Medical Assistance by Type of Service (In Thousands)
Total Budgeted Services FY 2017
Total Computable
Federal Share
Type of Service
(A)
(B)
1A) Inpatient Hospital / Regular Payment
1,004,960
502,803
1B) Inpatient Hospital / DSH Adj. Payment
0
0
1C) Inpatient Hospital / Supplemental Payments
1,093,786
546,893
1D) Inpatient Hospital - GME Payments
0
0
84,082
2A) Mental Health / Regular Payment
168,159
2B) Mental Health / DSH Adj. Payment
0
0
2C) Certified Community Behavioral Health Clinic Payments
65.00%
2,000
1,300
4A) Int. Care Facility - Ind. with Intellectual Disabilities: Public
Pmnts
132,285
66,143
4B) Int. Care Facility - Ind. with Intellectual Disabilities: Priv.
Pmnts
0
0
4C) Int. Care Facility - Ind. with Intellectual Disabilities: Suppl.
Pmnts
0
0
179,591
5A) Physician and Surgical / Regular Payments
354,752
5B) Physician and Surgical / Supplemental Payments
28,000
14,000
5C) Physician & Surgical Services - Evaluation and Management
5D) Physician & Surgical Services - Vaccine codes
6A) Outpatient Hospital / Regular Services
6B) Outpatient Hospital / Supplemental Services
7) Prescribed Drugs
7A1) Drug Rebate / Natl. Agreement
7A2) Drug Rebate / State Agreement
7A3) MCO - National Agreement
7A4) MCO - State Sidebar Agreement
7A5) Increased ACA OFFSET - Fee for Service - 100%
7A6) Increased ACA OFFSET - MCO - 100%
8) Dental Services
9A) Other Practitioners' Services / Regular Payment
9B) Other Practitioners' Services - Suppl. Payment
10) Clinic Services
11) Lab/Radiological Services
12) Home Health Services
13) Sterilizations
14) Abortions
15) EPSDT Screenings
16) Rural Health Clinic
17A) Medicare HIP / Part A Prem.
17B) Medicare HIP / Part B Prem.
17C1) Medicare Qual Individuals 120%-134% Poverty
17D) Medicare HIP / Coinsurance
18A) Medicaid HIP / MCO
18A1) Medicaid MCO - Evaluation and Management
18A2) Medicaid MCO - Vaccine codes
18A3) Medicaid MCO - Community First Choice
18A4) Medicaid MCO - Preventive Services Grade A OR B, ACIP
Vaccines and their Admin
18A5) Medicaid MCO - Certified Comm Behavioral Health Clinic
Paym 65.00%
18B1b) MCO PAHP - Vaccine codes
18B1c) MCO PAHP - Community First Choice
18B1d) MCO PAHP - Preventive Services Grade A OR B, ACIP
Vaccines and their Admin
18B1e) MCO PAHP - Certified Comm Behavioral Health Clinic

Submission Date: 2/15/2017
Total Budgeted Services FY 2018
Total Computable
Federal Share
(C)
(D)
1,025,658
513,109
0
0
427,750
213,875
0
0
175,396
87,698
0
0
1,000

650

112,740

56,370

0

0

0
294,870
28,000

0
149,977
14,000

8,570
24
573,186
693,595
679,202
-500,500
0
0
0
0
0
258,193
21,131
0
184,851
20,416
613,110
1,447
0
17,978
0
123,585
292,615
10,296
0
5,893,172
0
0
0

4,285
12
287,381
346,797
345,906
-250,250
0
0
0
0
0
129,102
10,682
0
95,561
10,258
306,571
1,156
0
9,118
0
61,793
146,307
10,296
0
3,554,086
0
0
0

17,140
48
601,736
318,550
679,413
-521,000
0
0
0
0
0
254,870
15,554
0
180,850
18,698
652,681
35
0
19,465
0
123,101
293,099
10,265
0
5,945,107
0
0
0

