State Children's Health Insurance Program (SCHIP) Report on Payables and Receivables (CMS-10180)

DEPARTMENT OF HEALTH & HUMAN SERVICES
Centers for Medicare & Medicaid Services
7500 Security Boulevard
Baltimore, Maryland 21244-1850

DATE:

February 28, 2020

TO:

Children’s Health Insurance Program (CHIP)/Fiscal Administrators

FROM:

Director, Division of Financial Reporting & Policy
Accounting Management Group
Office of Financial Management

SUBJECT:

Annual Survey of CHIP Payables and Receivables & Questionnaire

The Centers for Medicare & Medicaid Services (CMS) prepared its fiscal year (FY) 2018 Annual
Financial Report as required by the Public Law 103-356, (the Government Management Reform
Act of 1994), section 3515. CMS estimated 1) an accounts payable for the services rendered by
CHIP providers as of the end of the fiscal year, which have not yet been reported on the
Quarterly Statement of Medicaid Expenditures, Form CMS-21 (Medicaid program portion),
CMS-64.21U, and CMS-64.21, and 2) an accounts receivable for all amounts due to the states
from various sources, excluding the Federal Government. This estimate is referred to as
Entitlement Benefits Due and Payable or incurred but not yet reported (IBNR). IBNR payables
result from CHIP medical services incurred but not paid as of September 30, the Federal
Government’s fiscal year-end. The CHIP amount is the net of unreported expenses incurred by
the states less amounts owed to the states for overstated claims and drug rebates. CMS reported
a net estimate of $1.4 billion for FY 2018.
In April 2019, we asked each state and territory to complete Form CMS-10180, the Survey of
CHIP Payables and Receivables, and to complete a state questionnaire regarding the IBNR. We
are again asking each state and territory to prepare the Form CMS-10180 based on your final
audited payable and receivable numbers that are reported on your most recently audited
Comprehensive Annual Financial Report (CAFR). Do not report amounts owed to or due
from CMS related to deferrals and disallowances that exist as of the dates indicated in the
survey.
The Form CMS-10180 and questionnaire will be available through the Incurred But Not
Reported Survey (IBNRS) module of the web-based Medicaid and CHIP Financial (MACFin)
System, which is used to collect the required information. MACFin onboarding instructions will
be sent to users by email Monday, December 9, 2019 through Friday, January 17, 2020. A hard
copy of the State IBNRS User Guide will also be distributed at that time.
In addition, the CHIP IBNR state questionnaire is required to be completed prior to certification
of the entire submission. The CHIP IBNR state questionnaire directly follows the survey and
each state and territory will be prompted to answer the questions. CMS utilizes the state
questionnaire to determine if there were any "extenuating factors" that may affect the CHIP
IBNR calculation. States and territories will be able to fill out the state questionnaire and submit
their responses electronically. The CMS Regional Offices will be reviewing the survey and

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responses to the questions for reasonableness and accuracy. It is critical to the review process
that all responses be as detailed and descriptive as possible.
States and territories should document the process for identifying CHIP IBNR payables. Work
papers should be used to document and support any decisions drawn relating to the process used
and the payables reported on the survey. The new MACFin/IBNRS module features the option
of uploading work papers directly to the system. Work papers prepared by the states and
territories should be available upon request in the event that CMS Central Office, CMS Regional
Office staff, or other parties on behalf of CMS, come onsite to review state CHIP IBNR
documentation.
The IBNRS system will be available for input beginning Monday, March 2, 2020, for states
and territories to fill out and submit their surveys and questionnaires. The IBNRS system
will close on Tuesday, March 31, 2020. The surveys and questionnaires must be submitted
between March 2 and March 31, 2020.
For specific questions regarding the survey, you may contact Beverly Boher at 410-786-7806, or
[email protected].

Lataysheia Lance, CPA

cc:
Maria C. Montilla, CPA, Director, Accounting Management Group
Kristin Fan, Center for Medicaid and State Operations
All Associate Regional Administrators for Medicaid