FY 2011-12 Medical Services Premiums Exhibits

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