COBI 2015 - Other Seeded Services

Overview
Issues
Background
Financials

Sources Uses

FY 2016 Appropriation

Entities outside of the Department of Health contract with Medicaid, by sending some of their General Fund appropriations to the Division of Medicaid and Health Financing, which then uses those funds to draw down the matching federal Medicaid funds, then forwards all of the funds back to the original entities. This helps those entities leverage their funds by the federal match.

Funding History

Appropriation Overview

During the 2015 General Session, the Legislature appropriated for Fiscal Year 2016, $33,750,900 from all sources for Other Seeded Services. This is a 1.2 percent reduction from Fiscal Year 2015 revised estimated amounts from all sources.

A few examples of seeded services from State agencies include:

Office of Recovery Services to recover funds from health insurance companies covering Medicaid clients
Division of Services for People with Disabilities to claim federal Medicaid dollars on the Physical Disabilities Waiver, the Community Supports Waiver, and the Brain Injury Waiver
Division of Aging and Adult Services to claim federal Medicaid dollars on the Aging Waiver
Division of Child and Family Services to claim federal Medicaid dollars to determine Medicaid eligibility on foster care children
Department of Workforce Services to determine eligibility for Medicaid applicants

The Department of Health assesses an administrative fee to all entities for coordinating their funds with the Medicaid program. The Department of Health explains how the amount of the assessment is calculated with the following three scenarios based on total funds matched:

3% of amounts less than $500,000
$15,000 and 2% of amounts above $500,000 up to $1,000,000
$25,000 and 1% of amounts above $1,000,000

A few examples of seeded services from non-State agencies include:

University of Utah to provide Graduate Medical Education training
Counties to provide mental health, substance abuse, as well as the Early Periodic Screening, Diagnosis and Treatment Program
School districts to provide skill development services

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	15,800	0	0	3,200	0	0	0	0	0
Federal Funds	11,579,200	16,122,800	17,382,200	20,148,900	18,579,800	(137,600)	18,442,200	(178,400)	18,263,800
Dedicated Credits Revenue	0	3,281,900	3,541,900	6,138,700	3,541,900	574,700	4,116,600	0	4,116,600
Transfers - Intergovernmental	0	23,700	0	0	0	0	0	0	0
Transfers - Medicaid - DHS	8,788,900	8,127,700	7,704,800	8,134,400	8,582,600	(84,900)	8,497,700	(9,200)	8,488,500
Transfers - Medicaid - DAS	0	0	0	983,900	1,125,100	(60,000)	1,065,100	0	1,065,100
Transfers - Medicaid - JJS	0	39,900	0	0	0	0	0	0	0
Transfers - Medicaid - GOPB	0	857,800	1,065,100	0	0	0	0	0	0
Transfers - Medicaid - Internal DOH	1,395,200	185,000	2,778,900	2,692,400	3,247,300	(1,224,900)	2,022,400	(205,500)	1,816,900
Transfers - Medicaid - USDB	25,900	0	27,200	0	28,200	(28,200)	0	0	0
Transfers - Within Agency	812,100	1,338,100	0	0	0	0	0	0	0
Lapsing Balance	0	0	(32,100)	(1,000)	0	0	0	0	0
Total	$22,617,100	$29,976,900	$32,468,000	$38,100,500	$35,104,900	($960,900)	$34,144,000	($393,100)	$33,750,900

Show Table | Show Additional Information

Categories of Expenditure	FY11 Actual	FY12 Actual	FY13 Actual	FY14 Actual	FY15 Approp	FY15 Change	FY15 Revised	FY16 Change	FY16 Approp
Personnel Services	0	0	0	0	60,000	(60,000)	0	0	0
Current Expense	0	20,800	0	0	0	0	0	0	0
Other Charges/Pass Thru	22,617,100	29,956,100	32,468,000	38,100,500	35,044,900	(900,900)	34,144,000	(393,100)	33,750,900
Total	$22,617,100	$29,976,900	$32,468,000	$38,100,500	$35,104,900	($960,900)	$34,144,000	($393,100)	$33,750,900

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.