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Warning Text %XTableStyleMedium2PivotStyleLight16`~a enclosure 1̂ enclosure 2d enclosure 3 enclosure 4 enclosure 52 enclosure 6D gUPDATED HIV shell date FFY 2018 October-November-December 2018 dated February 8th 2019 ShellDY16Q4.xls InstructionsTotal Costs February 8 2019Sheet2Particip updatedrevisedtoDY16Q4Monitoring Assessment 12-31-18CMS64C FFY2018 Q4 downloadExp Target amountsExpansionDY16 Q3MedicaidDY16Q3Sheet1YYYYYYZ~cSA&]A@dFYA@pSA@]A@ ^AA]AUA@ؤ\A@QY]A]A@%z_AaAaA~aA^jAYYYY CUsersEmily.Bean.SOMAppDataLocalMicrosoftWindowsTemporary Internet FilesContent.OutlookHL7CDV12Quarterly Data Report by income levels.xlsx Data ReportMC without matching ADAPTara's worksheetYZp "@m@5@d@@_@)\u@ @Gz^@C@(\@@@Z@f@Z  2 Contact_Data_R1_Crosstab;  =  =ffx4 @zr8C3 A@@  IgIncomingOutgoing AdherenceAmbulance/TransportationCase Management Services Compliance EligibilityERIntroductory CallLaboratory/X-ray MedicationsOtherOut Dated ContactPharmacyPhone Call Follow UpPolicyProvider Services Unpaid Claim Viral Loads'Enclosure 5: Contact Tracking by ReasonContact ReasonTotal ContactsCollaboration Care coordination,Enclosure 6: Contact Tracking by Method Used Method UsedCallEmailFaxLetterFamily Planning%ADAP Funds Spent on MaineCare Clients Member Survey;Maine HIV/AIDS: Overall Service Costs by Demonstration YearDate Submitted to CMS:Quarter Report Period:0Population Group(s) (as identified in the MBES)Total Demo Year Costs ExpansionMedicaid-Actual Participation by Demonstration QuarterDemonstration Year 1:7/01/02 - 6/30/03 Quarter 1 Quarter 2 Quarter 3 Quarter 4Population Group(s) 7/01/02 - 9/30/0210/01/02 - 12/31/021/01/03 - 3/31/034/01/03 - 6/30/03Total Demo Year ParticipationDemonstration Year 2:7/1/03 - 6/30/047/01/03 - 9/30/0310/01/03 - 12/31/031/01/04 - 3/31/044/01/04 - 6/30/04Demonstration Year 3:7/01/04 - 6/30/057/01/04 - 9/30/0410/01/04 - 12/31/041/01/05 - 3/31/054/01/05 - 6/30/05Total Demo Year ParticpationDemonstration Year 4:7/1/05 - 6/30/067/01/05 - 9/30/0510/01/05 - 12/31/051/01/06 - 3/31/064/01/06 - 6/30/06Demonstration Year 5:7/1/06 - 6/30/077/01/06 - 9/30/0610/01/06 - 12/31/061/01/07 - 3/31/074/01/07 - 6/30/07Total Demo Year PartcipationDemonstration Year 6:7/1/07 - 6/30/087/01/07 - 9/30/0710/01/07 - 12/31/071/01/08 - 3/31/084/01/08 - 6/30/08Demonstration Year 7:7/1/08 - 6/30/097/01/08 - 9/30/0810/01/08 - 12/31/081/01/09 - 3/31/094/01/09 - 6/30/09Demonstration Year 8:7/1/09 - 6/30/107/01/09 - 9/30/0910/01/09 - 12/31/091/01/10 - 3/31/104/01/10 - 6/30/10Demonstration Year 9:7/1/10 - 6/30/117/01/10 - 9/30/1010/01/10 - 12/31/101/01/11 - 3/31/114/01/11 - 6/30/11Demonstration Year 10:7/1/11 - 6/30/127/01/1 - 9/30/1110/01/11 - 12/31/111/01/12 - 3/31/124/01/12 - 6/30/12Budget Neutrality Assessment 3(This page automatically calculates entered data.) Annual AssessmentTotal Computable CeilingCumulative Expenditure TargetsCosts Over/Under TargetDemonstration Year 117/1/12 - 6/30/137/01/12 - 9/30/1210/01/12 - 12/31/121/01/13 - 3/31/134/01/13 - 6/30/13 Total Demo Year Partcipation YTDMental Health/Substance Abuse Quarter 57/01/13 - 9/30/1310/01/13 - 12/31/131/01/14 - 3/31/144/01/14 - 6/30/14 Quarter 6Demonstration Year 1201/01/14 - 12/31/14Demonstration Year 11 plus7/1/13 - 12/31/13Expansion <=100% FPLExpansion >100% FPLExpansion