Submitted November 1, 2010
Schedule 13 - Summary of Change Request
Table of Contents
| Exhibit A |
Calculation of Request, Calculation of Fund Splits |
| Exhibit B |
Medicaid Caseload Forecast |
| Exhibit C |
History and Projections of Per Capita Costs |
| Exhibit D |
Cash Funds Report |
| Exhibit E |
Summary of Premium Request by Service Group, Comparison of Request to Long Bill Appropriation and Special Bills |
| Exhibit F |
Acute Care, Breast and Cervical Cancer Program Per Capita Detail, Antipsychotic Drug Expenditure, Calculation of Costs for Former Prenatal State Only Clients, Family Planning Enhanced Match Calculation, Half-Year Expenditure Splits |
| Exhibit G |
Community Based Long Term Care, Half-Year Expenditure Split |
| Exhibit H |
Long Term Care and Insurance Summary; Class I Nursing Facilities Request, Footnotes, and Supplemental Payments; Class II Nursing Facilities; Program for All-Inclusive Care for the Elderly (PACE); Supplemental Medicare Insurance Benefit (SMIB); Health Insurance Buy-In (HIBI) |
| Exhibit I |
Service Management - Summary; Single Entry Points; Disease Management; Prepaid Inpatient Health Plan Administration |
| Exhibit J |
Health Care Affordability Act of 2009 and Tobacco Tax Funded Estimates |
| Exhibit K |
Upper Payment Limit Financing |
| Exhibit L |
Appropriations and Expenditures for Prior Fiscal Year |
| Exhibit M |
Expenditure History by Aid Category and Service Category |
| Exhibit N |
Expenditure History by Service Category |
| Exhibit O |
Comparison of Budget Requests and Appropriations |
| Exhibit P |
Global Reasonableness; Expenditure and Caseload History; Estimate of Expenditures with Prior Year Cash Flow Pattern (Reference Only) |
| Exhibit Q |
Caseload History Graphs |
