State User Budget Neutrality Playbook
Populate
Workbook w/ Actuals/ Projected
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Beginning in 2018, CMS is starting to adopt usage of a Budget Neutrality Workbook to standardize how all states provide budget neutrality information. Standardized information makes it possible for CMS to develop future budget neutrality reports with consolidated and standardized information. Instead of a time-consuming process to extract this information from deliverable reports, the data is readily available in a consistent format. The Budget Neutrality Workbook allows CMS and the state to review a summary of the total costs associated with Medicaid Eligibility Groups for an 1115 demonstration. The workbook compares the actual costs associated with a demonstration (the With Waiver scenario) and the projected costs if the demonstration was not in place (the Without Waiver scenario) and calculates the variance. The workbook – which is an Excel file - will start to be rolled out to selected demonstrations beginning in 2018. Before a demonstration is confirmed to use the template, impacted State Users must receive training. This playbook can be used by a State User as a reference about both the process and the specific tasks for which a State User is responsible.
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When certain trigger events occur related to Budget Neutrality deliverables, e-mail notifications are automatically sent by the PMDA system to the points of contact identified for a demonstration. There are additional non-Budget Neutrality trigger events that send e-mails but these events are not listed below. |
Table 4: Trigger Events for Budget Neutrality (BN) Related E-mail Notifications
Trigger Event |
E-mail Sent to |
Copied to |
A new Budget Neutrality Workbook template has been uploaded by CMS |
State Points of Contact |
Project Officer Backup PO Technical Director |
The State submitted a Deliverable type=Budget Neutrality Report for CMS review |
Project Officer |
Backup PO PO/Financial Lead PO/Monitoring Lead Technical Director |
After Budget Neutrality functionality is turned on for a demonstration, the State submitted a Budget Neutrality Report for CMS Review. During upload of the Budget Neutrality Workbook, non-critical errors were identified that were not resolved by the State. |
Project Officer |
Backup Project Officer Technical Director PO/Financial Lead PO/Monitoring Lead |
CMS has reviewed a submitted Deliverable type=Budget Neutrality Report and accepted the deliverable |
State Points of Contact |
Project Officer ] Backup PO PO / Financial Lead PO/ Monitoring Lead Technical Director |
CMS has reviewed a submitted Deliverable type=Budget Neutrality Report and requested resubmission of the deliverable |
State Points of Contact |
Backup PO PO/ Financial Lead PO/ Monitoring Lead Technical Director |
For a deliverable type=Budget Neutrality Report, the state submitted an override request for CMS review |
Project Officer |
Backup PO PO/ Financial Lead PO/ Monitoring Lead Technical Director |
For a deliverable type=Budget Neutrality Report, CMS has reviewed a state override request and the CMS determination was Resubmission Required |
State Points of Contact |
Project Officer & Backup PO PO/Monitoring Lead PO/Financial Lead Technical Director |
For a deliverable type=Budget Neutrality Report, CMS has reviewed a state override request and the CMS determination was Accepted |
State Points of Contact |
Project Officer & Backup PO PO/Monitoring Lead PO/Financial Lead Technical Director |
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Project Officers and Regional Offices must approve and upload the BN Workbook template before it is available for download. If the download link is not visible on the Deliverables page, the BN Workbook template has not yet been uploaded. A State User receives an email notification whenever a new template is uploaded for a specific demonstration. A State User must download the template and follow the instructions on each tab to populate the file with the latest quarterly actual and projected data. The populated template is considered a Budget Neutrality Workbook. For future BN Workbook submissions, a State User can either open the same BN Workbook file and populate it with information for the current quarter and DY or can elect to download the uploaded BN Workbook template and add the new information to the downloaded template. When a demonstration has been amended or renewed, a Project Officer should update the BN Workbook template and upload the new BN Workbook template. State Users receive an email and should download the updated template and populate that version for future submissions.