Unknown FPLFEDERAL DOLLARS STATE DOLLARSDemonstration Populations0Average ADAP Expenditures for Prescription Drugs.Total ADAP Expenditures for Prescription Drugs&Average ADAP Expenditures for Premiums$Total ADAP Expenditures for Premiums3Average ADAP Expenditures for Copay Reimbursement1Total ADAP Expenditures for Copay Reimbursement InpatientDemonstration Year 1301/01/15 - 12/31/151/01/15 - 3/31/154/01/15 - 6/30/157/01/15 - 9/30/1510/01/15 - 12/31/15MBES (Federal Fiscal Year) DY - 1 FFY: 10/01/02 - 9/30/03DY - 2 FFY: 10/01/03 - 9/30/04DY - 3 FFY: 10/01/04 - 9/30/05DY - 4 FFY: 10/01/05 - 9/30/06DY - 5 FFY: 10/01/06 - 9/30/07DY - 6 FFY: 10/01/07 - 9/30/08DY - 7 FFY: 10/01/08 - 9/30/09DY - 8 FFY: 10/01/09 - 9/30/10DY - 9 FFY: 10/01/10 - 9/30/11DY - 10 FFY: 10/01/11 - 9/30/12DY - 11 FFY: 10/01/12 - 9/30/13DY - 12 FFY: 10/01/13 - 9/30/14DY - 13 FFY: 10/1/14 - 09/30/15Demonstration Year 1401/01/16 - 12/31/161/01/16 - 3/31/164/01/16 - 6/30/167/01/16 - 9/30/1610/01/16 - 12/31/16DY - 14 FFY: 10/1/15 - 09/30/16DY - 13: 1/1/15 - 12/31/15DY - 14: 1/1/16 - 12/31/16N/ADY - 15: 1/1/17 - 12/31/17DY - 15 FFY: 10/1/16 - 09/30/17Total Demo CostsNote - FFY15 Q2 (Waiver DY 12 2014): Updated the "Annual Expenditure Targets" with the figures provided in an email from CMS forwarded by Emily Bean on 5/20/015$ 7/01/14 - 9/30/1410/01/14 - 12/31/14Demonstration Year 1501/01/17 - 12/31/171/01/17 - 3/31/174/01/17 - 6/30/177/01/17 - 9/30/1710/01/17 - 12/31/17 Readmission01/01/18 - 12/31/181/01/18 - 3/31/184/01/18 - 6/30/187/01/18 - 9/30/1810/01/18 - 12/31/18DY - 16 FFY: 10/1/17 - 09/30/18DY - 16: 1/1/18 - 12/31/18Demonstration Year 16Date: 2/08/201910/01/18 - 12/331/2018FFY 2019;  Enrollees at or below 100% FPL: Demonstration  Enrollees  !1:6  Enrollees above 100% FPL: Demonstration  Enrollees  2  Members : HIV Positive and MaineCare eligible#October 1, 2018 - December 31, 2018 L LMMENDMOLOP-Q,QR7S6ST[UZ V V vWu X kYj sZr^[]\f]e^6_5ccB G u  dMbP?_*+%&?'?(?)?MOMS-CT4APRRCMP5054-1  odXX10DR7f SxxuSr! ?!4iсG##>7N@E+ Ƀ ,CH w/;XjD@ B2PН72*ʌ#Α,qJMLXSH=oxb@=o (g 3lDC!g 4pzgG$v5b[pi!4h)!0t:jʋG)Q}u@-TwJ#F~?>]B(]o)^̼PX} К׮fJbsQh%١^# \uߦ5#nry$}dKGWk*Fe8[L8)جabOS0յnA u'-"72kE`b"bۋe+QЦ庌rsRy-ٺuUWE\_EQG`HHYMp|_1-@YT:Ic)ѵxvv{:8LxR{6_1jLD HPځzL5M/h߱H3`ߎW'W QvoizFw"Ęsvi|Ov+)6=1ą+0gDn")XX333333?333333?&<3U} m} $ V00 0@I@ +@      l" m" qq  c c c c(qq n(a b b b b b b b b  b  b  b  b  c c c c do ep~ f"`%fHrADcA%fI}AD`mfA%f|AD`;iA%f ADqkA%gAD_`A%gӒAD fA%g;A D *AkA% gLA DSeA& gܣYA D kA& g0uӠA D 5uA& gf`A D `3hA hf`AD hf`AD hf`ADif`ADjf`A D kl~cSA Zl&]AZl@dFYAZl@pSAZl@]AZl@ ^AZlA]AZ lUAZ  l@ؤ\AZ  l@QY]A Z  l]A Z  l@%z_A Z laA ZlaA Zl~aAZl^jAZ#m^,A  %nn nq! oK DD* ozaW %D* o{e%D* otr %D* o@x %D* o`y %D* ooo} %D* o( %D* o % D * o % D * o(D % D * o,& % D * ox % D * oS %D* o ׃%D* oNz %D" oNz DD( (  &  " 44 \,:U ,,8"  PH0(  >@  " ggD G %Ԗx  dMbP?_*+%&?'?(?)?MOMS-CT4APRRCMP5054-1  odXX10DRAC:xuSAr0 =ĝ&m DBӿdɍ].% F] \/(>^5h8BodBU GB U9_ۊ0Xd#lbfVZHU1ʸ BlIs# r& Bp 0NF4R@wTv5$,JV$t%58D7}Q&($9+E dهʭVWlKY(?=ŋy7#d`?浫y,Xdg)jla3]vȨ[>Kպ&}X68b{-3ҍ^U2"G)-*fAYj K6ߙ]=5+F4>ٚ4jrO^0BoDfžzYQІ2rsRyɺuE;WD\=txSn0s*nRR=2:X^Ҫ^o Fq13;O*A;*=dhc(6)lEt% $ NzK]Kz_EQG`HHYMp|_1-@YT:Ic)ѵxvv{:8LxR{6_1jLD HPځzL5M/h߱H3`ߎW'W QvoizFw"Ęsvi|Ov+)6=1ą+0gDn"7XX333333?333333?&<3U} }  } } }  %hw 00 V0 0 0 w hhh  $ !" 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