Expenditure Reports From MBES/CBES

The automated Medicaid Budget and Expenditure System/State Children's Health Insurance Program Budget and Expenditure System (MBES/CBES) allows states to electronically submit their Form CMS-64 directly to the CMS Data Center and the Medicaid database. Summary state-by-state total expenditures by program for the Medicaid Program, Medicaid Administration and CHIP are available as well as summary state-specific data from the CMS-64 and the CMS-21.

The latest data are available on Data.Medicaid.gov:

Older data are available as zip files, which contain Excel files:

Each zip file contains spreadsheet files containing the financial data for the Federal Fiscal Year specified. The unzipped file can be identified as follows:

  • For Fiscal Years 1997 – 2012, columns A-F of the spreadsheet denotes the regular Title XIX Medicaid expenditures
  • For Fiscal Years 1997 – 2012, first half of columns G-J of the spreadsheet denotes the Title XIX Medicaid Administration expenditures.
  • For Fiscal Years 1997 – 2011, second half of columns G-J of the spreadsheet denotes the regular Title XXI CHIP expenditures.
  • For Fiscal Years 2012 – the Medicaid CHIP expenditures were removed from the FMR Net Expenditure file and a separate file was established denoting the total of all expenditures funded by CHIP allotments.
  • Beginning with the FY 2013, the Medicaid and Administration Expenditures are separated by state into different tab within the same file labeled “MAP” and “ADM” respectively and the Medicaid CHIP expenditures were removed from the FMR Net Expenditure file and a separate file was established denoting the total of all expenditures funded by CHIP allotments.
  • The C- in front of the service category denotes Medicaid CHIP expansion population expenditures funded by CHIP allotments.
  • The T- in front of the service category denotes the CHIP allotment funded portion of Qualifying State expenditures authorized for certain states under section 2105(g) of the Social Security Act.

Medicaid CMS-64 New Adult Group Expenditures Data Collected through MBES

These data have been transitioned to Data.Medicaid.gov to allow sorting, filtering, and sharing. You can download the data as an Excel file by following the link to your desired dataset, then selecting the “Export” button in the top right of the dataset. In the “Download” menu, select “CSV for Excel.”

The Affordable Care Act established a new adult eligibility group (VIII Group) to cover certain low-income individuals who are not otherwise eligible for coverage. An increased Federal Medical Assistance Percentage (FMAP) is available for medical services provided to people defined as “newly eligible” who are enrolled in the VIII Group. An increased FMAP rate is also available for certain “not newly eligible” expenditures for qualifying states that expanded coverage to the adult group prior to enactment of the Affordable Care Act. Recently, states began reporting Medicaid new adult group expenditures to CMS through the Medicaid Budget and Expenditure System (MBES) on the Form CMS-64.  

January 1, 2014 was the earliest that states could elect to cover individuals under the new adult group. Accordingly, some states began reporting new adult group expenditures on the Form CMS-64 for the quarter ended March 31, 2014. 

CMS has summary level expenditure data available for the Medicaid expenditures associated with the new adult group, including a breakout for individuals that are newly eligible (100% FMAP). This expenditure data, however, is not representative of the total amount of FFP associated with services provided to individuals in the new adult group from January 1, 2014 through June 30, 2015.

Specifically:

  • States generally report expenditures based on date of payment, not date of service. Please note that the date expenditures are incurred or reported is not entirely determinative of the applicable federal matching rate available for such expenditures.  
  • States may report additional expenditures applicable to this service period up to two years (possibly more) after the date of original service payment.
  • States may increase or decrease reported expenditures through prior period adjustments.
  • Some states have not certified expenditure reports for this period.
  • CMS is in the process of conducting oversight activities relating to these expenditures.

On a quarterly basis, states report summarized Medicaid expenditures on the Form CMS-64 which serve as the basis for the amount of Federal Financial Participation (FFP) paid to states to fund the Medicaid program. As part of their submission, states certify that their reported expenditures are actual expenditures allowable under federal requirements. States have up to two years, and occasionally longer, to report expenditures on the Form CMS-64. CMS performs various financial management oversight activities to ensure that reported expenditures are allowable under federal requirements. CMS has the authority to defer questionable expenditures or disallow improper expenditures as a result of its oversight activities. 

CMS has provided significant training and guidance to ensure that states have mechanisms and systems in place so as to be able to track and report expenditures appropriately new adult group. States must separately report expenditures for newly eligible individuals (which are currently 100% FMAP) and not newly eligible individuals (varying FMAP rates). Additionally, CMS has placed special emphasis on ensuring that FFP paid to states for the new adult group is accurate, including conducting enhanced reviews of new adult group expenditures.

We intend to post preliminary expenditure information for each state to this page on a regular basis. As described above, states may make prior period adjustments to previously reported expenditures. When posting a new quarter of preliminary expenditure data, we will also update the previously posted quarters. When preliminary data for a fiscal year is finalized, a financial management report for the entire fiscal year above.