C. Enrollment/Expenditure Cap 12 D. Phase-In 12 E. Benefit Package 12-13 Mandatory Populations 13 Expansion Populations 14 F. Coverage Vehicle 14 Figure III. Coverage Vehicle 15 G. Private Health Insurance Coverage Options 15 H. Cost Sharing 16 Figure IV. MEG Cost Sharing 16 VI. Accountability and Monitoring 17 1. Insurance Coverage 17 2. State Coverage Goals and State Progress Reports 17 VII. Program Costs 18 VIII. Waivers and Expenditure Authority Requested 18 A. Waivers 18 B. Expenditure Authority 19 Figure V. Waivers and Expenditure Authority Requested 20 IX. Attachments 20 X. Signature 20 Attachment A Discussion - how the state will ensure covering individuals above 200% FPL 21 – Attachment B - Detailed Description of Expansion Populations 21 MEG 1) MHSP Waiver 21 ………. MEG 2) ABD Waiver…………. 22 Attachment C Benefit Package Descriptions 22 – MEG 1) MHSP Waiver 22 MEG 2) ABD Waiver 22 Attachment D Private and Public Health Insurance Coverage Options 22 – Medicaid Health Insurance Premium Payments (HIPP) 22-23 Attachment E - Cost Sharing Limits 23 Waiver Individuals Subject to Cost 23 Medicaid Cost Share Amounts and Exempt Services 23 Attachment F - Additional Detail Regarding Measuring Progress 23 Waiver for Additional Services and Populations Evaluation Design 23 Waiver for Additional Services and Populations Goal 24 Objectives One Two, Measurements 24-25 – National and State Data Sources 25 Figure VI. Waiver Reporting Deliverables 26
C. Enrollment/Expenditure Cap 12 D. Phase-In 12 E. Benefit Package 12-13 Mandatory Populations 13 Expansion Populations 14 F. Coverage Vehicle 14 Figure III. Coverage Vehicle 15 G. Private Health Insurance Coverage Options 15 H. Cost Sharing 16 Figure IV. MEG Cost Sharing 16 VI. Accountability and Monitoring 17 1. Insurance Coverage 17 2. State Coverage Goals and State Progress Reports 17 VII. Program Costs 18 VIII. Waivers and Expenditure Authority Requested 18 A. Waivers 18 B. Expenditure Authority 19 Figure V. Waivers and Expenditure Authority Requested 20 IX. Attachments 20 X. Signature 20 Attachment A – Discussion - how the state will ensure covering individuals above 200% FPL 21 Attachment B - Detailed Description of Expansion Populations 21 MEG 1) MHSP Waiver ………. 21 MEG 2) ABD Waiver…………. 22 Attachment C – Benefit Package Descriptions 22 MEG 1) MHSP Waiver 22 MEG 2) ABD Waiver 22 Attachment D – Private and Public Health Insurance Coverage Options 22 Medicaid Health Insurance Premium Payments (HIPP) 22-23 Attachment E - Cost Sharing Limits 23 Waiver Individuals Subject to Cost 23 Medicaid Cost Share Amounts and Exempt Services 23 Attachment F - Additional Detail Regarding Measuring Progress 23 Waiver for Additional Services and Populations Evaluation Design 23 Waiver for Additional Services and Populations Goal 24 Objectives One – Two, Measurements 24-25 National and State Data Sources 25 Figure VI. Waiver Reporting Deliverables 26