Updated Spending Guidance:

What if my state needs additional time to spend the enhanced FMAP beyond the end of the Program?

Friday, March 20, 2015

Due to spending delays across the majority of States, this guidance provides an update to existing policy pertaining to the timeline for investing Balancing Incentive Program award amounts earned on eligible services provided by Sept. 30, 2015.

CMS will entertain State specific requests to extend the timeframe for investment of Balancing Incentive Program enhanced FMAP through Sept. 30, 2017. Extensions should be focused on existing activities which require additional time to complete. Any proposed activities/uses of funding should align with the goals of the program.

Interested States should submit the following information, by July 1, 2015, to your assigned CMS Project Officer:

  1. The currently approved budget for the use of enhanced Balancing Incentive Program Funding including the amount of enhanced FMAP earned to date, and amount of enhanced FMAP spent to date by each activity in the approved budget.
  2. A revised/updated budget which details how the remaining funding as well as projected funding from the beginning of the next federal fiscal quarter through the end of the final fiscal quarter (no later than Sept. 30, 2017) by distinct activity by federal fiscal quarter. If the proposed uses deviate from the currently approved budget, please explain how these planned uses:
    1. Increase offerings of or access to non-institutional long-term services and supports;
    2. Are for the benefit of Medicaid recipients; and
    3. Are not a prohibited use of Medicaid funding. Finally, include an updated sustainability plan for how these proposed uses will be sustained after the Balancing Incentive Program funding has been exhausted.
  3. The State Medicaid Director must sign the proposed budget and associated workplan described above.

If the extended budget and workplan are approved, the State must continue to meet with the assigned CMS project officer monthly and complete quarterly online reports. The State Medicaid Director must submit a quarterly attestation letter confirming the uses and corresponding amounts of the Balancing Incentive Program funding.