Medicaid & CHIP - North Dakota - Kaiser State Health Facts

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Medicaid & CHIP

Medicaid Spending

Total Medicaid Spending

Spending by Service, FY2007

Spending on Acute Care, FY2007

Spending on Long Term Care, FY2007

Growth in Medicaid Spending, FY90-FY07

Payments by Enrollment Group, FY2006

Medicaid Payments per Enrollee, FY2006

Federal Matching Rate and Multiplier

Federal/State Share of Spending, FY2007

Federal DSH Allotments

Medicaid Spending by Residence, 95-04

State Medicaid Spending

State Medicaid Spending, SFY2008

Temporary Federal Medicaid Relief

ARRA Medicaid Grant Funds (2 Qtrs.)

ARRA Federal Matching Rate

ARRA Medicaid Grant Funds (Total)

Federal DSH Allotments under ARRA

Medicaid Budget Actions

Medicaid Cost Containment, FY2009

Medicaid Cost Containment, FY2010

Positive Medicaid Policy Actions, FY2009

Positive Medicaid Policy Actions, FY2010

Medicare Drug Benefit: Clawback Payments

Baseline Dual Eligible Enrollment

Baseline FFS Drug Payments for Duals

Esimated Annual Clawback Payments

Per-Capita Monthly Clawback Amounts

Medicaid Physician Fees

Medicaid Fee Index

Medicaid-to-Medicare Fee Index

Change in Medicaid Fees

Medicaid Enrollment

Total Medicaid Enrollment

Medicaid Enrollment as a % of Total Pop

Distribution by Enrollment Group, FY2006

Monthly Medicaid Enrollment

Monthly Medicaid Enrollment - Children

Monthly Medicaid Enrollment - Adults

Medicaid Enrollment % Change - June

Monthly Enrollment Change - December

Monthly Enrollment % Change - Children

Monthly Enrollment % Change - Adults

Children's Medicaid and CHIP Eligibility

Income Eligibility-- Medicaid

Income Disregards -- Medicaid

Income Eligibility -- Separate CHIP Prog

Income Disregards -- CHIP Program

Medicaid/CHIP Eligibility

Income Eligibility- Low Income Adults

Income Eligibility-- Pregnant Women

SSI Beneficiaries

Total SSI Beneficiaries

SSI Beneficiaries as % of Population

Distribution of Total SSI by Age

Aged SSI as % of Population Ages 65+

SSI with Disabilities

SSI with Disabilities as % of Population

Medicaid Medically Needy

Total Enrollment

Enrollment by Eligibility Category

Medically Needy Total Spending

Spending by Eligibility Category

Total per Enrollee Spending

Per Enrollee Spending by Category

Medicaid Managed Care

Total Medicaid MC Enrollment

Medicaid Managed Care as a % of Medicaid

Dual Eligible Enrollment by MC Plan Type

Enrollment by Medicaid MC Plan Type

Medicaid Managed Care Capitation Rates

Births Financed by Medicaid

Total Medicaid Births

As Percent of State Births

Enrollment Practices for Pregnant Women

Presumptive Eligibility

Enrollment Practices for Children

Joint Application: Medicaid & CHIP

Face-to-Face Interview:Medicaid & CHIP

Asset Test: Medicaid & CHIP

Presumptive Eligibility:Medicaid/CHIP

Income Verification: Medicaid/CHIP

Renewal Practices for Children

Joint Renewal: Medicaid/CHIP

Face-to-Face Interview: Medicaid/CHIP

12-Mo.Continuous Eligibility:Medi/CHIP

Premiums and Co-Payments for Children

Premiums and Co-Payments

Total CHIP Spending

Monthly CHIP Enrollment

Monthly CHIP Enrollment % Change

CHIP Enrollment by FPL

