FY 2015-16 Medical Services Premiums Exhibits

Schedule 10 - 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, Total Title XIX and Title XXI Services Per Capita Costs

Exhibit D


Cash Funds Report

Exhibit E

Summary of Total Requested Expenditure 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, Dental, Antipsychotic Drug Expenditure and Pharmacy Enhanced Rebates, Family Planning Enhanced Match Calculation, Indian Health Services

Exhibit G

Community Based Long-Term Care, Half-Year Expenditure Split, Hospice Request and Footnotes, Private Duty Nursing, Colorado Choice Transitions

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

Hospital Provider Fee Financing

Exhibit K

Upper Payment Limit Financing

Exhibit L 

Department Recoveries

Exhibit M  

Expenditure History by Aid Category and Service Category

Exhibit N

Expenditure History by Service Category, Total Cost of Care Title XIX and Title XXI 

Exhibit O

Comparison of Budget Requests, Appropriations and Expenditure for Prior Years

Exhibit P

Global Reasonableness; Expenditure and Caseload History (Reference Only)

Exhibit Q 

Title XIX and Title XXI Services Expenditure History by Service Category