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Table 2 describes all the tabs in the Budget Neutrality Workbook including those a State User is responsible for populating. The Overview tab contains instructions about each tab. There are three types of tabs in the workbook:
A Project Officer validates information on the blue and green tabs which are initially populated by the PMDA Help Desk. The PMDA Help Desk will also do an initial population of the C Report tab which is a red tab. |
Table 2: Budget Neutrality Workbook Template Tab Names
Tab Name |
Description |
Source and Responsible Role |
Overview |
Contains a description of each tab and instructions on how to populate data. |
n/a |
DY Def (Demonstration Year Definitions) |
Validate that the DY Start and End dates align with the demonstration’s period of performance including renewals. Note: the dates for all the demonstration’s DYs are entered on this tab. |
Source: STC Project Officer Regional Office |
MEG Def (Medicaid Eligibility Groups Definitions) |
proper categories (such as Medicaid per Capita or Medicaid Aggregate), and that the correct properties have been selected. If a MEG needs to be placed under a different category or a new MEG needs to be added, please work with the Help Desk on this change. Properties: Properties for each MEG can be easily changed, in most cases using dropdown menus. Let’s review each column.
Column Savings Phase Down – Validate if the MEG uses a Savings Phase down approach. Only the MEGs in the Medicaid Per Capita category are candidates. Note: if a MEG uses a Savings phase down approach, you need to ensure that the Summary TC tab reflects the correct phase down percentages. |
Source: STC Project Officer Regional Office |
MEG Def (Medicaid Eligibility Groups Definitions) (continued) |
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WOW PMPM & Agg (WithOut Waiver Per Member Per Month and Aggregate) |
Validate the projected PMPM values for the DYs based on the STC and make corrections if necessary. |
Source: STC Project Officer Regional Office |
Program Spending Limits |
Validate the expenditure caps for the demo’s programs together with the MEGs that are subject to the program’s expenditure cap. |
Source: STC Project Officer Regional Office |
C Report |
Copy and paste information from Schedule C of the CMS 64 Expenditure Report to the appropriate section of the Budget Neutrality workbook. This information adds actual expenditures, by MEG, by demonstration year to the workbook. Update the fields at the top of the page. NOTE: It is very important that a State User copy and paste C Report information in the exact location identified in the BN workbook, as this drives calculations on other tabs within the workbook. |
Source: CMS-64 C Report State User |
C Report Grouper |
Validate that the correlations between a waiver MEG from the C Report and the defined MEG is correct. The PO should also identify if any additional MEGs should be brought over. |
Source: STC Project Officer Regional Office |
Total Adjustments |
When adjustments are relevant for a demonstration, enter the actual numbers of total contributions to the reported expenditures, per each MEG, for the reporting quarter. Add new reported adjustments to any existing numbers for previous quarters for the reporting quarter. Update the fields at the top of the page. Note: Any adjustments that reduce expenditures must be entered as negative numbers (for example, -$10,000). |
Source: Actuals State User |
WW Spending Actual (With Waiver Spending Actual) |
Using data entered by the Project Officer and State User, calculates With Waiver Spending costs, by MEG, by demonstration year. Calculations are broken out between Total Computable and Federal Share costs.
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Calculated |
WW Spending Projected (With Waiver Spending Projected) |
Populate the forecasted spending costs at the per capita and aggregate level, by MEG, by demonstration year. Forecasts are provided at both the Total Computable and Federal Share levels. For each reporting quarter, update the projected numbers so they reflect only future quarter projections. Update the fields at the top of the page.
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Source: Actuals State User |
WW Spending Total (With Waiver Spending Total) |
Using data entered by the Project Officer and State User, calculates Total With Waiver Spending costs, summing actuals to projections. Totals are provided by MEG, by demonstration year. |
Calculated |
MemMon Actual (Member Month Actual) |
Populate actual member months (number of beneficiaries times the number of enrolled months) for quarters to date for each active DY. For the reporting quarter, add the actual number of member months per each MEG to the previous actual number. The number should equal the total of ALL actual member months. MEGs are auto-populated from the MEG Def tab. DYs are auto-populated from the DY Def tab. Update the fields at the top of the page. |
Source: Actuals State User |
MemMon Projected (Member Month Projected) |
Enter projected number of member months for each active DY per MEG for the demonstration. Forecasts are only collected for MEG and Hypothetical MEGs. For the current DY, enter only the number that reflects future quarters. MEGs are auto-populated from the MEG Def tab. DYs are auto-populated from the DY Def tab. Update the fields at the top of the page. |
Source: Actuals State User |
MemMon Total (Member Month Total) |
Using data entered by the Project Officer and State User, calculates Total Member Months, summing actuals to projections. Totals are provided by MEG, by demonstration year. |
Calculated |
Summary TC (Summary Total Computable) |
On the Summary TC tab, information is consolidated from all tabs. WW and WOW numbers are compared to determine the budget neutrality status of the demonstration.
