| Notes: | On October 14, 2005, each State Medicaid Director was notified by CMS of the per capita monthly payment amount they will be assessed for each Medicare beneficiary enrolled with full benefits in their state Medicaid program during 2006. These amounts were calculated by CMS according to provisions set out by the MMA using each state''s 2003 Medicaid administrative data as submitted through the MSIS, supplemented with data provided by each state on their capitated dual eligible enrollment, and information from the Medicaid Drug Rebate Program. For more details on how the "clawback" payment amount was calculated, see KCMU''s "The ''Clawback:'' State Financing of Medicare Drug Coverage," available at http://www.kff.org/medicaid/7118a.cfm.
Due to the change in the state FMAP, 39 states will pay a different per capita amount under the clawback during the last 3 months of calendar year 2006 during the first quarter (Q1) of FY 2007. |
| Sources: | Kaiser Commission on Medicaid and the Uninsured (KCMU) analysis of 10/14/05 Dear State Medicaid Director Letters from the Centers for Medicare and Medicaid Services (CMS), 2005. Available at http://www.kff.org/medicaid/upload/7438.pdf. |
| Definitions: | Full-Year Equivalent: The full-year equivalent dual eligible enrollment is calculated by adding the total months of enrollment for all full dual eligibles in each state and dividing the total by 12 months. For example, to determine the full-year equivalent for one dual enrolled for six months and one dual enrolled for 12 months, compute (6+12)/12 to get 1.5 full-year equivalents. These figures are based on the October 14, 2005 letters to Medicaid Directors referenced above. The "full-year equivalent" dual eligible enrollment differs from the "full" dual eligible enrollment described in Dual Eligibles Enrollment, 2003, a separate topic on statehealthfacts.org. The full dual eligible enrollment is calculated by adding all full duals that were "ever on" the rolls during calendar year 2003 based on the MSIS.
Clawback: The mechanism through which the states will help finance the new Medicare drug benefit is commonly referred to as the "clawback," the statutory term for which is "phased-down state contribution."
CMS: The Centers for Medicare and Medicaid Services.
MSIS: Medicaid Statistical Information System |
Medicaid Spending