8,570
24
301,739
159,275
346,733
-260,500
0
0
0
0
0
127,443
7,826
0
95,260
9,419
326,369
18
0
9,886
0
61,550
146,550
10,265
0
3,616,053
0
0
0

0

0

0

0

2,000
0
0

1,300
0
0

1,000
0
0

650
0
0

0

0

0

0

CMS 37.3

State: Massachusetts

Medicaid Program Budget Report
Estimated Medical Assistance by Type of Service (In Thousands)
Total Budgeted Services FY 2017
Total Computable
Federal Share
Type of Service
(A)
(B)
Paym 65.00%
2,000
1,300
18B2b) MCO PIHP - Vaccine codes
0
0
18B2c) MCO PIHP - Community First Choice
0
0
18B2d) MCO PIHP - Preventive Services Grade A OR B, ACIP
Vaccines and their Admin
0
0
18B2e) MCO PIHP - Certified Comm Behavioral Health Clinic
Paym 65.00%
2,000
1,300
18E) Medicaid HIP / Other
0
0
19A) Home-Comm Serv/Regular Payment (Waiver)
1,516,301
758,150
19B) Home-Comm Serv/State Pl 1915(i) Only Payment
0
0
19C) Home-Comm Serv/State Pl 1915(j) Only Payment
19D) Home & Community Based Services State Plan 1915(k)
Community First Choice
22) All-Inclusive Care for Elders
23A) Personal Care / Regular Payments
23B) Personal Care / SDS 1915(j)
24A) Targeted Case Mgmt. / Community Case-Mgmt.
24B) Case Mgmt. / State Wide
25) Primary Care Case Mgmt. Services
26) Hospice Benefits
27) Emeg. Service Undoc. Aliens
28) Federally Qual. Health Center
29) Non-Emergency Medical Transportation
30) Physical Therapy
31) Occupational Therapy
32) Services for Speech, Hearing and Language
33) Prosthetic Devices, Dentures, Eyeglasses
34) Diagnostic Screening & Preventive Services
34A) Preventive Services Grade A OR B, ACIP Vaccines and their
Admin
35) Nurse Mid-Wife
36) Emergency Hospital Services
37) Critical Access Hospitals
38) Nurse Practitioner Services
39) School Based Services
40) Rehabilitative Services (non-school-based)
41) Private Duty Nursing
42) Freestanding Birth Center
43) Health Home for Enrollees w Chronic Conditions
44) Tobacco Cessation for Preg Women
49) Other Care Services
50) Subtotal
51) Collections
52) Prior Period Adjustments
53) Total Medicaid (non-M-CHIP)
54) M-CHIP Expansions
55) Total Medicaid

Submission Date: 2/15/2017
Total Budgeted Services FY 2018
Total Computable
Federal Share
(C)
(D)
1,000
650
0
0
0
0
0

0

1,000
0
1,337,563
0

650
0
668,781
0

0

0

0

0

0
149,800
1,134,121
0
105,261
0
0
101,819
45,147
0
0
0
0
3,486
13,765
0

0
74,900
567,074
0
52,631
0
0
50,915
22,574
0
0
0
0
1,743
6,882
0

0
149,800
1,118,950
0
90,007
0
0
101,810
45,662
0
0
0
0
5,686
20,429
0

0
74,900
559,494
0
45,004
0
0
50,912
22,831
0
0
0
0
2,843
10,214
0

0
587
0
0
5,103
100,536
357,823
3,592
0
0
0
1,108,957
18,212,957
-163,056
-64,316
17,985,585
282,375
18,267,960

0
294
0
0
2,552
50,268
178,912
1,796
0
0
0
554,486
9,778,577
-81,528
-32,158
9,664,891
248,490
9,913,381

0
878
0
0
7,032
105,318
362,085
2,361
0
0
0
991,557
16,934,429
-186,278
880
16,749,031
287,067
17,036,098

0
439
0
0
3,516
52,659
181,042
1,181
0
0
0
495,783
9,180,365
-93,139
440
9,087,666
252,619
9,340,285