COBI 2015 - Financial Services

Overview
Issues
Financials

Sources Uses

FY 2016 Appropriation

The Bureau of Financial Services is responsible for the following functions within the Division:

Managing the administration and service budgets for Medicaid, Utah's Premium Partnership for Health Insurance, Primary Care Network programs, and the Children's Health Insurance Program.
Monitoring, tracking, invoicing, and collecting drug rebates due from pharmaceutical manufacturers.
Purchasing office equipment, computer hardware, and software for the Division.
Managing contracts for the Division.
Performing budget neutrality calculations on contracted health plans and comparing results to fee-for-service payments.
Overseeing the collection of money from provider assessments.
Preparing reports for the Centers for Medicare and Medicaid.
Monitoring, tracking, invoicing, and collecting the Nursing Home and Hospital provider assessments.
Projecting and forecasting the Medicaid budget.
Monitoring, tracking, invoicing, and collecting seed revenue from other governmental entities.
Preparing the Medicaid and Health Finance Annual Report.

Funding History

Appropriation Overview

During the 2015 General Session, the Legislature appropriated for Fiscal Year 2016, $14,225,000 from all sources for Financial Services. This is a 2.5 percent increase from Fiscal Year 2015 revised estimated amounts from all sources. The total includes $1,270,400 from the General/Education Funds, a reduction of 24.6 percent from revised Fiscal Year 2015 estimates.

Appropriation Adjustments

In addition to statewide compensation and internal service fund cost increases, the following appropriation adjustments were made during the 2015 General Session:

DescriptionOngoingOne-Time ARRA Adjustments$0$833,000

OngoingOne-TimeFinancing Source

$0$833,000American Recovery and Reinvestment Act

The Legislature expressed interest in reviewing the federal stimulus or American Reinvestment and Recovery Act (ARRA) money separate from the annual review of federal funds.

Intent Language

HB0003: Item 78

Under Section 63J-1-603 of the Utah Code, the Legislature intends up to $475,000 provided for the Department of Health's Medicaid and Health Financing line item in Item 24 of Chapter 13, Laws of Utah 2014 shall not lapse at the close of Fiscal Year 2015. The use of nonlapsing funds is limited to compliance with federally mandated projects and the purchase of computer equipment and software.

HB0003: Item 78

Under Section 63J-1-603 of the Utah Code, the Legislature intends up to $1,000,000 provided for the Department of Health's Medicaid and Health Financing line item in Item 70 of Chapter 282, Laws of Utah 2014 shall not lapse at the close of Fiscal Year 2015. The use of nonlapsing funds is limited to the purchase of telehealth equipment.

SB0002: Item 72

The Legislature intends that the Inspector General of Medicaid Services pay the Attorney General's Office the full state cost of the one attorney FTE that it is using at the Department of Health.

SB0007S01: Item 3

All General Funds appropriated to the Department of Health - Medicaid and Health Financing line item are contingent upon expenditures from Federal Funds - American Recovery and Reinvestment Act (H.R. 1, 111th United States Congress) not exceeding amounts appropriated from Federal Funds - American Recovery and Reinvestment Act in all appropriation bills passed for fiscal year 2016. If expenditures in the Medicaid and Health Financing line item from Federal Funds - American Recovery and Reinvestment Act exceed amounts appropriated to the Medicaid and Health Financing line item from Federal Funds - American Recovery and Reinvestment Act in fiscal year 2016, the Division of Finance shall reduce the General Fund allocations to the Medicaid and Health Financing line item by one dollar for every one dollar in Federal Funds - American Recovery and Reinvestment Act expenditures that exceed Federal Funds - American Recovery and Reinvestment Act appropriations.

SB0007S01: Item 3

The Legislature intends that the Department of Health report on the following performance measures for the Medicaid and Health Financing line item: (1) average decision time on pharmacy prior authorizations (Target = 24 hours or less), (2) percent of clean claims adjudicated within 30 days of submission (Target = 98%), and (3) total count of Medicaid and CHIP clients educated on proper benefit use and plan selection (Target = 90,000 or more) by January 1, 2016 to the Social Services Appropriations Subcommittee.

SB0007S01: Item 14

Display By:

Funding Source

Expenditure Category

Appropriation Type:

Appropriation History by

Sources of Finance	FY11 Actual	FY12 Actual	FY13 Actual	FY14 Actual	FY15 Approp	FY15 Change	FY15 Revised	FY16 Change	FY16 Approp
General Fund	549,100	340,200	1,162,300	1,260,900	1,704,100	(21,700)	1,682,400	(416,300)	1,266,100
General Fund, One-time	0	21,200	87,200	(713,900)	2,100	0	2,100	2,200	4,300
Federal Funds	6,190,400	7,330,300	9,301,800	8,974,300	7,885,100	1,295,900	9,181,000	682,200	9,863,200
American Recovery and Reinvestment Act	184,200	394,100	527,700	637,700	833,000	0	833,000	0	833,000
Dedicated Credits Revenue	0	2,295,200	1,809,400	2,624,300	1,369,500	185,500	1,555,000	59,400	1,614,400
Transfers	0	0	0	0	0	0	0	8,000	8,000
Transfers - Medicaid - DHS	0	0	318,200	380,100	605,500	(432,600)	172,900	19,100	192,000
Transfers - Medicaid - Internal DOH	0	0	0	8,300	0	44,900	44,900	0	44,900
Transfers - Medicaid - UDC	0	0	0	20,200	0	25,000	25,000	0	25,000
Transfers - Medicaid - USDB	0	0	0	42,600	0	30,000	30,000	0	30,000
Transfers - Within Agency	2,300,000	327,100	324,000	382,700	0	345,200	345,200	(1,100)	344,100
Lapsing Balance	0	0	0	(50,800)	0	0	0	0	0
Total	$9,223,700	$10,708,100	$13,530,600	$13,566,400	$12,399,300	$1,472,200	$13,871,500	$353,500	$14,225,000

Categories of Expenditure	FY11 Actual	FY12 Actual	FY13 Actual	FY14 Actual	FY15 Approp	FY15 Change	FY15 Revised	FY16 Change	FY16 Approp
Personnel Services	1,541,000	1,789,000	2,300,900	2,122,900	2,256,100	273,700	2,529,800	116,900	2,646,700
In-state Travel	700	600	800	100	800	(600)	200	0	200
Out-of-state Travel	7,100	7,800	8,400	7,000	6,400	700	7,100	0	7,100
Current Expense	742,100	1,399,200	1,712,700	1,623,400	2,689,000	(1,064,700)	1,624,300	900	1,625,200
DP Current Expense	6,098,100	7,218,300	8,337,700	9,813,000	7,447,000	2,263,100	9,710,100	235,700	9,945,800
DP Capital Outlay	834,700	293,200	1,086,500	0	0	0	0	0	0
Other Charges/Pass Thru	0	0	83,600	0	0	0	0	0	0
Total	$9,223,700	$10,708,100	$13,530,600	$13,566,400	$12,399,300	$1,472,200	$13,871,500	$353,500	$14,225,000

Show Table | Show Additional Information

Other Indicators	FY11 Actual	FY12 Actual	FY13 Actual	FY14 Actual	FY15 Approp	FY15 Change	FY15 Revised	FY16 Change	FY16 Approp
Budgeted FTE	24.90	17	19.04	27.30	24.70	2.05	26.75	0	26.75
Actual FTE	19.50	21.50	27.10	22.40	0	0	0	0	0

COBI contains unaudited data as presented to the Legislature by state agencies at the time of publication. For audited financial data see the State of Utah's Comprehensive Annual Financial Reports.