COBI 2015 - Non-service Expenses

Overview
Issues
Financials

Sources Uses

FY 2016 Appropriation

The funding in this program goes for three different purposes, each of which is discussed below:

Direct Graduate Medical Education -- these funds represent payments up to the Medicare Upper Payment Limit. About 75% of the available funding goes to the University of Utah. The other 25% goes to other non-university hospitals with residency programs. The State provides the match money for these payments.
Inpatient State Teaching Hospital Payments -- these funds help offset some of the costs of residency programs that serve Medicaid clients as well as other uncompensated care costs. The University of Utah Hospital receives 100% of the total available funding. The University of Utah provides the match money for these payments.
Physician Enhanced Payments -- two types: (1) payments to the University of Utah Medical Group (UUMG) for the difference between the average commercial rate, which is seeded by UUMG, and the Medicaid fee schedule as well as (2) a 12% enhancement for payments to rural physicians.

Funding History

Appropriation Overview

During the 2015 General Session, the Legislature appropriated for Fiscal Year 2016, $77,806,000 from all sources for Non-service Expenses. This is a 14.5 percent reduction from Fiscal Year 2015 revised estimated amounts from all sources. The total includes $100 from the General/Education Funds, a change of 0 percent from revised Fiscal Year 2015 estimates.

Appropriation Adjustments

The following appropriation adjustments were made during the 2015 General Session:

DescriptionOngoingOne-Time ARRA Adjustments$0$10,775,000

OngoingOne-TimeFinancing Source

$0$10,775,000American 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

SB0002: Item 75

The Legislature intends that with the funding appropriated for the building block titled, "Intermediate Care Facilities - Intellectually Disabled," the Department of Health shall: 1) Direct funds to increase the salaries of direct care workers; 2) Increase only those rates which include a direct care service component, including respite; 3) Monitor providers to ensure that all funds appropriated are applied to direct care worker wages and that none of the funding goes to administrative functions or provider profits; In conjunction with Intermediate Care Facilities - Intellectually Disabled providers, report to the Office of the Legislature Fiscal Analyst no later than September 1, 2015 regarding: 1) the implementation and status of increasing salaries for direct care workers, 2) a detailed explanation with supporting documentation of how Intermediate Care Facilities - Intellectually Disabled providers are reimbursed, including all accounting codes used and the previous and current rates for each accounting code, and 3) a conceptual explanation of how Intermediate Care Facilities - Intellectually Disabled providers realize profit within the closed market of providing Intermediate Care Facilities - Intellectually Disabled services.

SB0002: Item 75

The Legislature intends that, if funds are available, Medicaid fee-for-service payments for anesthesia services be increased from the current amount of $18.27 to $23.73 for Fiscal Year 2016.

SB0002: Item 75

The Legislature intends that 5% of all funds provided in the Medicaid program for managed care dental plans be used for contracted plan administration and that any funds provided for the Affordable are Act premium tax not be included in that 5% administrative funds amount.

SB0003: Item 123

Under Section 63J-1-603 of the Utah Code the Legislature intends that up to $3,216,000 of the appropriations provided for the Medicaid Optional Services line item not lapse at the close of Fiscal Year 2016. The use of any nonlapsing funds is limited to a pilot program for assistance for children with disabilities and complex medical conditions to be used in similar amounts over three years with the goal of serving a similar number of clients over three years.

SB0007S01: Item 6

The Legislature intends that the Department of Health report on the following performance measures for the Medicaid Optional Services line item: (1) annual state general funds saved through preferred drug list (Target = $8.5 million general fund or more), (2) count of new choices waiver clients coming out of nursing homes into community based care (Target = 390 or more), and (3) emergency dental program savings (Target = $250,000 General Fund savings or more) by January 1, 2016 to the Social Services Appropriations Subcommittee.

SB0007S01: Item 18

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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	15,140,700	158,400	100	0	100	0	100	0	100
General Fund, One-time	(1,508,200)	(158,300)	0	0	0	0	0	0	0
Federal Funds	63,814,600	66,725,300	72,375,400	48,846,000	71,156,300	(33,681,700)	37,474,600	11,371,400	48,846,000
American Recovery and Reinvestment Act	7,102,000	12,191,000	15,948,000	28,740,700	0	35,365,000	35,365,000	(24,590,000)	10,775,000
Dedicated Credits Revenue	11,157,300	34,357,000	38,321,600	18,184,900	29,731,000	(11,546,100)	18,184,900	0	18,184,900
Transfers - Fed Pass-thru	3,330,100	0	0	0	0	0	0	0	0
Transfers - Medicaid - DHS	1,475,700	0	0	(1,300,000)	0	0	0	0	0
Transfers - Within Agency	0	(4,176,900)	(8,590,600)	0	0	0	0	0	0
Lapsing Balance	0	0	0	(1,587,200)	0	0	0	0	0
Total	$100,512,200	$109,096,500	$118,054,500	$92,884,400	$100,887,400	($9,862,800)	$91,024,600	($13,218,600)	$77,806,000

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
Other Charges/Pass Thru	100,512,200	109,096,500	118,054,500	92,884,400	100,887,400	(9,862,800)	91,024,600	(13,218,600)	77,806,000
Total	$100,512,200	$109,096,500	$118,054,500	$92,884,400	$100,887,400	($9,862,800)	$91,024,600	($13,218,600)	$77,806,000

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.