CHIP Program Name and Type

Federal Matching Rate

Federal CHIP Allotments, FY2009

Home and Community-Based Services

Total HCBS Waivers

Participants by HCBS Waiver Type

Expenditures by HCBS Waiver Type

Aged & Aged/Disabled Participants

Aged & Aged/Disabled HCBS Expenditures

Waiting Lists for HCBS Waivers, 2007

Waiting Lists for HCBS Waivers, 2008

Home Health Participants

Home Health Expenditures

Personal Care Participants

Personal Care Expenditures

Individual Budget-Based Models of LTC

Health Care Fraud

States With a False Claims Act

State Health Care Fraud Laws

North Dakota: Medicaid Spending

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Medicaid Spending

Total Medicaid Spending, FY2007
	ND $	US $
	$508,004,001	$319,676,945,585

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Distribution of Medicaid Spending by Service, FY2007
	ND %	ND $	US %	US $
Acute Care	36.6%	$185,677,970	60.9%	$194,774,315,186
Long Term Care	63.1%	$320,695,511	34.1%	$108,911,978,089
Disproportionate Share Hospital Payments	0.3%	$1,630,520	5.0%	$15,990,652,310
Total	100.0%	$508,004,001	100.0%	$319,676,945,585

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Distribution of Medicaid Spending on Acute Care, FY2007
	ND %	ND $	US %	US $
Inpatient Hospital	26.2%	$48,564,332	24.5%	$47,816,204,638
Physician, Lab & X-Ray	16.7%	$31,057,201	6.0%	$11,695,647,706
Outpatient Services	22.9%	$42,431,678	11.7%	$22,739,097,439
Prescribed Drugs	12.0%	$22,204,751	7.7%	$15,025,018,020
Other Services	17.2%	$31,847,465	14.0%	$27,282,064,497
Payments to Medicare	4.7%	$8,746,682	5.7%	$11,041,893,306
Managed Care & Health Plans	0.4%	$825,861	30.4%	$59,174,389,580
Total	100.0%	$185,677,970	100.0%	$194,774,315,186

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Distribution of Medicaid Spending on Long Term Care, FY2007
	ND %	ND $	US %	US $
ICF-MR	20.0%	$64,042,332	11.5%	$12,486,987,363
Mental Health Facilities	3.0%	$9,502,450	4.4%	$4,824,014,750
Nursing Facilities	52.5%	$168,472,951	44.0%	$47,884,851,201
Home Health & Personal Care	24.5%	$78,677,778	40.1%	$43,677,723,192
Total	100.0%	$320,695,511	100.0%	$108,874,000,000

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Average Annual Growth in Medicaid Spending, FY1990 - FY2007
	ND %	US %
FY 1990-2001	6.8%	10.9%
FY 2001-2004	6.2%	9.4%
FY 2004-2007	1.2%	3.6%

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Distribution of Medicaid Payments by Enrollment Group (in millions), FY2006
	ND %	ND $	US %	US $
Children	14.0%	$71	18.6%	$49,847
Adults	8.2%	$42	11.9%	$31,871
Elderly	35.7%	$181	24.3%	$65,389
Disabled	40.9%	$207	40.9%	$109,899
Unknown	1.1%	$6	4.3%	$11,634
Total	100.0%	$506	100.0%	$268,641

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Medicaid Payments per Enrollee, FY2006
	ND $	US $
Children	$1,931	$1,708
Adults	$2,582	$2,142
Elderly	$18,652	$10,691
Disabled	$19,535	$12,874
Total	$6,925	$4,575

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Federal Matching Rate (FMAP) for Medicaid and Multiplier
	ND #	ND %	US #	US %
FY2004	2.49	71.31%	1.00¹	50.00%¹
FY2005	2.08	67.49%	1.00¹	50.00%¹
FY2006	1.93	65.85%	1.00¹	50.00%¹
FY2007	1.83	64.72%	1.00¹	50.00%¹
FY2008	1.76	63.75%	1.00¹	50.00%¹
FY2009	2.33	69.95%	1.28¹	56.20%¹

