CMS-21 ARP Section 9821 (Line 26)

Quarterly Medicaid and CHIP Budget and Expenditure Reporting for the Medical Assistance Program, Administration and CHIP (MBES/CBES Forms CMS-21 and -21B, -37, and -64) -- (CMS-10529)

Section 9821 CMS-21

Quarterly Children's Health Insurance Program Statement of Expenditures for Title XXI (CMS-21 and CMS-21B)

OMB: 0938-1265

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CMS 21
State: Alaska
Children's Health Expenditures By Type of Service
For the Title XXI Program
Expenditures In This Quarter
Program: akbo
1A) Premiums - Up To 150%: Gross Premiums
Paid
1B) Premiums - Up To 150%: Cost Sharing
Offset
1C) Premiums - Over 150%: Gross Premiums
Paid
1D) Premiums - Over 150%: Cost Sharing
Offset
2) Inpatient Hospital
3) Inpatient Mental Health
4) Nursing Care Services
5) Physician/Surgical
6) Outpatient Hospital
7) Outpatient Mental Health
8) Prescribed Drugs
8A) Drug Rebate
9) Dental Services
10) Vision Services
11) Other Practitioners
12) Clinic Services
13) Therapy Services
14) Laboratory/Radiological
15) Medical Equipment
16) Family Planning
17) Abortions No. 0
18) Screening Services
19) Home Health
20) Health Services Initiatives
21) Home and Community
22) Hospice
23) Medical Transportation
24) Case Management
25) Translation and Interpretation FFP Rate:
75%
26) ARP Section 9821 COVID
Vaccine/Vaccine Administration
31) Other Services
32) Outreach
32A) Increased Outreach and Enrollment of
Indians
32B) Increase Outreach and Enrollment of
children through premium subsidies
33) Administration
34) PERM Administration FFP Rate: 90%
35) Citizenship Verification Technology35A) CVT Development FFP Rate: 90%
35B) CVT Operation FFP Rate: 75%
50) Total

Quarter/Year: Qtr 4th 2021
Quarter Ended: 09/30/2021

Total Computable

Federal Share
69.34%

(A)

(B)

Subject To 10% Limit
Federal Share
Total Computable
69.34%
(C)
(D)

Total Federal Share
(E)


File Typeapplication/pdf
File TitleCMS-21 with ARP Section 9821 Change
AuthorChristopher Kessler
File Modified2021-08-24
File Created2021-08-24

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