To be validated by Project Officers:
To be validated by State Users:
To change the expenditure information that displays:
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Source: STC (for Savings Phase Down %) Project Officer Regional Office State User |
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After a State User has populated a Budget Neutrality Workbook with actual and projected information, they need to submit the Workbook for CMS review. They upload the Workbook to a Budget Neutrality Report deliverable type and change the status to Ready for CMS Review. During upload, the 1115 PMDA system validates the Workbook by performing several checks. If there are critical issues identified, the State User must correct these issues. If there are non-critical errors identified, the State User has the option to override (or ignore) these errors. The Project Officer can review non-critical errors during their review of the deliverable. When a State User is not able to provide an updated Budget Neutrality Workbook file for a Budget Neutrality Report deliverable type, the State User can request an override of the budget neutrality requirement. The PO is notified of the override request and can either accept the override request or request resubmission meaning the State User must upload a Budget Neutrality Workbook for the deliverable. To upload a Workbook to a deliverable and submit the deliverable for CMS review:
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Table 3 describes the critical and non-critical errors that may be identified by the PMDA system. If the error is based on data in a specific tab, the Tab column identifies the tab name. The Error Trigger column identifies the trigger for the error. The Error Message Text column identifies the error that is displayed to both the state user and Project Officer. |
Table 3: Critical and Non-Critical Validation Errors
Error Type |
Tab |
Error Trigger |
Error Message Text |
Critical |
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The uploaded Workbook file is not in the correct file format. |
The uploaded file is not in the .xlsm format. |
Critical |
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The Document ID associated with the uploaded template does not match the Document ID associated with the submitted Budget Neutrality Workbook. |
There may be a mismatch with the version of the BN workbook that is being used. Please ensure that you are using the most current version. If this problem persists, please reach out to the PMDA Help Desk. |
Critical |
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No active BN Template is available in PMDA for the demonstration |
A Budget Neutrality template is not currently uploaded for this demonstration. Please contact the PMDA Help Desk.
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Critical |
C Report |
Waiver data is not pasted into correct location. Cells A100 and A200 should have value = 'Waiver Name'. |
C Report tab - Data is not pasted correctly. Please refer to the instructions on the tab. |
Critical |
C Report |
The 'Reporting DY' value is blank. |
C Report tab - Reporting DY value is missing. |
Critical |
C Report |
The 'Reporting Quarter' value is blank. |
C Report tab - Reporting Quarter value is missing. |
Non-Critical |
C Report |
The value for the 'Total Less Non-Adds' field of the MAP Waiver Total Computable section is the same as that from the last submitted workbook. Ignored if this is the first workbook submission. |
C Report tab - The total actual expenditures entered for the current reporting period this matches the total from previous submission. Please confirm that the workbook you are submitting contains data from current C Report. |
Non-Critical |
C Report |
'Last Updated:' field is blank |
C Report tab - 'Last Updated:' field is blank |
Non-Critical |
C Report |
'Last Updated By:' field is blank |
C Report tab - 'Last Updated By:' field is blank |
Non-Critical |
C Report |
'Data Pulled On:' field is blank |
C Report tab - 'Data Pulled On:' field is blank |
Non-Critical |
C Report |
'For the Time Period Through:' field is blank |
C Report tab - 'For the Time Period Through:' field is blank |
Critical |
C Report |
Expenditure data is present for DY(s) that extend beyond the Reporting DY |
C Report tab –What has been entered includes data for one or more demonstration years that exceed the entered Reporting DY. Please ensure that data is being reported for the correct demonstration years. |
Critical |
MemMon Actual |
Data entry field(s) contains a non-numerical value |
MemMon Actual tab - Numerical fields contain non-numerical values |
Non-Critical |
MemMon Actual |
'Last Updated:' field is blank |
MemMon Actual tab - 'Last Updated:' field is blank |
Non-Critical |
MemMon Actual |
'Last Updated By:' field is blank |
MemMon Actual tab - 'Last Updated By:' field is blank |
Non-Critical |
