How much time do States have to spend the enhanced FMAP?

Due to spending delays across the majority of States, CMS updated guidance to policy pertaining to the timeline for investing Balancing Incentive Program funds. With approval from CMS, states can spend Program enhanced FMAP through Sept. 30, 2017. Interested States were required to submit the following information to CMS for approval:

  • The previously 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.
  • A revised/updated budget which detailed 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, States had to 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, States provided an updated sustainability plan for how these proposed uses will be sustained after the Balancing Incentive Program funding has been exhausted.
  • The State Medicaid Director must sign the proposed budget and associated Work Plan described above.

If the extended budget and Work Plan were approved, the State must continue to meet with the assigned CMS Project Officer monthly and complete quarterly online reports. The State Medicaid Director had to also submit a quarterly attestation letter confirming the uses and corresponding amounts of the Balancing Incentive Program funding.