Design Other Funding for MES Expansion

[beparticular]

About Other Funding and Cost Allocation

Other Funding and Cost Allocation is related to the breakdown of how much the different entities in State Medicaid programs should pay into a system that is being built. People apply for benefits: healthcare, food and nutrition, heating and housing, WIC, SNAP, etc. CMS knows the number of people applying for these benefits both in total and by program. CMS also knows utilization numbers. These numbers help determine which entities will benefit at what percentages.

There is a tool called the CAM Toolkit that helps states break down and split out costs of building a system to the different programs. This also helps determine the Medicaid share, the number that gets broken down by the FFP selection in the eAPD system.

When looking at Cost Allocation and Other Funding an APD needs to be able to show or do the following:

• show the payers - who benefits from this component that is being built. This helps determine, what is a fair share from each source/payer?
• provide a case that it's a reasonable break down of how costs are distributed across the program
• Use the same rounding principles in other tables
• Generated the other funding amount from the breakdown provided (not typed in as it is in HITECH)

Considerations:

Regulations: https://www.ecfr.gov/cgi-bin/text-idx?node=sp45.1.95.e&rgn=div6#se45.1.95_1509

• The total cost will be known at this point, how does the math here relate to the FFP selection.
• In HITECH APDs, we didn’t care how Other Funding was broken down, in MES APDs, that is important information.
• Free text fields are still valid for the page, but what should go under Other Funding Description or what should go under Description of Cost Allocation Methodology (see also #2921) or should different fields exist?
• What happens if the numbers don’t add up to 100%.

Also reference #2921 for this design effort as they affect the same page

Export view

Where do reviewers want to see this summary reflected and how?

Example

• This is one example, not all possibilities of what other funding could be from.
• 10-12 is on the higher side of the number of other funding sources included
• Medicaid+CHIP+5 sources is common.
• 48% of this example would be “Other Funding”

[beparticular]

@NAretakis no rush, maybe before backlog refinement next week, but it would be great if you could look over what I've added in this ticket and make sure to point out anything that might have been lost in translation between our last design sync and writing this up? Thanks!