Medical Services Premiums

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
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, Antipsychotic Drug Expenditure, Family Planning Enhanced Match Calculation, Indian Health Services
Exhibit G Community Based Long-Term Care, Half-Year Expenditure Split, Hospice Request, and Footnote 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
Exhibit O Comparison of Budget Requests, Appropriations and Expenditure for Prior Years
Exhibit P Global Reasonableness; Expenditure and Caseload History; Estimate of Expenditures with Prior Year Cash Flow Pattern (Reference Only)