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Notes:	FY2004: Figures apply to the first three quarters of FY2004. Fiscal relief legislation (P.L. 108-27) increased the FMAP for two quarters of FY 2003 and three quarters of FY 2004. FY2005: Effective from October 1, 2004 to September 30, 2005. FY2006: Effective from October 1, 2005 to September 30, 2006. FY2007: Effective from October 1, 2006 to September 30, 2007. FY2008: Effective from October 1, 2007 to September 30, 2008. FY2009: Effective from October 1, 2008 to September 30, 2009. FY 2009 FMAPs reflect additional federal Medicaid funding available for the first two quarters (October 1, 2008 through March 31, 2009) of nine total quarters under Section 5001 of the American Recovery and Reinvestment Act of 2009 (ARRA). The ARRA holds harmless all states from any declines in their FMAP that would have otherwise occurred based on changes in their per capita income relative to the national average; increases the federal share every state receives by 6.2 percentage points; and further reduces the state share in most states by 5.5%, 8.5%, or 11.5% depending on changes in each state's unemployment rate. The estimated total amount of additional federal Medicaid funding that each state could potentially receive over all nine calendar quarters (October 1, 2008 through December 31, 2010) is available on statehealthfacts.org here, where you can also find more information on the ARRA Medicaid FMAP provisions.
Sources:	FY2004: Federal Register, June 17, 2003 (Vol. 68, No. 116), pp. 35889-35890, at http://a257.g.akamaitech.net/7/257/2422/14mar20010800/edocket.access.gpo.gov/2003/pdf/03-15274.pdf. FY2005: Federal Register, December 3, 2003 (Vol. 68, No. 232), pp. 67676-67678, at http://aspe.os.dhhs.gov/health/fmap05.htm. FY2006: Federal Register, November 24, 2004 (Vol. 69, No. 226), pp. 68372, at http://aspe.os.dhhs.gov/health/fmap06.htm. FY2007: Federal Register, November 30, 2005 (Volume 70, Number 229), pp. 71856-71857, at http://aspe.os.dhhs.gov/health/fmap07.htm. FY2006 and FY2007 for Alaska: Federal Register, May 15, 2006 (Vol. 71, No. 93), pp. 28041-28042, at http://aspe.hhs.gov/health/fmap07a.htm. FY2008: Federal Register, November 30, 2006 (Vol. 71, No. 230), pp.69209-69211, at http://aspe.hhs.gov/health/fmap08.htm. FY2009: Federal Register, April 21, 2009 (Vol. 74, No. 75), pp 18236-18237, at http://edocket.access.gpo.gov/2009/pdf/E9-9095.pdf http://frwebgate1.access.gpo.gov/cgi-bin/PDFgate.cgi?WAISdocID=32613962233+4+2+0&WAISaction=retrieve" target="_blank">. KCMU estimates of the multiplier are based on the FMAP.
Definitions:	The amount of Federal payments to a State for medical services depends on two factors. The first is the actual amount spent that qualifies as matchable under Medicaid and the FMAP. The Federal Medical Assistance Percentage (FMAP) is computed from a formula that takes into account the average per capita income for each State relative to the national average. By law, the FMAP cannot be less than 50%. The multiplier is based on the FMAP. For every dollar the state spends on Medicaid, the federal government matches at a rate that varies year to year. For FY2004, the rate for Alabama was 1:2.80 (73.70%). For information about the multiplier effect of Medicaid spending, see The Kaiser Commission on Medicaid''s policy brief released in July 2004, "Role of Medicaid in State Economies: A Look at the Research" available at http://www.kff.org/medicaid/7075a.cfm.
Footnotes:	The federal minimum FMAP is 50% for FY04-FY08 and 56.2% under ARRA for FY09.

Federal and State Share of Medicaid Spending, FY2007
	ND %	ND $	US %	US $
Federal	64.7%	$328,780,189	56.7%	$181,378,422,620
State	35.3%	$179,223,812	43.3%	$138,298,522,965
Total	100.0%	$508,004,001	100.0%	$319,676,945,585

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Federal Medicaid Disproportionate Share Hospital (DSH) Allotments
	ND $	US $
FY2008	$8,997,202¹	$10,367,561,890
FY2009	$9,591,017¹	$11,337,262,543

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Medicaid Spending Estimates by State of Residence (in millions), 1995-2004
	ND $	US $
1995	$308	$136,250
1996	$331	$144,510
1997	$337	$150,648
1998	$344	$158,206
1999	$372	$171,341
2000	$390	$186,972
2001	$400	$208,883
2002	$448	$230,659
2003	$466	$250,894
2004	$499	$269,892

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