MemMon Actual |
'Data Pulled On:' field is blank |
MemMon Actual tab - 'Data Pulled On:' field is blank |
Non-Critical |
MemMon Actual |
'For the Time Period Through:' field is blank |
MemMon Actual tab - 'For the Time Period Through:' field is blank |
Critical |
MemMon Projected |
Data entry field(s) contains a non-numerical value |
MemMon Projected tab - Numerical fields contain non-numerical values |
Non-Critical |
MemMon Projected |
Projected values for any MEG for the current Demonstration Year (DY) is equal to the value provided in the prior submitted workbook. Ignored if this is the first workbook submission. |
MemMon Projected tab - Projected number for [MEG name] for the current demonstration year is unchanged since last deliverable submission. Please confirm that the projected number is entered correctly. |
Non-Critical |
MemMon Projected |
Values are present for a past DY for any MEG |
MemMon Projected tab - [MEG name] shows projected numbers for a preceding demonstration year. |
Non-Critical |
MemMon Projected |
'Last Updated:' field is blank |
MemMon Projected tab - 'Last Updated:' field is blank |
Non-Critical |
MemMon Projected |
'Last Updated By:' field is blank |
MemMon Projected tab - 'Last Updated By:' field is blank |
Non-Critical |
MemMon Projected |
'Data Pulled On:' field is blank |
MemMon Projected tab - Data Pulled On:' field is blank |
Non-Critical |
MemMon Projected |
'For the Time Period Through:' field is blank |
MemMon Projected tab - 'For the Time Period Through:' field is blank |
Non-Critical |
Summary TC |
1115A Dual Demonstration Savings (state preliminary estimate) amount entered for any DY is positive |
Dollar amount for '1115A Dual Demonstration Savings (state preliminary estimate)' must be negative or zero. |
Non-Critical |
Summary TC |
1115A Dual Demonstration Savings (OACT certified) amount entered for any DY is positive |
Dollar amount for '1115A Dual Demonstration Savings (OACT certified)' must be negative or zero. |
Critical |
Total Adjustments |
Data entry field(s) contains a non-numerical value |
Total Adjustments tab - Numerical fields contain non-numerical values |
Non-Critical |
Total Adjustments |
'Last Updated:' field is blank |
Total Adjustments tab - 'Last Updated:' field is blank |
Non-Critical |
Total Adjustments |
'Last Updated By:' field is blank |
Total Adjustments tab - 'Last Updated By:' field is blank |
Non-Critical |
Total Adjustments |
'Data Pulled On:' field is blank |
Total Adjustments tab - 'Data Pulled On:' field is blank |
Non-Critical |
Total Adjustments |
'For the Time Period Through:' field is blank |
Total Adjustments tab - 'For the Time Period Through:' field is blank |
Critical |
WW Spending Projected |
Data entry field(s) contains a non-numerical value |
WW Spending Projected tab - Numerical field cell XXX contain non-numerical values |
Non-Critical |
WW Spending Projected |
Projected values for any MEG for the current Demonstration Year (DY) is greater than or equal to the value provided in the prior submitted workbook. Ignored if this is the first workbook submission. |
WW Spending Projected tab - Projected number for [MEG name] for the current demonstration year is unchanged since last deliverable submission. Please confirm that the projected number is entered correctly. |
Non-Critical |
WW Spending Projected |
Values are present for a past DY for any MEG |
WW Spending Projected tab - [MEG name] shows projected numbers for a preceding demonstration year. |
Non-Critical |
WW Spending Projected |
'Last Updated:' field is blank |
WW Spending Projected tab - 'Last Updated:' field is blank |
Non-Critical |
WW Spending Projected |
'Last Updated By:' field is blank |
WW Spending Projected tab - 'Last Updated By:' field is blank |
Non-Critical |
WW Spending Projected |
'Data Pulled On:' field is blank |
WW Spending Projected tab - 'Data Pulled On:' field is blank |
Non-Critical |
WW Spending Projected |
'For the Time Period Through:' field is blank |
WW Spending Projected tab - 'For the Time Period Through:' field is blank |
Table 5: Record of Changes to this Document
Version Number |
Date |
Author/Owner |
Description of Change |
1.0 |
2/22/2018 |
C. Thomas |
Includes 2 new dual demo fields State User may populate on the Summary TC tab |
1.1 |
3/13/2018 |
C. Thomas |
Added the new critical error & hyperlinks on the front page |
1.2 |
3/22/2018 |
C. Thomas |
Added ML/FL roles to process descriptions and to role table, added data entry done by State User on the Summary TC tab, added how to change the DYs that display on the Summary TC tab, Updated email and trigger events based on BN redesign and including FL/ML |
1.3 |
4/19/2018 |
C. Thomas |
Updated PMDA submission screens with redesign for BN functionality |
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | Customer Interaction Framework |
Author | Susan Hendrich |
File Modified | 0000-00-00 |
File Created | 2021-01-21 |